在大学校园开展社区健康促进实践教学的设计与实施

目的 探讨对护理本科生在大学校园开展社区健康促进实践教学的实施方法及效果.方法 在2008级本科社区护理教学中,利用大学校园开展群体健康促进活动,对活动满意度进行问卷调查,并对护理专业学生的实践成绩与反思报告进行分析.结果 学生在健康促进实践活动中的平均成绩为91.5分;健康促进活动的参与者对活动各项指标满意率均为100%:80%以上的学生认为该活动促进了他们实践能力、创新能力、团队合作能力的提高,有助干增强职业认同感.结论 在大学校园内开展社区健康促进实践活动有助于提高护生对社区健康促进理论的应用能力和自身综合素质.     

小组合作学习模式在护理教育学实践课教学中的应用

探讨小组合作学习在护理教育学实践课教学的应用。将小组合作学习模式应用于12个班890名学生的护理教育实践课教学，以问卷调查其效果。结果显示小组合作学习能增强学生团结协作，提高其学习兴趣和积极性，并能促进其认知发展，提高多种能力。     

不同层次护生学习策略的调查分析与对策

学习策略是学生在形成概念和知识结构的过程中如何运用各种认知，过程及其不同组合形式开展学习活动的技术和方法。我们通过调查专本连读和高职护生的学习策略，发现其特点与差异，实施因材施教的学习策略性教学，教会学生学习，促进学生的自主学习能力和终身学习能力的发展。     

小组合作性学习对护理本科学生自主学习能力的影响

[目的]探讨小组合作性学习对护理本科学生自主学习能力的影响。[方法]将2009级46名普通班学生设为对照组,将2009级40名急危重症班学生设为实验组,在儿科护理学教学中对照组采用传统教学法,实验组采用小组合作性学习的教学方法,并于课程结束时采用自主学习能力量表评价两组学生的自主学习能力。[结果]实验组学生自主学习能力得分明显高于对照组(P<0.05)。[结论]小组合作性学习有利于提高护理本科学生的自主学习能力。     

《护理教育学》实践教学中小组合作学习法的运用探索

目的:探讨小组合作学习模式在《护理教育学》实践教学中的应用效果。方法:将学生分为20个小组,每组5~6人,每组推选一名小组长,集体讨论,分工合作,以小组为单位进行汇报,以团体的成绩为评价标准,授课教师点评,课程结束后填写评价表。结果:学生对小组合作学习模式认可度达98.02%,认为其能增强学生团队合作能力,提高学习兴趣,并能促进教学技能提高,发展多种能力。结论:小组学习合作模式应用于《护理教育学》实践教学中值得进一步推广和深入研究。     

以大学生社团为平台培养护理高职生的科研与创新能力

通过对护理高职生科研意识和能力培养的问卷调查,了解学生对科研能力培养的认识,采用在学生社团中开展科研宣传、成立科技活动小组、创办学生科普刊物、开办科技沙龙和讲座、开展科技创新活动读书征文及科研论文写作比赛、科技创新演讲赛、科技制作作品展示等活动,倡导一种良好的科研创新氛围,促进学生科研意识的形成和科研创新能力的培养.     

《护理学基础》网络课程的建设与应用

目的 了解《护理学基础》网络课程的教学效果,以进一步完善网络课程的设制,达到丰富教学内容,改革教学手段,实现教育资源共享和提高教学质量的目的.方法 充分利用学校“THEOL清华教育在线”网络教学平台,对《护理学基础》网络课程进行建设.对我校2008级141名护理本科生开展《护理学基础》网络课程教学实践,并对其教学效果进行评价.结果 72.0％的学生对网络课程学习适应性较强,75.0％的学生认为网络课程资源丰富,68.0％的学生赞同网络教学平台能代替部分课堂教学.网络课程在提高学生自主学习能力、协作学习能力和研究性学习能力方面,学生满意度达到69.6％～78.5％,网络课程有利于对教学效果真实反馈的满意度达到75.0％.结论 开展《护理学基础》网络课程建设非常必要,能较好地实现教学资源的共享,是一种有效的辅助教学方法,有助于学生自主学习能力、协作学习能力、研究性学习能力和实践能力的培养.     

内科护理学技能考核改革初探

目的 探索适合内科护理学技能考核的新方法,促进学生临床能力的提高.方法 结合客观结构化临床考试方法和合作学习模式,采用模拟情境小组考核法,对117名护理专业学生的临床护理技能进行考核,并调查其效果.结果 99名(84.6%)学生考核成绩在中等以上;回收的107份有效问卷中,大多数学生认为考核有利于各项临床能力的提高.结论 该考核方法促进了理论与实践的结合,密切了师生联系,有助于学生临床综合能力的提高.     

