江西省护理管理者对专科护士使用管理现状的调查研究

[目的]了解江西省护理管理者对专科护士使用管理的评价。[方法]自行设计江西省专科护士的使用管理调查表,对江西省96名护理管理者进行问卷调查。[结果]93.75%护理管理者认为专科护士在临床护理方面发挥了作用,90.63%护理管理者认为专科护士在护理教学方面发挥了作用,但专科护士各职能发挥参差不齐;护理管理者重视专科护士的发展,但在专科护士的使用管理上存在"各自为政"现象;阻碍专科护士工作发展因素主要为"没有明确的角色定位""没有体现工作岗位价值的待遇"和"工作负荷重,时间不足"。[结论]专科护士的发展非常必要,且具有可行性,但需要尽早建立规范的专科护士使用管理制度。     

完善护理管理机制 促进专科护士发展

随着医学科学和诊疗技术的飞速发展,以及病人对护理服务需求的不断提高,护理的专业化发展已成为我国临床护理实践发展的必然趋势。与世界发达国家相比,我国专科护士的培养和使用尚处于起步阶段,专科护士的职责、角色及管理机制还处于探索之中。在卫生部颁发的《中国护理事业发展规划纲要(2005-2010年)》中,已明确提出要在重症监护、急诊急救、器官移植、手术室护理、肿瘤病人护理等专科护理领域开展专业护士培训,培养一批临床专业化护理骨干。五年来,各地区都培养出了许多专业化护理骨干人才,这些人中有的已成为了本专业的学术带头人,对促进我国护理专业化发展起到了重要的作用。但也有一些人,经过了专业化培训,但在护理实践中其专业特长的施展和发挥受到传统岗位职责和用人机制的制约。因此,探讨专科护士岗位与职责的定位、充分发挥这些专业骨干人才的作用已成为护理管理者面临的重要课题之一,也是我国专科护理能否快速发展的关键。我国亟需建立真正符合国情、更为合理的专科护士使用和管理机制,以提高护理专业水平及护理人员整体素质,促进护理向专业化发展。本期特别策划栏目特邀请了相关专家介绍垂直管理对保证专科护士充分使用的意义,在ICU、糖尿病、肿瘤专科领域中护士的专业化角色和职责,以及造口治疗师的管理与使用经验,以期为探索我国护士专业化发展提供参考。欢迎各地护理管理者就此进行讨论,分享成功经验。     

男护士在专科护理发展中的作用

摘要：随着优质护理的深入开展,专科护士发挥着越来越重要的作用,专科化护理服务体现了护理专业化、学科化的发展。现在男性从事护理职业逐渐得到了认可,男护士在职业生涯中的发展不仅体现了人的价值,也体现了男性在护理领域里对人类健康做出的不朽贡献。本文从分析男护士自身的优势出发,探讨男护士的职业生涯规划,阐述男护士和专科护理发展之间的关系,以期社会和医院管理者关注男护士,同时也希望男护士从关注自身开始,合理规划职业生涯,为病人和社会提供高质量的护理服务。     

我院发展专科护理的方法与效果

目的 探讨发展专科护理的方法与效果.方法 成立专业护理小组,落实护理会诊制度、层级管理与管床责任制,开设专科护理门诊,设立专科护士岗位.结果 7个专业护理小组运作良好,全院年护理会诊数量逐年增多,日专科护理门诊量30～40例;护嘱制度得到进一步完善;护理差错及护理投诉逐年减少;护士离职率逐年下降;护士对专业护理小组、护理会诊和专科护理门诊等工作表示认可.结论 发展专科护理有利于提高护士专业水平与职业归属感,更好地为病人提供优质护理服务.     

吉林省专科护士循证护理素质及影响因素研究

[目的]调查吉林省专科护士循证护理素质及其影响因素,为更好地促进专科护士开展循证护理提供依据。[方法]2016年6月采用一般情况调查表、临床护理人员循证护理素质调查表和循证护理实践障碍量表对参加吉林省专科护士培训的198名专科护士进行调查。[结果]专科护士循证护理素质调查表总得分为(213.15±35.67)分,处于合格水平,专科护士循证实践障碍量表总分为(77.23±23.45)分,处于中度影响水平;专科护士职称、职务、学历是影响专科护士循证护理素质的因素。[结论]吉林省专科护士循证护理素质还有待提高。     

江西省首届ICU专科护士工作现状调查及分析

目的：了解江西省首届ICU专科护士的工作现状,为后期ICU专科护士的合理使用与规范管理提供依据。方法采用自行设计的江西省首届ICU专科护士工作现状调查表,对首届15名ICU专科护士目前的工作情况进行问卷调查。结果40%专科护士参与了专科护理小组、专科护理会诊及ICU专科护理教师培训的工作,53%专科护士进行了院级护理查房,33%专科护士参与了危重症患者个案管理,80%专科护士参与了科研活动,47%专科护士担任了护理管理者,73%认为成为 ICU专科护士后自我能力水平大幅度提高。 ICU专科护士临床使用与管理中普遍存在的问题包括角色定位模糊,继续教育较少,待遇有待提高及缺乏政策支持。结论科学有效地使用ICU专科护士,进一步明确ICU专科护士的角色定位,加强ICU专科护士岗位管理,可促进ICU专科护理工作的发展。     

