护理本科学生实习差错危险行为的调查研究

目的调查护理本科学生实习差错危险行为的现状,为临床实习教学改革提供客观依据。方法采用护理专业学生实习差错危险行为自评量表对2007级188名护理本科实习学生进行问卷调查,分析诱发实习差错的危险行为及其相关因素。结果 25.7%的护理专业学生实习期间出现过护理差错;学生差错危险行为主要体现在求成心理、专注性缺乏、方法问题等方面。省内、省外不同实习地点的学生在严谨性缺乏和求知消极方面差异有统计学意义(P<0.05)。结论实习学生护理差错发生率较高,建议护理教育者针对求成心理、专注性缺乏等开展必要的教育,同时针对不同实习地点,积极进行护理安全方面的教育,以避免医疗纠纷的发生。     

对护理实习生进行安全文化教育的方法及效果

目的探讨对护理实习生进行安全文化教育的方法及效果。方法在359名护理实习生临床实习岗前培训中加入28学时安全文化教育培训,在实习期间组织学生参加院内的安全分析及护理不良事件讨论会。比较培训后3个月与培训前学生的患者安全文化知识及护理不良事件认知情况;与上届学生对比临床实习前6个月发生患者安全及护理不良事件的情况。结果培训后3个月学生的患者安全文化知识及护理不良事件认知情况优于培训前(P<0.01);经过培训的学生临床实习前6个月患者安全及护理不良事件发生率低于上届未经过培训的学生(P<0.05)。结论院校和教学医院应积极对护理实习生进行安全文化教育,以提高学生对患者安全文化知识及护理不良事件认知,减少护理不良事件的发生。     

神经外科ICU护士对患者安全文化认知与实践的质性研究

目的深入了解神经外科ICU护士对患者安全文化的认知与实践,为促进患者安全文化的构建提供参考。方法应用现象学研究方法,对12名神经外科ICU护士进行半结构式深度访谈,对访谈资料进行转录、编码、类属分析、描述和组织。结果神经外科ICU护士对患者安全文化的认知可归纳为高度的认同与肯定和支持患者参与患者安全2个主题;对影响患者安全文化构建实践中的障碍因素可提炼为护理人力资源配置不当、全员共同参与患者安全的氛围缺乏、患者安全的教育培训体系缺乏、不良事件非惩罚性上报机制的不完善和对护士的心理支持关注不足5个主题。结论护士在医院患者安全文化构建中发挥着引导和示范作用,了解护士对患者安全文化的认知及影响其实践行为的因素,可为制订科学、系统的患者安全文化管理体系提供参考。     

229起护士给药错误分析及对策

目的 分析护士给药错误发生的原固和特点,探讨如何避免发生给药错误.方法 在建立半结构性非惩罚护理意外事件上报系统的基础上,回顾分析某三级综合性医院2008～2010年系统上报的229起给药错误事件,对护士发生给药缺陷的类型、特点、原因进行分析.结果 ①遗漏和5R类错误是护士给药错误的主要类别.给药错误的前三位原因为不遵守操作流程(低年资护士)、沟通不良和干扰(高年资护士).②护士年资是影响给药错误的重要因素,工作年限低于3年的护士给药错误发生率最高,3年以上者发生率明显降低.③护士给药错误容易发生在白天交接班时,尤其是在12:00左右.④与其他科室相比,外科护士给药错误的发生率更高.⑤给药错误各影响因素中,与结局相关者为沟通(P=0.044)、遗漏(P=0.019)、给药速度(P=0.008)、监测(P=0.000)和药品(P=0.009),Ⅱ级以上结局主要与高危药物有关.结论 护理管理人员应根据护士发生给药错误的特点制订针对性的预防措施.护士排班时应增加中午值班人员数量.对重点科室和高危药物应重点监测并提出降低给药错误的风险预案.     