多元文化护理课程自主学习模式的构建与应用

目的培养护理学专业学生自主学习能力,提高人文类课程的教学效果。方法针对教学中存在的问题,在2011年构建并实施自主学习模式,以自主学习指南、学生独立认知、小组合作主题探究、教师导学答疑为要素,加强过程管理。结果在对239名本科学生调查中发现,学生对教学满意度和自我评价较高,实施后学生的自主学习能力提高(P<0.05)。结论自主学习模式有利于学生自主学习习惯的养成,提高自主学习能力,有利于人文课程知识的学习和内化,也有利于自我可持续发展。     

护理临床实践教学中学生元认知策略培养初探

探讨了在护理临床实践教学中对学生元认知策略的培养.包括从丰富学生的元认知知识,培养学生的元认知策略,提高护理实践教学效果.认为现代护理观要求从全新的角度培养护理人才,在有限的临床实践教学中,加强元认知策略的培养有助于提高学生的元认识能力,有助于学生学会如何学习、思考,能促进个性化自主学习,提高临床护理实践能力和创新性思维能力.     

专业组长在护理质量控制中的作用

目的探讨专业组长在护理质量控制中的作用。方法具有大专学历,护师或以上职称者轮流担任,经过三年实践,评选出一部分工作出色的专业组长继续担任。结果低年资及聘用护士的工作能力得到明显提高;对病人实施系统化的健康教育,调动病人的积极性,促进病人的康复;协助护士长的督察、管理,提高护理质量,减少护理差错。结论专业组长在临床护理中,提高了临床护理的质量及健康教育的内涵,改善了护患关系,改变了护士的专业形象。     

护理本科生自主学习能力调查与分析

目的了解在校护本科生自主学习能力,以利于有针对性地进行自主学习培养。方法采用自主学习自评量表（SRSSDL）对183名护理本科生进行调查。结果不同年级护理本科生的自主学习能力总分及4个维度得分差异有统计学意义（P〈0．05）,专业态度对自主学习影响有统计学意义（P〈0．05）。结论护理本科生自主学习能力较强,护理教育者应重视增强学生专业认同感,对不同年级护理本科生的自主学习给予有针对性的培养。     

Educational intervention to increase nurses’ knowledge,self-efficacy and usage of telehealth: A multi-setting pretest-posttest study

The widespread use of telehealth, providing healthcare remotely, is hampered by various barriers. Dutch nurses currently working in practice never received education in this new way of healthcare delivery. Education is frequently suggested as a strategy to overcome barriers in telehealth use. However, the nature and effectiveness of such education has not yet been specified and tested in practice. In a previous study, we identified 14 nursing telehealth activities and accompanying competencies. In the current study, we established the effectiveness of training in these competencies on nurses' subjective knowledge, self-efficacy and usage of telehealth. A two-day tailored training program in nursing telehealth activities was evaluated in a Dutch context among 37 participants across three settings: (a) twelve primary care (PC), (b) fourteen homecare (HC) and (c) eleven hospital (H) nurses. In each team, telehealth knowledge significantly increased during the training sessions. In each team, nurses' telehealth self-efficacy also significantly increased 6–10 weeks after the training. After the training, the number of remote consultations increased from 2 to 12 in primary care, 12 to 35 in homecare and decreased from 28 to 17 in the hospital setting. We conclude that training nurses in telehealth activities contributes to their knowledge and self-efficacy.     

Promoting cognitive and metacognitive reflective reasoning skills in nursing practice: self-regulated learning theory

BACKGROUND: Effective clinical reasoning in nursing practice depends on the development of both cognitive and metacognitive skills. While a number of strategies have been implemented and tested to promote these skills, educators have not been able consistently to predict their development. Self-regulated learning theory suggests that this development requires concurrent attention to both the cognitive and metacognitive dimensions of reasoning in nursing care contexts. AIMS: This paper reports on a study to explore the impact of self-regulated learning theory on reflective practice in nursing, and to advance the idea that both cognitive and metacognitive skills support the development of clinical reasoning skills. METHODS: Integrative review of published literature in social science, educational psychology, nursing education, and professional education using the Cumulative Index to Nursing and Allied Health (CINAHL), Educational Resource Information Center (ERIC), and American Psychological Association (PsychInfo) Databases. The search included all English language articles with the key words clinical reasoning, cognition, critical thinking, metacognition, reflection, reflective practice, self-regulation and thinking. FINDINGS: Reflective clinical reasoning in nursing practice depends on the development of both cognitive and metacognitive skill acquisition. This skill acquisition is best accomplished through teaching-learning attention to self-regulation learning theory. A critical analysis of the literature in the areas of critical thinking and reflective practice are described as a background for contemporary work with self-regulated learning theory. It is apparent that single-minded attention to critical thinking, without attention to the influence of metacognition or reflection, is but one perspective on clinical reasoning development. Likewise, single-minded attention to metacognition or reflection, without attention to the influence of critical thinking, is another perspective on clinical reasoning development. While strategies to facilitate critical thinking and reflective practice have been used in isolation from each other, there is evidence to suggest that they are inextricably linked and come together with the use of self-regulated learning prompts. CONCLUSIONS: Students and practising nurses are able to improve their cognitive and metacognitive skills in clinical contexts by using self-regulated learning strategies. The self-regulated learning model in nursing is offered to support teaching and learning of reflective clinical reasoning in nursing practice contexts.     

