基于核心胜任力的助产方向专科护士培训实践

目的探讨基于核心胜任力的助产方向专科护士培训效果。方法以2019年参加助产方向专科培训的39名学员为研究对象,以助产士核心胜任力为框架,从孕前保健、孕期保健、分娩保健、产后保健、新生儿保健、公共卫生保健对其进行理论(7周)与技能(9周)的培训,培训前后评价学员的理论知识、临床技能及助产士核心胜任力。结果培训后学员的理论成绩与临床技能成绩均较培训前提高(P<0.05),学员的助产士核心胜任力由(3.79±0.47)分提升至(4.16±0.43)分,差异有统计学意义(P<0.05)。结论基于核心胜任力的助产方向专科护士培训可有效提升助产士核心胜任力。     

Simulation training program for midwives to manage postpartum hemorrhage: A randomized controlled trial

PurposeTo explore the effectiveness of a simulation training program for midwives in performance and knowledge for the management of postpartum hemorrhage (PPH).MethodsThe study design was a randomized controlled trial. Midwives working at one obstetrics ward in an urban area were randomly assigned to simulation training program or no training. This “simulation program” included pre study e-learning and simulation. Inclusion criteria were midwives who: 1) had two or three years of clinical experience, 2) worked in an obstetrics ward, and 3) had experience with birth assistance. There was one exclusion criterion namely prior experience of simulation training for PPH. Change in performance was evaluated using a PPH scenario performance test at one month after the simulation training. Change in knowledge was evaluated by a 25-item multiple-choice questionnaire completed shortly before the training and one month after the training. The ethical review committee of St Luke's International University granted approval (No. 14-096).ResultsEighty-one midwives were randomly assigned to either the intervention group (n = 40) or the control group (n = 41). Performance in the simulation training group was significantly better in comparison to the no training group; mean performance score was 23.85(SD 2.71) in the training group versus 18.00(SD 3.01) in the no training group (MD 5.85 95% CI 4.85–7.12, t = 9.17, p < 0.001). Knowledge was significantly increased in the simulation training group; amount of knowledge score was 3.65(SD 3.40) in the training group versus − 0.02(SD 3.02) in the no training group (MD 3.67 95% CI 2.25–5.10, t = 5.14, p < 0.001).ConclusionBoth performance and knowledge about the management of PPH were significantly improved after simulation training. However, assessments of long-term effects on performance, and knowledge and the clinical outcomes in managing of obstetric complications are necessary to adequately evaluate the effectiveness of simulation training.     

The effect of laughter yoga applied before simulation training on state anxiety,perceived stress levels,self-confidence and satisfaction in undergraduate nursing students: A pragmatic randomized controlled trial

AimThis study aimed to examine the effect of laughter yoga applied before simulation training on state anxiety, perceived stress levels, self-confidence and satisfaction in undergraduate nursing students.BackgroundClinical simulation-based teaching implied a revolution in nursing education. Along with the many opportunities that simulation offers, some disadvantages, such as anxiety and stress experienced during simulation scenarios, could affect students’ satisfaction and self-confidence in learning. Therefore, laughter yoga could be an alternative method that reduces students' anxiety and stress levels and increases their self-confidence and satisfaction with simulation training.DesignThe study was designed as a pragmatic randomized controlled trial.SettingThis study was conducted at a university in Turkey.ParticipantsA total of 88 undergraduate nursing students were randomized to the intervention group (n = 44) or control group (n = 44).MethodsThe intervention group participated in the laughter yoga sessions just before the clinical simulation scenario, while the control group only performed the simulation training. The researchers examined the effect of laughter yoga on state anxiety, perceived stress levels, self-confidence and satisfaction in learning before and after the intervention. Data were collected between January - February 2022.ResultsThis study showed that the mean scores of state anxiety, perceived stress, mean pulse rate and arterial pressure of the intervention group were significantly lower than those of the control group (p < 0.05). In addition, there was also a significant group*time interaction between the groups on state anxiety, perceived stress, pulse, respiratory and mean arterial pressure scores (p < 0.05). Moreover, the mean scores of student satisfaction and self-confidence in the learning of the intervention group were significantly higher than those of the control group (p < 0.05).ConclusionThe findings showed that laughter yoga helped nursing students reduce their state anxiety and perceived stress levels related to simulation training and improved their self-confidence and satisfaction with learning. Additionally, it enhanced the students' vital signs (including mean pulse rate and mean arterial pressure). These positive results are promising for using LY as an easy, safe and effective method to reduce undergraduate nursing students’ stress and anxiety levels and to improve their learning satisfaction and self-confidence levels in clinical skills training such as simulation training.     

