五环教学法引导高职护生自主学习的实践探索

[目的]探索符合高职护生认知特点的教学方法,改变自主性学习差、教学效率低的状况。[方法]随机抽取3个教学班(110人)作为观察组,3个教学班(113人)作为对照组,观察组采用"激发情趣-设疑引领-自主探究-评价矫正-巩固提升"五环教学实践,对照组采用常规教学,1学年后,比较两组护生自主学习能力测评结果。[结果]观察组护生自主学习能力测评总分及自我管理能力、合作学习能力和信息素质得分均高于对照组,两组护生学习动机得分差异无统计学意义,但较之前均有提升。[结论]"五环教学法"较适合高职护生的认知特点,其中激发职业情趣是引领护生自主学习的基础,设置疑问是引领护生自主学习的关键,学习方法和过程的引导是培养护生自主学习能力的重要策略,激励性评价是护生自主学习呈螺旋式递进的催化剂。     

概念图教学法在五官科护理临床带教中的应用

[目的]探讨概念图教学法在五官科护理临床带教中的应用。[方法]将64名护生随机分为两组,观察组32名,对照组32名,对照组采用传统带教方法,观察组护生参与概念图教学法培训。采用"护理专业学生自主学习能力测评量表"评估护生干预前后自主学习能力,比较两组护生出科考核成绩。[结果]观察组护生干预后自主学习能力得分高于对照组;观察组出科考核成绩均优于对照组(P<0.05)。[结论]在五官科护理教学中应用概念图教学法,可激发护生学习兴趣,有效提高护生的实习效果。     

结合学习共同体的TBL教学法在《内科护理学》教学中的应用研究

[目的]评价结合"学习共同体"的任务型教学(TBL)法对护生自主学习能力及评判性思维能力的影响。[方法]将2010级"3+2"护理专业护生分成两班,A班118人采用TBL整合教学法,B班123人采用常规教学法,比较两班教学效果。[结果]两班护生考试成绩、评判性思维能力评分分布、自主学习能力测评总均分及学习动机、学习合作能力两个分量表评分比较差异有统计学意义(P<0.05);[结论]结合"学习共同体"的TBL教学法,能有效调动护生的学习积极性、提升护生自主学习能力和评判性思维能力,对提升"3+2"护理专业护生专业课程教学效果和推动教学改革具有重要意义。     

基于微视频弹幕的TBL教学法在高职护生外科护理学教学中的应用

[目的]探讨基于微视频弹幕的TBL教学法在高职护生外科护理学教学中的应用效果。[方法]选取新疆医科大学护理学院2014级高职护生139名为对照组,2015级高职护生131名为试验组,对照组采用传统LBL教学模式,试验组采用微视频弹幕的TBL教学方法。课程结束后通过理论考试成绩、自主学习能力测评、批判性思维能力测评及对教学效果的满意度进行效果评价。[结果]两组高职护生的理论考试成绩、自主学习能力及对教学效果的满意度比较差异有统计学意义,试验组高于对照组(P<0.05)。批判性思维能力量表中护生寻找真相、开放思维、分析能力、系统化能力、自信心、求知欲6个维度得分试验组高于对照组(P<0.05)。[结论]将微视频弹幕的TBL教学法应用于高职护生外科护理学教学中,能够有效提高教学效果,全面提升其自主学习能力及综合应用能力,护生对教学效果的满意度较高。     

双语教学在涉外护理专业学生实习前护理专业技能训练中的实践

[目的]通过对涉外护生实习前护理技能训练进行双语教学的实践,探索适合五年制高职涉外护理专业双语教学模式。[方法]选取2006级涉外护理专业74名学生为实验组,2006级高职护理专业74名学生为对照组,实验组采用双语教学法,对照组采用传统教学法,通过专业技能考核量化评价教学效果,通过学生问卷调查评价双语教学的满意度。[结果]实验组技能考核成绩(84.67分±7.83分)和对照组技能考核成绩(85.31分±8.92分)比较差异无统计学意义(P>0.05)。实验组双语教学后技能考核成绩明显高于双语教学前(P<0.05)。大部分学生对双语教学评价较高。[结论]双语教学在实习前护理技能训练教学中的运用,巩固了专业技能,激发了学生学习专业英语的兴趣。     