Knowledge,attitude and practice regarding nursing interruptions among Chinese nurses: A nationwide cross-sectional survey

ObjectivesTo explore the knowledge, attitude and practice of Chinese nurses regarding nursing interruptions and related factors.MethodsA total of 6,400 nurses from 31 hospitals in China were investigated by using the Knowledge, Attitude and Practice (KAP) Questionnaire of Nursing Interruptions. The questionnaire consists of three dimensions, knowledge, attitude and practice, containing 10, 9 and 7 items, with full score of 50, 45 and 28, respectively.ResultsThe mean overall KAP score regarding nursing interruptions of Chinese nurses was 74.05 ± 16.65 (range: 26–123), with scores for the knowledge, attitude, and practice component being 21.74 ± 9.80, 34.83 ± 6.98, and 17.49 ± 4.97, respectively. Among the nurses, 70.8% of them experienced an average level of KAP toward nursing interruptions while 15.5% were at a poor level. The knowledge, attitude, and practice of nursing interruptions were better in chief nurses, managers, nurses with a master degree or above, nurses ever received training, and nurses with a strong agreement to leadership compared to nurses in other groups (P < 0.05). In addition, employment type, professional title, position, standardized training and leaders’ attention were predictors of KAP in nurses.ConclusionChinese nurses have a moderate level of KAP regarding nursing interruptions. Leaders’ attention, standardized training, position, professional title and employment type could predict nurses’ KAP state of nursing interruptions. Thus, a targeted training program should be implemented for clinical nurses by nursing leaders, with a particular focus on feasibility and professionalism.     

Barriers to,and facilitators of post‐operative pain management in Iranian nursing: a qualitative research study

Background: Unrelieved post‐operative pain continues to be a major clinical challenge, despite advances in management. Although nurses have embraced a crucial role in pain management, its extent is often limited in Iranian nursing practice. Aim: To determine Iranian nurses' perceptions of the barriers and facilitators influencing their management of post‐operative pain. Methods: This study was qualitative with 26 participant nurses. Data were obtained through semi‐structured serial interviews and analysed using the content analysis method. Findings: Several themes emerged to describe the factors that hindered or facilitated post‐operative pain management. These were grouped into two main themes: (1) barriers to pain management after surgery with subgroups such as powerlessness, policies and rules of organization, physicians leading practice, time constraints, limited communication, interruption of activities relating to pain, and (2) factors that facilitated post‐operative pain management that included the nurse–patient relationship, nurses' responsibility, the physician as a colleague, and nurses' knowledge and skills. Conclusion: Postoperative pain management in Iran is contextually complex, and may be controversial. Participants believed that in this context accurate pain management is difficult for nurses due to the barriers mentioned. Therefore, nurses make decisions and act as a patient comforter for pain after surgery because of the barriers to effective pain management.     

Two approaches to nursing: a study of Iranian nurses

BACKGROUND: Studying nurses' experience from a sociocultural perspective can contribute to improving knowledge and understanding in this field. PURPOSE: To describe and compare three different groups of Iranian nurses' experiences of their profession. METHODS: The study was conducted in Iran and Sweden. The data were collected from semi-structured telephone interviews and analysed with latent content analysis. The participants were three groups of registered nurses (RNs) (21 persons). All RNs were born and grew up in Iran. The first group (A) were educated and had worked in Iran but were now working and living in Sweden. The second group (B) were educated and worked in Sweden. The third group (C) were educated and worked in Iran. FINDINGS: The nurses in Sweden worked with a patient-orientated approach while nurses in Iran worked with a task-orientated approach. Nurses in all three groups explained that they suffered from stress, had a heavy workload, were underpaid and understaffed. The findings showed that RNs working with a patient-orientated approach, experienced work satisfaction to a greater extent than RNs working with a task-orientated approach, although other aspects also influenced the nurses' situation considerably.     

护理专业学生实习期间差错取向的现状分析研究

目的探讨护理专业学生实习期间的差错取向现状及其相关影响因素。方法采用便利抽样的方法,应用Rybowiak等编制、由郭维维等翻译的中文版差错取向问卷,对福州市3所三级甲等医院实习的护理专业328名学生进行调查。结果护理专业实习学生差错取向的得分为(2.93±0.52)分,经成组t检验、单因素方差分析,男生的风险承受能力高于女生(P<0.05);农村生源的实习生相较于非农村者更善于进行差错沟通(P<0.05);而不同学历实习学生的差错取向中有5个维度存在统计学差异(P<0.05)。结论应尽快建立实习生无惩罚性护理差错管理制度,以引导实习生差错学习、差错思考,增强学生应对差错的信心。     

The professional self-image of nurses in Belgian hospitals: a cross-sectional questionnaire survey

This paper reports data on the professional self-image of 9638 nurses employed in 22 Belgian general hospitals with the goal of identifying problems affecting recruitment and retention. Nurses reported having a positive self-image. Most were proud to be a nurse and considered themselves competent health professionals having great responsibility. Although they reported that an ideal practice requires effective teamwork, supportive management, societal recognition, and sufficient time to perform their duties, they also felt that these essential conditions were absent in daily practice.     