Expert patient illness narratives as a teaching methodology: A mixed method study of student nurses satisfaction

ObjectiveTo evaluate nursing students' satisfaction with Expert Patient Illness Narratives as a teaching and learning methodology based on patient involvement.Methods and DesignMixed methods were used in this study: online survey with quantitative and qualitative items designed by researchers.Settings and ParticipantsSixty-four nursing students of the Universitat Autònoma de Barcelona, attending a Medical Anthropology elective course.ResultsWomen more frequently considered that the new learning methodology was useful in developing the competency “to reason to reason the presence of the triad Health-Illness-Care in all the groups, societies and historical moments” (p-value = 0.02) and in that it was consolidated as a learning outcome (p-value = 0.022). On the other hand, men considered that this methodology facilitated the development of critical thinking (p = 0.01) and the ability to identify normalized or deviant care situations (p = 0.007). Students recognized the value of Expert Patient Illness Narratives in their nursing training as a way to acquire new nursing skills and broaden previously acquired knowledge. This educational innovation improved nursing skills and provided a different and richer perspective of humanization of care.ConclusionsThe results of the present study demonstrate that nursing students found Expert Patient Illness Narratives satisfactory as a learning and teaching methodology, and reported improvement in different areas of their training and also the integration of new knowledge, meaning, theory applicability, as well las critical and reflective thinking. Involvement of patients as storytellers also provides a new humanizing perspective of care. Nonetheless, further studies of Expert Patient Illness Narratives are needed in order to improve its benefits as a teaching and learning methodology.     

Development and evaluation of a clinical simulation for new graduate nurses: A multi-site pilot study

BackgroundNew nursing graduates have revealed that they perceive a gap between theory and practice with reference to their education and the real workplace setting. Additionally, many nurses experience a reality shock when they participate in clinical practice.PurposeThe purpose of this study was to develop and test the effects of a scenario-based simulation training program on new graduate nurses' competency, critical thinking dispositions, and interpersonal communication skills.MethodThis pilot multi-site study used a pretest-posttest control group design. It was conducted at four sites of a university-affiliated simulation center in Korea. Participants were recruited utilizing a convenience sample from four tertiary hospitals in Korea. Twenty-four new graduate nurses participated in this study.ResultsAt the three-month follow-up, the levels of communication skills used in practice among the intervention group were statistically significantly higher than those of the control group participants (U = 151.50, p = .005). However, there were no significant differences between the groups in changes in nursing competency (U = 287.50, p = .992) or critical thinking disposition scores (U = 269.50, p = .702). The participants' mean rating scores concerning the objectives, intentions, and recommendations for other nurses were positive and high.ConclusionThe involvement of current practicing of nursing in certain scenarios and the implementation of simulation learning could enhance the readiness of new graduate nurses.     

Application of nursing core competency standard education in the training of nursing undergraduates

PurposeTo evaluate the effectiveness of nursing core competency standard education in undergraduate nursing training.MethodsForty-two nursing undergraduates from the class of 2007 were recruited as the control group receiving conventional teaching methods, while 31 students from the class of 2008 were recruited as the experimental group receiving nursing core competency standard education. Teaching outcomes were evaluated using comprehensive theoretical knowledge examination and objective structured clinical examination.ResultsThe performance in the health information collection, physical assessment, scenario simulation and communication in the experimental group were significantly higher than those of the control group (p < 0.05).ConclusionsNursing core competency standard education is helpful for the training of nursing students' core competencies.     