基于e-教学平台的五星教学模式在老年护理学中的应用

[目的]探讨基于e-教学平台的五星教学模式在老年护理学中的应用效果。[方法]选取山西省某高校2015级4年制大学三年级护理本科生214人为研究对象,随机分为观察组106人和对照组108人,观察组采用五星教学法实施教学,同时以e-教学平台辅助教学实施,对照组采用传统教学法进行教学。课程结束后比较两组学生的考试成绩,运用护理专业学生自主学习能力测评量表比较两组的自主学习能力得分。[结果]观察组学生考核成绩、自主学习能力得分优于对照组,差异有统计学意义(P0.05)。[结论]将基于e-教学平台的五星教学模式应用于老年护理学教学中,有利于教学效果及学生自主学习能力的提高。     

涉外护理专业《医护英语》英文会话情景模拟实训课程的构建

[目的]探讨涉外护理专业《医护英语》英文会话情景模拟实训课程的构建对教学效果的影响。[方法]随机选取2009级涉外护理专业学生60人为观察组,在常规理论教学基础上开展英文会话情景模拟实训;选取2007级、2008级涉外护理专业学生72人为对照组,应用常规教学法。采用问卷调查和考试两种方法对教学实效进行评价。[结果]调查问卷显示,观察组各条目得分明显高于对照组;观察组技能考试成绩高于对照组,差异有统计学意义（P〈0．05）。[结论]《医护英语》英文会话情景模拟实训课程的构建能提高学生的英语实际运用能力、自主学习能力、团队合作能力。     

PBL教学法结合情景模拟教学法在儿科护理教学中的应用

目的:探讨问题引导(PBL)教学法结合情景模拟教学法在儿科护理教学中的应用效果。方法:将93名全日制护理本科专业三年级的学生随机分为对照组46名和观察组47名,对照组实施传统教学方式,观察组实施PBL教学法结合情景模拟教学法;比较教学后两组理论和实践操作技能成绩,评判性思维能力测量表(CIDI-CV)评分,护理专业学生自主学习能力测评量表评分,一般自我效能感量表(GSES)评分,医学生沟通技能态度量表评分。结果:教学后观察组简答题、论述题等理论考试成绩和技能操作成绩、CIDI-CV各项评分、护理专业学生自主学习能力测评量表评分、GSES评分及沟通技能态度量表评分均优于对照组(P 0. 05)。结论:在儿科护理教学中应用PBL教学法结合情景模拟教学法,能提高护理教学效果,促进学生综合能力的提升。     

以循证护理为依托的信息化教学法在外科护理教学中的应用

[目的]探讨以循证护理为依托的信息化教学法在外科护理教学中的应用效果。[方法]将100名护生随机分为两组各50人,对照组采用传统教学模式授课,观察组护生采用信息化教学模式授课,比较两组教学效果及观察组护生对新型教学方法的评价。[结果]观察组88%护生认为新型教学模式优于传统教学模式,92%护生认为新型教学模式能够提高文献自主学习能力,94%护生认为新型教学模式能够提高文献检索能力;观察组护生的主观题理论考核成绩高于对照组护生（P〈0.01）。[结论]以循证护理为依托的信息化教学方法用于外科护理教学中有助于提高护生的综合能力。     

情景模拟教学法与案例学习法在护生自主学习能力培养中的效果

[目的]探讨情景模拟教学法在本科护生自主学习能力培养中的效果。[方法]将2012年8月—2013年4月在我院儿科实习的本科护生126名随机分为观察组和对照组。观察组采用情景模拟教学法,对照组采用案例教学法。两组护生实习后接受理论、护理技能考核,实习前后填写《护理专业学生自主学习能力》的问卷调查。[结果]观察组护生理论、护理技能成绩及优秀人数均明显高于对照组,差异有统计学意义(均P0.05),观察组护生在实习后自主学习能力高于对照组(P0.05)。[结论]情景模拟教学法较案例教学法更能提高本科护生的自主学习能力。     

Putting policy into practice: pre- and posttests of implementing standardized languages for nursing documentation

