临床护理人员关怀能力状况的调查

目的 调查临床护理人员关怀能力并分析相关因素,为提高临床护理人员关怀能力提供依据.方法 对北京市某所三级甲等综合医院参加工作1年及以上的172名临床护理人员进行关怀能力的问卷调查.结果 临床护理人员的关怀能力总分为(189.42±17.23)分,属于低水平;主管护师及以上临床护理人员的认知维度得分高于护师和护士(P＜0.05);国际部门急诊和病房护理人员的认知维度得分高于内科和外科病房护理人员(P＜0.05);有出国经历及有配偶、有子女的护理人员关怀能力较高(P＜0 05);年龄和工作年限与关怀能力认知得分呈正相关(P＜0.01).结论护理管理部门应参考引进国外先进人文关怀理念与技能,有针对性地加强临床护理人员关怀能力的培养.     

上海地区本科及以上临床护理人员循证护理认知现状及相关因素的调查

[目的]探讨上海地区本科及以上临床护理人员对循证护理的认知现状及影响护理人员开展循证护理的相关因素。[方法]对上海地区13所三级医院、2所二级医院的722名本科及以上临床临床护理人员进行问卷调查,其内容包括循证护理知晓情况、认知情况及影响开展循证护理的因素。[结果]93．2％本科及以上学历临床护理人员听说过循证护理,68．1％护理人员了解循证护理,56．2％护理人员认为非常需要开展连续、系统的循证护理专题培训;影响护理人员开展循证护理的因素很多,与护士的主观能力不足、认识不够、现有研究及客观条件局限性有关。[结论]本科及以上学历临床护理人员开展循证护理教育培训以及适合的培训计划的设计具有迫切性;对本科及以上学历临床护理人员开展循证护理教育培训对循证护理发展具有重要意义。     

上海地区本科及以上临床护理人员循证护理认知现状及相关因素的调查

[目的]探讨上海地区本科及以上临床护理人员对循证护理的认知现状及影响护理人员开展循证护理的相关因素.[方法]对上海地区13所三级医院、2所二级医院的722名本科及以上临床临床护理人员进行问卷调查,其内容包括循证护理知晓情况、认知情况及影响开展循证护理的因素.[结果]93.2%本科及以上学历临床护理人员听说过循证护理,68.1%护理人员了解循证护理,56.2%护理人员认为非常需要开展连续、系统的循证护理专题培训;影响护理人员开展循证护理的因素很多,与护士的主观能力不足、认识不够、现有研究及客观条件局限性有关.[结论]本科及以上学历临床护理人员开展循证护理教育培训以及适合的培训计划的设计具有迫切性;对本科及以上学历临床护理人员开展循证护理教育培训对循证护理发展具有重要意义.     

护理人员循证护理知识及技能的调查

目的探讨护理人员背景因素与循证护理知识和技能的关系.方法采用自制问卷调查法抽样调查146名护理人员对循证护理相关知识的理解和实施应用技能情况.结果经一元方差分析(多重比较)及Kruskal-Wallis H多独立样本非参数统计检验,不同学历、职称背景因素的护理人员对循证护理的理解程度和应用技能有显著性差异:本科与专科显著性水平P=1＞0.05,无显著性差异;本科与中专、专科与中专显著性水平均为P＜0.01,有显著性差异.护士与护师之间无显著性差异(P＞0.05),其余各组之间存在显著性差异(P＜0.01).结论学历是影响循证护理质量的重要因素之一,提高护理质量的根本在于提高护理人员的学历水平;不同职称的护理人员基本体现出其相应具备的理论知识和护理实践能力.     