综合性医院专科护理工作小组的发展建设

目前,专科护士培养在我国仍处于摸索发展阶段,为适应当前医院的发展和各护理专科的进步,与国际水平接轨,在每一个临床科室培养2～3名理论知识丰富、操作技术娴熟、心理应激能力较强的护士并在专科护理领域发挥带头作用已成为护理人才培养的必须[1-3].     

专科护理巡查在护理质量管理中的实践与成效

目的探讨专科护理巡查在护理质量管理中的实践与效果。方法成立糖尿病、慢性伤口造口、静脉治疗、危重症护理4个专科护理小组,对全院护士进行分层次培训与指导,每月按计划对全院各科室进行专科护理质量巡查并及时反馈。结果护士专科知识掌握程度和患者满意度提高(P0.01),护理不良事件发生率降低(P0.05)。结论专科护理巡查对护理质量持续改进具有很好的促进作用。     

医联体模式下上级医院对基层医院专科护理发展的影响

目的:探讨医联体模式下上级医院对基层医院专科护理发展的影响。方法:医联体上级单位对成员单位实施护理共建、一对一帮扶指导、畅通沟通平台、建立培训机制等措施来实现提高基层医院专科护理发展,比较医联体管理前后基层医院专科护理发展情况、专科护士核心能力年度考核情况、专科护理工作质量。结果:医联体模式下,基层医院护理专科在专科数量、专科护理人才的培养及核心能力、专科护理质量考核方面显著优于管理前(P<0.01)。结论:医联体模式能有效促进基层医院专科护理发展,有利于提升基层医院专科护士的核心工作能力,提升专科护理质量。     

开展专科护理查房探讨

随着护理学科的发展，护理查房日渐普及，我院护理部近年运行的专科业务护理查房，对加强专科疾病护理的质量管理；对加强护士专科护理业务学习；对加强护士长间的病区管理竞争意识，有着实践指导作用。本文仅就专科护理查房的管理及查房方式，内容进行总结，以便在今后护理实践中进一步探讨、完善。     

心血管疾病患者增长对专科护理发展的思考和建议

目前我国心血管疾病发病率持续增长,医疗技术水平亦不断提高,新技术、新业务广泛应用于临床,心血管疾病专科护理领域出现了疾病的复杂性提高、对护理服务的需求增加和护士护理教育、人力配备、专业化发展方面的问题。通过分析现阶段心血管疾病护理工作面临的机遇和挑战,提出合理配置护理人力资源、加强护十培训和探索心血管疾病专科护士培训方式等建议,以适应医学的快速发展,为患者提供安全优质的护理服务。     

Classifying general and specialist children's nursing competencies

BACKGROUND: Whilst there is evidence in the literature to support the continuation of a children's nursing qualification, the distinction between generalist and specialist nursing is insufficiently comprehensive to distinguish children's nursing from other branches of nursing. AIM: To develop a definition of children's nursing and specialist children's nursing in terms of competencies as the basis for differentiating them from other forms of nursing. DESIGN: A multi-method comparative design incorporating a case study approach was used. This included a nominal group technique, focus groups, Delphi survey and semi-structured interviews. Two arms of data collection were undertaken concurrently (during 1998-2000) with children's nurses (n = 146) and specialist children's nurses (children's cancer nurses, n = 37) from a number of centres in the United Kingdom (UK). FINDINGS: The holistic competencies developed from the data exposed characteristics of knowledge, skills, abilities, values and qualities displayed in the context of professional work for both groups of nurses. A classification of competencies was developed inductively from the data by two independent researchers through the labelling, defining and ordering of competencies. The resulting hierarchy of competencies and sub-competencies illustrates relationships between children's nurses and specialist children's nurses and provides a detailed definition of children's nursing and specialist children's nursing. CONCLUSION: There is a significant common element in these two areas of nursing practice, and generalist preparation in children's nursing is the foundation of specialist children's nursing practice. Generalist knowledge and skills are expanded in specialist practice and there is also evidence of specialist practice that is beyond the scope of general nursing practice.     

我院专科护理管理体系的建立与实践

目的 探索专科护理管理体系的建立与实践的方法与效果.方法 建立健全组织体系,加强专业护士培训,制订科学流程,完善质量控制体系、持续改进护理方法、执行会诊制度等.结果 提高了护理质量合格率和病人满意度,护理不良事件发生率降低,重点护理技术开展增多,差异均具有统计学意义(P<0.01或P<0.05).结论 专科护理管...     