Aims and objectives. To describe the change in documentation of the nursing process in all inpatient wards in a 900‐bed university hospital. Major research question was what are the differences between before and after implementation of documentation policy related to the steps of the nursing process? Background. Implementation of standardized languages has been shown to be difficult to accomplish in clinical practice. Patients are the source of data and their conditions, responses and well‐being should be reflected in the nursing record. As such, nursing documentation can create the premises for the development of new knowledge in nursing and the improvement of nursing performance and can provide data and information necessary for nursing researchers to evaluate the quality of interventions and participate in the formulation of healthcare policy. This study is part of longitudinal project to prepare nurses for electronic documentation within the interdisciplinary health record and to improve documentation of nursing using standardized languages. Design and method. A cross‐sectional study design was used: a pretest (n = 355 nursing records) for baseline status of nursing documentation, an intervention and a post‐test (n = 349 nursing records) to obtain data on nursing documentation. The year‐long intervention comprised planned work in groups, and educational and supporting efforts. Results. A statistically significant improvement was found in the use of Functional Health Patterns for documentation of nursing assessment, NANDA for nursing diagnoses and Nursing Interventions Classification for nursing interventions in documentation of daily nursing care for inpatients. Conclusion. At all organizational levels intervention aimed at putting policy regarding documentation into clinical practice considerably improved daily use of standardized nursing languages. Relevance to clinical practice. Nurses need to use standardized language to document patient care data in the electronic health record and to demonstrate contributions to nursing care.     

Structure and content in Norwegian nursing care documentation.

In 1994, the Norwegian Board of Health (NBH) published recommendations for nursing care documentation. The two-fold purpose of the present study was to see if 5 wards in 2 Norwegian hospitals fulfilled the proposed NBH recommendations and guidelines regarding documentation, and to evaluate them in terms of the proposed structure and key words of the VIPS model. Results showed that all nursing records (n = 55) had an admission assessment. A nursing care plan was present in 62% of the records. Nursing goals were lacking in the remaining 38%, diagnosis and planned interventions were absent in 18%, and 45% of the diagnoses lacked information concerning patient progress or outcome. The nursing care plans were updated in only 40% of the records and discharge notes were present in 35%, confirming that NBH recommendations were not met in this sample. The key words of the VIPS model covered all information present in the records, and high interrater reliability was obtained for the majority of key words categorized by two independent researchers. It is suggested that the VIPS model components and key words can contribute to a reliable and uniform model for nursing care documentation and enhance comprehensive and systematic documentation, which is presently lacking in Norwegian records.     

提升护理服务综合价值的研究

目的:研究护理综合价值的提升。方法:分析护理价值研究背景,阐述护理价值研究进展结果:提出护理价值研究途径。结论:有利于达成一种共识,使广大护理人员认识护理价值、研究护理价值、开发护理价值,重视护理综合价值研究和提升。 护理服务价值是护理服务劳动产品的价值和服务本身所创造的价值的总和,即使用价值与价值的统一。目前日本、美国、德国和中国都在加强护理价值研究的探索,但仍存在使用价值与价值研究分离问题。因此,我们应不断加强护理综合价值研究,以适应卫生事业改革对护理管理的挑战。本研究主要在分析国内外护理价值研究的基础上,提出综合护理价值研究途径,以达到合理评价护理价值的目的。     

Research and the configuration of nursing services

• ? This paper is concerned with the way in which nursing research has influenced changes in the organization of nursing services, particularly the shift from so-called traditional nursing to new nursing. To this end published research and professional literature are selectively reviewed.
• ? The case is made to support the view that change in nursing has been driven forward by the evangelical zeal of opinion leaders rather than evidence.
• ? It is suggested that holistic care as embodied in new nursing is no longer affordable. Market pressures have precipitated a revisiting of the task basis of nursing. An effective anchor would have been a solid body of research evidence pointing up the value new nursing may have. Regrettably not enough research was done prior to the diffusion of new nursing. What was done was not always adequate, and what was adequate was not effectively deployed by nurse leaders.
• ? Nursing is the largest workforce in the NHS and has attracted a great deal of policy interest. It is suggested that it will become increasingly important for nursing to be more strategic, and develop its own professionally driven research agenda.
• ? The future of the nursing profession is uncertain. It is clear that evidence-based practice is centre stage, and there is a need for nursing to re-negotiate its professional boundaries and to develop intellectual partnerships in order to move the knowledge base of practice forward.