循证护理在培养护理本科学生评判性思维中的应用

目的探讨护理本科生临床实习阶段的教学方法。方法调查47名护理本科生对循证护理知识的认识情况,针对影响认知因素对这些护理本科生采用循证护理教学方法,比较教学前后学生评判性思维能力及有关循证护理知识认知水平。结果教学后对循证护理相关知识及评判性思维各项特质得分均比教学前高,差异有统计学意义(P0.01);教育后专科理论成绩比教育前提高,差异有统计学意义(P0.05)。结论循证护理教学法有利于学生评判性思维能力的提高,促进专科知识的掌握。     

临床护理人员对循证护理认识的调查

目的通过调查上海市综合性医院护理人员对实施循证护理障碍和有利因素的认识,了解障碍产生的根源和有利循证护理开展的各因素。方法采用Funk等设计的循证护理障碍量表对上海市部分综合性医院的563名护理人员进行问卷凋查。结果不同学历、职务及职称的护士对实施循证护理障碍的认识在统计学上无差异（P〉0．05）;不同学历、职务及职称的护士对实施循证护理有利因素的认识在统计学上存在差异（P〈0．05）,但其中护师与护士相比较未显示有差异（P〉0．05）。结论循证护理是护理发展的必然趋势,要充分认识循证护理障碍所产生的根源,积极寻求促进循证护理开展的有利因素并有效地开展循证护理。     

护理人员循证护理相关认知调查及分析

目的:调查我院临床护理人员对循证护理的认知水平及相关因素和相关培训需求,为进一步提高我院护士循证护理能力和开展我院循证护理查房提供依据和指导。方法:应用自行设计的"临床护理人员循证护理调查问卷"对临床科室218名护士进行问卷调查。结果:我院护理人员循证护理认知水平普遍偏低,不同职称、学历、英语水平和职务的护理人员对循证护理认知水平均无统计学差异(P0.05);不同护龄护理人员的循证护理认知得分有差异(P0.05),护龄小于5年的护士比护龄5年以上的护理人员循证护理认知水平高。结论:临床护理人员对循证护理能力总体偏低,绝大多数护理人员对学习循证护理知识持积极态度,具有较强的学习意愿,护理管理者应从各个层面给予支持,积极制定相关对策开展循证护理实践。     

临床护理人员对循证护理认知、态度及应用现状分析

目的探讨临床护理人员对循证护理的认知、态度及应用程度.方法采用自设问卷调查法抽样调查北京市某三级甲等医院100名护理人员对循证护理相关知识的认知、态度及应用技能情况.结果不同学历及职称背景的护理人员对循证护理的理解程度和应用技能有统计学差异(P＜0.05).结论学历是影响循证护理质量的重要因素之一.     

循证护理模式对帕金森病患者认知功能、不良心理及生活质量的影响

目的:探讨循证护理模式对帕金森病患者认知功能、不良心理及生活质量的影响。方法:将收治的70例帕金森病患者随机分为对照组和观察组各35例,两组接受常规治疗,对照组采用优质护理模式,观察组采用循证护理模式,比较两组临床疗效、认知功能、不良心理及生活质量。结果:观察组总有效率高于对照组(P0.01);护理后两组认知功能评分及生活质量评分均高于护理前(P0.01),且观察组优于对照组(P0.01)。护理后两组焦虑和抑郁不良心理评分低于护理前(P0.01),且观察组优于对照组(P0.01)。结论:循证护理模式对帕金森病患者具有较好的护理效果,可改善患者的认知功能和不良心理,提高生活质量。     

护理人员埃博拉出血热感染控制认知的调查研究

目的:探讨护理人员对埃博拉出血热(EBHF)感染控制认知的现状。方法:采用简单随机抽样法,并使用EBHF认知量表对泉州市某医院共395名护理人员EBHF感染控制认知进行调查。结果:护理人员获取EBHF讯息的渠道最主要为新闻媒体报道(77.97%),其次为医院宣传56.20%,第三是杂志(40.00%),培训率仅为30.13%;护理人员对EBHF的认知总均分为(54.53±9.54)分,处于中等水平,且不同特征的护理人员在认知水平上存在差异,其中年龄≤30岁组的认知水平明显低于41岁以上组(P0.05);主管护师组显著高于护师(P0.05)和护士组(P0.05);高护理年资(护龄21年以上)组明显高于低年资(护龄6年)组(P0.05);急诊科护士的得分明显高于内科、外科(P0.05)。结论:护理人员对EBHF的认知为中等水平,故应加强护理人员EBHF相关知识的宣传教育与培训,提高其应对突发性EBHF的自我保护意识。     

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。