The training needs of Korean intensive care unit nurses regarding delirium

ObjectivesThe aim of this study was to investigate high-priority training needs by analysing the perceived importance and self-reported performance of nurses’ delirium care competency.DesignA cross-sectional survey with a convenience sample of 255 Korean intensive care units nurses.SettingIntensive care units in the Republic of Korea.Main outcome measuresIntensive care unit nurses’ delirium care competency.ResultsExploratory factor analysis of the Nurse Delirium Care Competency Scale showed a six-factor structure, which accounted for 67.51% of the variance in nurses’ delirium care competency: management algorithm, prevention, communication, nursing management, assessment, and collaboration. The self-reported performance scores of all six factors were significantly lower than their perceived importance scores. The delirium assessment factor was identified as a high training priority on the importance-performance matrix for new graduate nurses.ConclusionTraining programmes should be developed considering the six delirium care competency factors identified in this study. Further, nurse educators must adopt active educational modalities such as case-based small group learning and simulation-based learning to improve nurse competency in recognising and managing delirium.     

Effects of preobserving peers’ performance on students’ anxiety,perceived competency,and satisfaction during a clinical simulation: A quasiexperimental study

AimThis study aimed to determine the effects of preobserving peers’ performance on students’ anxiety, nursing competency and learning satisfaction in a high-fidelity simulation.BackgroundObserving peers’ performance for mental practice is reportedly effective in reducing simulation anxiety and enhancing learning, but the evidence remains insufficient.DesignAn experimental two-group pre–post-test design with a wait-list control group with crossoverMethodsNinety-five senior nursing students enrolled in a simulation-based course at a university were categorized into two groups nonrandomly: students observing peers’ performance before entering a simulation scenario (preobservation or intervention) and students not observing before a scenario experience (control). Self-reported nursing competency, state-trait anxiety inventory, perceived stress level andsatisfaction with learning were then measured.ResultsSelf-reported nursing competency was significantly higher andthe learning satisfaction was partially higher in the preobservation group than in the control group. The preobservation group also had lower anxiety and stress levels than the control group, although the difference was not significant.ConclusionsMental practice by observing peers’ performance before entering a simulation could enhance the learning and satisfaction of students who are new to simulation.     

助产士层级培训效果评价

目的 探讨对助产士进行层级培训的方法及效果.方法 便利选择2所三级甲等医院产房的68名助产士作为研究对象,干预前采用助产士能力评估工具表对其进行能力评估,按照得分将其分为新手层、胜任层、精通层和专家层,根据构建的助产士层级培训方案对其进行2年的培训,并根据考核结果对护士进行层级调整.比较培训前后各层级助产士理论与实践考...     

Inteligencia emocional de enfermeras de cuidados críticos: scoping review

ObjectiveEmotional intelligence is often described as the ability to know own emotions and to be aware of other emotions. The emotional intelligence of critical care nurses is a necessary competence for work performance. The aim of this review is to map the evidence on emotional intelligence of nurses working in this specific context.MethodsScoping review based on Joanna Briggs Institute guidance. Nurses as a population, critical care as a context and emotional intelligence as a concept were considered. Search was conducted using databases and electronic platforms such as CINAHL Complete, MEDLINE complete, Cochrane Central Register of Controlled Trials, Nursing & Allied Health Collection: Comprehensive (via EBSCOhost), MedLine (via PubMed), SCOPUS and Web of Science. From a total of 40 citations, 9 articles have been included in the review.ResultsThe 9 articles emphasise the relevance of emotional intelligence in the professional experience, in emotional exhaustion and burnout prevention, in enhancing the safety culture of the sick, in contributing to organisational citizenship behaviour, and in resilience.ConclusionEmotional intelligence is a core competency of critical care nurses, with professional, personal and organisational implications.     