Admiral nursing competency project: practice development and action research

Aims and background. Admiral Nurses are specialist dementia care nurses working in the community with carers of those who have a dementia. The aim of the competency project (2000–2003) was threefold. Firstly to work collaboratively with these specialist nurses to facilitate the development a competency framework that reflects the needs of the Admiral Nursing Service. Secondly, to provide a way to structure evidence demonstrating evolving competency. Thirdly, to specifically enable the nurses to demonstrate evidence of achieving the UK Nursing and Midwifery Council's Higher Level Practice standard. Design and methods. The two complementary approaches of emancipatory action research and systematic practice development were adopted. Methods were taken from action research and systematic practice development approaches with an emphasis on promoting and enabling enlightenment, critical reflection, ownership and creating the best conditions for long‐term commitment to the competency framework. Results. The main outcome from this project was the development of a specialist nursing competency framework. The Admiral Nurses’ Competency Framework is made up of a set of eight core competencies with three levels of competency statements, loosely structured around the Higher Level Practice standard, and guidance documentation to illustrate how work‐based evidence can be generated to demonstrate competence. There were also process‐derived outcomes associated with combining systematic practice development with emancipatory action research that had an impact on the culture. The main outcomes here were that practitioners engaged in and experienced learning about how to research their own practice and the consequences of doing this. They also learnt about specialist nursing practice more widely than Admiral Nursing. Finally, there was some increase in awareness about the culture within their teams and organizations. The final competency framework reflects the needs of the service, is owned by the majority of practitioners and project commissioners and this has had a positive impact on implementation. Conclusion. In this paper, we report on combining systematic practice development with action research to achieve immediate project aims. In addition we show how a project of this nature can contribute to developing skills in practitioners necessary for cultural changes in practice and contributes to wider issues of modernization within nursing and health care. Relevance to clinical practice. This competency framework will enable Admiral Nurses to demonstrate their level of specialist practice, as individuals and collectively as a service and it also promotes the principles of nurses as life long learners. This may have relevance to other groups of specialist nurses. The project has widespread relevance for two reasons. Firstly, it shows that nurses can be involved in designing and testing a competency framework as collaborators. Secondly, that to achieve this within the spirit of approaches, such as systematic practice development and action research, can be testing for all collaborators even were there is a shared or espoused aim.     

利益相关群体对护理硕士专业学位与专科护士并轨培养的认知调查研究

目的了解护理专业型硕士、专科护士、护理专家对护理硕士专业学位与专科护士并轨培养的认知及态度。方法在文献研究的基础上编制问卷,采用便利抽样,从全国东北、东、中、西部部分省市调查护理硕士专业学位研究生250名、专科护士250名和护理专家50名。结果专科护士和护理专家对护理硕士专业学位的了解程度不同,差异有统计学意义(P0.01)。护理专硕和护理专家对专科护士的了解程度相对较高。三组人群普遍对并轨相关政策不太了解。三组人群普遍认为护理硕士专业学位教育与专科护士培训并轨是可行的,且支持护理硕士专业学位教育与国家级专科护士培训并轨。从临床实践环节实施并轨是三组人群认可度最高的并轨方式。结论我国护理硕士专业学位与专科护士并轨培养是可行的,但护理专业型硕士与专科护士之间的了解不足。护理硕士专业学位教育可尝试与国家级专科护士培训并轨,从临床实践环节实现接轨。     

Profile of advanced nursing practice in Spain: A cross‐sectional study

In this study, we described the profile of advanced nursing practice in Spain. A cross‐sectional study design was used to explore the extent and patterns of advanced nursing practice activity within the domains of expert care planning, integrated care, interprofessional collaboration, education, research, evidence‐based practice, and professional leadership. Data were collected in 2015/2016. Purposive sampling yielded a sample of 165 specialist and expert nurses employed by a dual tertiary and community hospital in an urban setting. The study included specialist and expert nurses who had a higher practice profile than registered general nurses. The performance of activities according to age, current position, years of experience, nursing grade, and education was compared. Practice domains were more strongly influenced by the predictors of nursing position and professional career ladder. Age and experience predictors were found to be weak predictors of advanced practice domains. This study offers essential information of the nursing workforce, and clarifies both the advanced nursing practice profile and nomenclature in the context of study.     

ICU专科护士培训评价的研究进展

通过资料回顾,显示我国的ICU专科护士培训尚缺乏衡量各培训基地教学质量的科学标准。建立一套科学、规范的ICU专科护士培训评估指标体系是顺应时代的要求,对加强ICU专科护士培训建设,确保ICU专科护士培训质量,从而提高整个医疗队伍素质,有着重大和深远的意义。     

临床护理专家的发展现状与趋势

综述了我国临床护理专家的发展现状,包括含义、分类、职能、管理、教育以及认证等,并对其发展趋势进行展望。