Delineating advanced practice nursing in New Zealand: a national survey

Background

A variety of advanced practice nursing roles and titles have proliferated in response to the changing demands of a population characterized by increasing age and chronic illness. Whilst similarly identified as advanced practice roles, they do not share a common practice profile, educational requirements or legislative direction. The lack of clarity limits comparative research that can inform policy and health service planning.

Aims

To identify advanced practice roles within nursing titles employed in New Zealand and practice differences between advanced practice and other roles.

Method

Replicating recent Australian research, 3255 registered nurses/nurse practitioners in New Zealand completed the amended Advanced Practice Delineation survey tool. The mean domain scores of the predominant advanced practice position were compared with those of other positions. Differences between groups were explored using one‐way ANOVA and post hoc between group comparisons.

Results

Four nursing position bands were identified: nurse practitioner, clinical nurse specialist, domain‐specific and registered nurse. Significant differences between the bands were found on many domain scores. The nurse practitioner and clinical nurse specialist bands had the most similar practice profiles, nurse practitioners being more involved in direct care and professional leadership.

Conclusions

Similar to the position of clinical nurse consultant in Australia, those practicing as clinical nurse specialists were deemed to reflect the threshold for advanced practice nursing. The results identified different practice patterns for the identified bands and distinguish the advanced practice nursing roles.

Implications for nursing policy

By replicating the Australian study of Gardener et al. (2016), this NZ paper extends the international data available to support more evidence‐based nursing workforce planning and policy development.     

护理差错110例分析及管理启示

目的:探讨护理差错发生的高危因素及防范措施,确定管理对策,减少临床护理差错事故的发生。方法:对发生的110例护理差错进行回顾分析。结果:发生差错者75人,与医嘱处理、核对、执行有关的差错发生率最高;工作年限1~5年及16年以上的护士出现差错的几率较高;上午、夜班时间差错率比中午和下午高。结论:护理管理者应重视工作程序和方法的改进,重视环节质量管理,重视新护士、实习护士的管理,关心、爱护、高年资护士,尤其是个人生活有波折者,实行弹性排班制,加强高危时段护士的人力管理。     

“磁性医院”管理模式在护士实习带教过程中的应用

目的:探讨磁性医院管理模式在护生实习带教过程中的应用效果。方法:对2011年6月~2013年6月来院实习的护生分别进行传统带教(对照组)和磁性医院管理模式带教(试验组),磁性医院管理模式带教即建立、健全护理实习生的管理制度,对她们进行多方位心理干预,同时采取有效的磁性教育措施。比较两组护生工作适应时间及实习结束后各项指标评价和考核情况。结果:试验组护生工作适应时间短于对照组,各项工作考核均优于对照组(P0.05)。结论:磁性医院管理模式在我院护生实习带教过程中效果满意,值得推广运用。     

护理管理实习目标体系的建构

目的探讨和建立护理管理实习目标体系,为临床护理管理实习提供指导。方法从管理的时间、信息、人力、财力、物力五大基本管理对象体系建构了护理管理实习目标体系。结果护理管理实习目标体系为护生和临床带教老师的临床护理管理实习起到了很好的引导和标准作用。结论从管理的时间、信息、人力、财力、物力五大基本管理对象体系建构护理管理实习目标体系是可行的。     

护理管理实习目标体系的建构

目的探讨和建立护理管理实习目标体系,为临床护理管理实习提供指导。方法从管理的时间、信息、人力、财力、物力五大基本管理对象体系建构了护理管理实习目标体系。结果护理管理实习目标体系为护生和临床带教老师的临床护理管理实习起到了很好的引导和标准作用。结论从管理的时间、信息、人力、财力、物力五大基本管理对象体系建构护理管理实习目标体系是可行的。     

病人满意度调查在护理管理中的应用

目的:把病人满意度调查应用于护理管理实践,提高护理质量,从而更好地满足病人健康的需要。方法:自制病人满意度调查表,把日常护理工作尽量较全面地设计到表格中,并通过满意度调查及时发现并解决护理工作中出现的问题,指导护士的日常工作。结果:病人对护理工作的总体满意度以及护士对护士长管理的满意度有了一个明显的提高。结论:病人满意度地调查应用于日常护理管理,取得了很好的效果。