Impact of prebriefing on competency performance,clinical judgment and experience in simulation: An experimental study

BackgroundPrebriefing is the introductory phase of the simulation process, however, little nursing education research is available on this aspect of simulation. Reflection theory and concept mapping informed a model-based structured prebriefing activity to prepare students for meaningful simulation learning.ObjectivesThe aim of this study was to examine the intervention of structured prebriefing for its effect on nursing students' competency performance, clinical judgment and their perceived prebriefing experience.DesignAn experimental group-randomized design was used in this study; the intervention group who received structured prebriefing was compared to the control group.SettingThe study was conducted at a university school of nursing in Canada.ParticipantsBaccalaureate nursing students (N = 76) enrolled in a fourth-year medical-surgical course participated in this study.MethodCompetency performance, clinical judgment, and the perception of the prebriefing experience of those participants receiving structured prebriefing and those receiving traditional prebriefing activities, were compared. The relationship between simulation performance and students' self-rated prebriefing experience was also examined. Scores from the Creighton Competency Evaluation Instrument and the Prebriefing Experience Scale were analyzed using parametric and non-parametric statistics.ResultsA statistically significant difference was demonstrated between groups for competency performance (p < 0.001), clinical judgment (p < 0.001) and prebriefing experience (p < 0.001). No relationship was found between perception of prebriefing experience and students' simulation performance.ConclusionTheory-based, structured prebriefing can impact nursing student competency performance, clinical judgment and perceptions of prebriefing, and may enhance meaningful simulation learning.     

Training maternal and child health nurses in early relational trauma: An evaluation of the MERTIL workforce training

BackgroundParents who experience relational trauma may inadvertently create contexts of care that undermine secure beginnings to life for their young children. Universal health services such as Maternal and Child Health (MCH) services offer a unique whole-of-population platform for prevention through early detection and intervention. To date however, relevant workforce training has been minimal.ObjectivesWe report on an evaluation of state-wide workforce training to support MCH nurses to identify and respond to early relational trauma within parent-child dyads.DesignProcess and learning evaluation data were obtained at baseline (N = 1450), exit (n = 734) and follow-up (n = 651).Settings and participantsSpecialist training was developed and delivered to 1513 MCH staff in Victoria, Australia, via a 20-hour program of online learning and clinical skills workshops.ResultsAt baseline, across eight measures of confidence in recognizing and responding to relational trauma, 30–49% of nurses rated their confidence as low. Significant increases in all areas of self-rated learning were found post-training. Three months post-training, gains in confidence and capability were sustained, with no significant variations by participant role or setting. Overall program satisfaction was >90%. Continuing concerns at follow-up focused on pragmatic concerns about inadequacy of referral networks and appropriate intervention pathways.ConclusionsIn this evaluation of a state-wide training program for nurses working with early relational trauma, we found excellent uptake and program satisfaction, and results support learning impact and retention. Findings are discussed with regard to translation potential across early childhood settings.     

Australian and Danish nurses’ and midwives’ wellbeing during COVID-19: A comparison study

BackgroundMost investigations of nurses’ and midwives’ psychological wellbeing during the COVID-19 pandemic have been conducted in a single setting.AimTo assess and compare the psychological wellbeing of nurses and midwives in Australia and Denmark during the COVID-19 pandemic.MethodsNurses and midwives employed at four metropolitan health services in Australia and one in Denmark completed an anonymous online survey, which assessed depression, anxiety, and stress symptoms (The Depression, Anxiety and Stress Scale - 21 Items (DASS-21)), and sociodemographic and employment factors.FindingsCompleted surveys were received from 3001 nurses and midwives (1611 Australian and 1390 Danish). Overall, approximately one in seven of the nurses and midwives surveyed reported moderate to extremely severe levels of depression (n = 399, 13.5%), anxiety (n = 381, 12.9%) and stress (n = 394, 13.4%). Australian nurses’ and midwives’ scores on all DASS-21 subscales were significantly higher (representing higher levels of depression, anxiety and stress) than the scores for the Danish nurses and midwives. Fewer years of clinical experience, living in Australia and being employed on a part-time basis were significantly associated with higher levels of psychological distress.DiscussionA considerable proportion of nurses and midwives experienced distress during the COVID-19 pandemic; however, the proportion and severity varied by country. Australian nurses and midwives experienced higher levels of distress than their Danish colleagues.ConclusionNurses and midwives working in countries with relatively low numbers of COVID-19 cases and deaths are also likely to experience psychological distress. Nurses and midwives would benefit from targeted country-specific support and wellbeing initiatives.     