基于职业核心胜任力培养的护理学基础第二课堂活动

目的 探讨护理学基础第二课堂活动的应用方法及对提高护理本科生核心胜任力和综合素质培养的作用.方法 以学习理论基础为指导,设计第二课堂活动方案,在2008级护理本科生中实施.结果 参与人数最多的活动是病例收集、技能比赛、课件比赛.参与的学生认为该活动使基本知识和技能得到了巩固和提高,提高了信息获得能力和学习兴趣.同时,也提出了缺乏教师指导、没有时间、信息资源缺乏、活动难度过大等问题.结论 护理学基础第二课堂活动有助于巩固学生对基本知识和技能的掌握,培养职业核心胜任力.应针对学生遇到的问题,进一步完善第二课堂活动的设计.     

品管圈在漏斗胸术后早期下床活动中的应用

目的 探讨品管圈(QCC)在提高漏斗胸术后患儿早期下床活动依从性中的应用效果.方法 成立品管圈小组,以"提高漏斗胸术后患儿早期下床活动依从性"为主题,分析相关因素,制定对策并加以实施,经由效果确认并结合临床实际制定标准化流程以便持续改进.结果 漏斗胸术后患儿早期下床活动依从性由13.3%升至56.7%(目标值53.5%)(P<0.05),另外,品管后患儿在便秘、并发症等方面较品管前有所改善,QC团队的品管能力综合评分由品管前(19.50±4.116)分提高到品管后的(24.20±4.158)分(P<0.05).结论 开展QCC提高了漏斗胸术后患儿早期下床活动依从性,减少便秘,促进患儿术后康复,改善护理服务品质,不仅提升了护理质量,更有益于护理团队建设.     

Time changes for scheduled nursing assessments: impact on clinical decisions and patient discharge

Using a shared governance model, a clinical nursing practice change was implemented to increase collaborative decision making among health care providers at morning rounds. The goal of this project was to improve nursing workflow at the beginning of the shift and improve patient flow by discharging patients earlier. By changing the time of morning vital signs and nursing assessments from 0800 to 0600, staff reported increased collaboration among the multidisciplinary team and improved nursing workflow.     

What is the nursing team involvement in maintaining and promoting the mobility of older adults in hospital? A grounded theory study

Aims of the paper

To present a grounded theory of the nursing team involvement in the process of maintaining and promoting the mobility of hospitalised older adults.

Background

Being able to mobilise is an important determinant of quality of life in late adulthood. However, advancing age is often accompanied by worsening mobility, which may deteriorate further as a result of illness and particularly hospitalisation. Targeted in-patient rehabilitation interventions may have the capacity to maintain and promote older adults’ mobility. Some authors suggest that the nursing team may have a central role in such activities.

Objectives

The study set out to describe the involvement of the nursing team in the process of maintaining and promoting the mobility of hospitalised older adults. It also sought to understand how members of the nursing team viewed their work in relation to physiotherapists and in relation to hospital policy on patient handling.

Design

Grounded theory provided the philosophical and structural underpinning to the study.

Settings

Data collection centred on three clinical settings which included a general rehabilitation ward, a regional spinal injuries unit and stroke rehabilitation ward.

Participants

Semi-structured interviews with 39 rehabilitation staff and 61 h of non-participant observation comprised the data set.

Findings

The nursing team involvement in patients’ mobility maintenance and rehabilitation was explained by the core category ‘care to keep safe.’ This category identified how the nursing team focused primarily on preventing patient problems rather than focusing on rehabilitation goals. A number of contextual factors in the workplace meant that the nursing team found it difficult to engage in activities to support mobility maintenance and rehabilitation.

Conclusions

Significant changes in the micro and macro context for rehabilitation practice are needed to enable the nursing team to engage more fully in the processes of mobility rehabilitation. Nurse-led initiatives which allow the nursing team to take an active role in implementing intentional strategies to maintain and promote mobility should be implemented and trialled for effectiveness.