     

我国护理行业的改革与发展

从我国护理行业的现状、卫生体制改革以及基本国情出发 ,着重探讨护理管理、护理教育、护理环境、护理经济与管理体系、护理立法等方面的发展途径     

Innovations in United States genetics nursing: Practice and research

Aim: Clinical and research applications from human genome discoveries are growing and creating both opportunities and challenges to the integration of genetic concepts into practice and research. Nurses have a long history of caring for individuals, families, and groups with genetic conditions. In the past two decades, a small group of nurses in the USA have used a variety of strategies to further develop the field of genetics nursing. In this paper we identify innovative approaches to identifying genetics‐related nursing roles and opportunities, as well as successful collaborative efforts beyond nursing to address the emerging health and societal challenges related to human genetics discoveries. Methods: The information presented here comes from a variety of sources where the authors or genetics nurses directly participated, including: (i) a systematic literature review of genetics nursing; (ii) a comprehensive research study of models of delivering clinical genetics services and the roles of health professionals; and (iii) participation in numerous national research, planning, programmatic, and advisory groups involved with clinical genetics‐related health services, research, education, and public policy. Results: Genetics nurses in the US have developed innovative responses to genetics‐related challenges within and beyond the profession of nursing. These include: (i) establishing an organization for nurses in genetics and gaining formal recognition of genetics as a specialty of nursing; (ii) defining the scope of genetics nursing practice and developing a new genetics nursing credential; (iii) establishing a multiprofessional genetics education coalition and defining genetic competency for health‐care practice; (iv) creating new clinical practice roles for nurses that integrate emerging genetics concepts and skills into diverse clinical practice areas; (v) expanding nursing involvement in genetics‐related research; and (vi) participation in high‐level genetics advisory groups. Conclusions: The US experience shows that nurses have made substantial progress in expanding their involvement in genetic services through visionary leadership, innovative approaches to challenges, establishing support with nurse colleagues, and engaging in multiprofessional efforts. The most important first step is developing a supportive environment for nurse advancement. In the US, the genetics nurses’ organization known as the International Society of Nurses in Genetics (ISONG) has provided this base.     

整体护理病房三级护理查房的体会

我院自1999年7月开始在整体护理模式病房中实施三级护理查房。1年多来,对800例危重病人进行了护理查房,查房的形式为责任护士每天查,主管护师或护士长每周查,副主任护师以上或科护士长每月抽查,护理部主任每季抽查。通过查房,明显提高了危重病人的护理质量,病人得到了更为优质的服务,护理服务满意率提高;对护理人员来说,提高了业务水平,锻炼了口头表达能力;对护理管理来说,及时了解护士对护理程序的应用情况,掌握危重病人的护理质量,对护理中存在的不足及时提出指导意见。     

基层医院整体护理的实施与对策

目的:总结实施整体护理的经验,提高护理质量。方法:全面综合分析实施整体护理的对策和措施。结果:经验:领导的高度重视和大力支持,是实现整体护理模式转变的坚实基础;提高人员整体素质,确保整体护理的有效开展;多做少写,以点带面,实行非模式病房开展整体护理工作;积极开展健康教育,巩固整体护理效果;实施整体护理质量管理的措施。体会:领导的重视和支持,是开展整体护理工作的根本保证;提高了社会公众对护理工作的认可程度和护士的社会地位;显示了护士的自身价值;改善了护患关系,提高了病人满意度,同时也密切了医护关系;护理队伍整体素质提高,敬业精神增强。结论:实施整体护理,促进了护理学科的发展。     

Towards an aesthetics of nursing

Towards an aesthetics of nursing This paper re-appraises the work of Barbara Carper on aesthetics and the art of nursing. It identifies serious flaws in Carper's original arguments and the way in which she and subsequent authors have conflated the concepts of art and aesthetics in nursing. The paper explores a broader approach to aesthetics and proposes a way in which a theoretical approach to nursing aesthetics could be developed. The paper concludes that nursing is a fit object of aesthetic appreciation and that aesthetic quality is a necessary attribute of good nursing practice.     

晨间护理缺陷分析及对策

目的提高晨间护理质量。方法通过向住院病人和护士发放问卷调查及每周不定期检查各病区晨间护理质量,了解晨间护理工作中存在的缺陷,提出整改的措施。结果晨间护理工作中存在的主要缺陷:51.8%的病人认为护士与病人的沟通少,进病房时未向病人问好,整理病房时未向病人解释,口腔清洁率70.3%,头发清洁率45.3%,皮肤清洁率69.5%,病房安静整洁率67.3%,床单位整洁率86.5%,病情关注情况67.9%,健康教育执行情况48.6%,协助生活不能自理的病人进食、入厕、更衣、床上排便等占75.4%,时间安排满意度75.6%,护士认为晨间护理重要的占30%,晨间护理内容知晓率占60.9%,认为工作量大来不及做的占56.7%。结论提高护士对晨间护理的认识,规范晨间护理内容和程序,加强与病人的沟通,提供符合个体化需要的晨间护理,合理安排护理人员、工作重点和时间,持续质量改进,有助于提高晨间护理质量。