产科护士核心能力评价指标体系的构建及信效度检验

目的构建产科护士核心能力评价指标,为产科护士核心能力评价提供有效的测评工具。方法通过文献分析、参考相关量表基础上,应用Delphi法等构建产科专科护士核心能力评价指标体系,并以构建的指标体系为依据,编制自评问卷;采用该问卷对北京市5所三级甲等医院238名产科护士进行自评调查,以检验该指标体系的信效度。结果最终确立了包含一级指标5个(专业实践能力、专业发展能力、沟通协调能力、批判性思维能力、管理能力)、二级指标13个、三级指标68个的产科护士核心能力评价指标体系。指标体系的总体Cronbach’sα系数为0.896,内容效指数S-CVI为0.950,一级指标与总体相关系数为0.744~0.958(P<0.05)。结论产科核心能力评价指标体系可靠、信度较高,具有一定的区分度,可以作为后续产科护士培训和考核准入的有效测量工具。     

Delivering culturally competent care to the lesbian,gay, bisexual,and transgender (LGBT) population: Education for nursing students

PurposeDespite well-documented healthcare disparities in the lesbian, gay, bisexual, and transgender (LGBT) community, nursing education has lagged other health professions in promoting culturally competent care to members of this minority group.MethodsUsing national guidelines, the author developed an educational program for BSN students to improve competency in providing care for LGBT individuals. One hundred twenty-four students completed online modules and a simulation exercise, which explored LGBT healthcare topics. One hundred eight participants completed surveys pre-, post-, and 1 month after the intervention.ResultsOverall LGB competence scores improved from pre- (M = 4.42) to post-test (M = 5.20) and did not significantly decrease at one-month (M = 5.03, p < .001). Similar findings were observed in the transgender cultural competence scores (pre- (M = 4.02); post- (M = 5.08); one-month (M = 4.92, p < .001)).ConclusionEducational content focused on cultural competency for nurses may lead to improved health outcomes among the LGBT community.     

低年资护士核心能力和关怀能力现状及其相关性研究

正护士的核心能力是护士专业价值的集中体现,是建立在护理职责基础之上的知识、技能、态度、价值观的综合优势~([1])。Waston人性关怀理论指出"人性关怀是护理学的本质"~([2]),而良好关怀的结果是护理人员和患者皆达到人格的升华~([3])。低年资护士指从院校毕业后从事临床工作不超过3年的护士~([4])。目前各医院均较重视低年资护士基本技能和专业技能的培训~([5]),     

Bringing simulation to the classroom using an unfolding video patient scenario: A quasi-experimental study to examine student satisfaction,self-confidence,and perceptions of simulation design

BackgroundTeaching strategies to promote experiential learning in the classroom are important to facilitate students' clinical reasoning abilities. Using video to simulate unfolding patient scenarios in the classroom has the potential to engage students through active learning and to enhance their ability to connect theory to practice.ObjectivesStudy objectives were to: (1) Evaluate nursing students' satisfaction and self-confidence in learning and perceptions of the design of a simulated patient scenario delivered via video in the classroom and (2) Compare findings to students' satisfaction, self-confidence, and perceptions of the design of prior high-fidelity simulation experiences in the laboratory.DesignA quasi-experimental approach was used.SettingThe study setting was a nursing classroom at a University in the southeast United States.ParticipantsConvenience sampling was utilized and 54 students in their final semester of a pre-licensure baccalaureate nursing program participated.MethodsThe intervention was an unfolding video patient scenario delivered in the classroom. Prior to the intervention, participants completed two measurement tools to collect information about their satisfaction, self-confidence, and perceptions of the design of prior high-fidelity simulations. After the intervention, these tools were administered again to collect data about the video simulation experience in the classroom.ResultsParticipants had a higher level of satisfaction (p = 0.002) and self-confidence (p < 0.001) following the classroom intervention than for prior high-fidelity simulations in the laboratory. Student perceptions of the simulation design were more favorable for the classroom intervention than for prior laboratory simulations (p < 0.001).ConclusionsUse of unfolding video patient scenarios in the classroom can promote student engagement in learning. Nurse educators should consider this teaching strategy that provides students with opportunities to connect and apply classroom content to patient care.