现场追踪与mini-CEX考核在新护士独立上岗前考核中的应用

目的探索现场追踪与迷你临床演练评估(mini-cex)考核法在新护士独立上岗前临床综合实践能力考核中的效果。方法将2013年的230名新护士作为对照组,2014年的201名新护士作为观察组。对照组按传统床边实践能力考核法进行考核,观察组则采取现场追踪与mini-cex相结合的方法,评价新护士护理面谈技能、护理评估检查能力、专业态度、临床判断与解决问题、沟通技能、组织效能、整体临床胜任能力。计算两组考核所需时间及患者拒绝或不满的次数。并于考试结束后对新护士及教师进行考核方法的满意度调查。结果观察组新护士护理面谈技能等7项能力平均分都达到合格要求,但单项能力未达合格比例为5.0%~15.9%,观察组考核所需时间及患者拒绝或不满频次显著少于对照组(均P0.01);新护士及教师对追踪与mini-CEX考核方法的满意率为88.6%~100.0%。结论现场追踪与mini-CEX考核法是一种客观、有效、贴近临床且被考核双方接受及认可的临床综合能力考核方法。

Application of on-site tracer activity and the Mini-Clinical Evaluation Exercise (mini-CEX) for assessing newly graduated nurses before independent practice

Objective To explore the effects of owsite tracer activity and the rnini-CEX for assessing newly graduated nurses before independent practice.Methods Two hundred and thirty newly graduated nurses employed in 2013 were treated as the control group and were subjected to traditional bed-side examination for assessing their practical skills,while their counterparts employed in 2014(n=201) were assigned into the observation group and received on-site tracer activity and mini-CEX for assessing nursing intcrviewing skills,physical examination/assessment skills,hurnamstic quali ties/professionalism,clinical judgment and problem-solving ability,counseling skills,organization/efficiency,and overall clinical competence.Time spent on examination and frequencies of patient's rejection or dissatisfaction were recorded for both groups.Nurses' and teachers' satisfaction with the examination were surveyed at the end of the exarninatior.Results All nurses in the observation group were qualified,but 5.0％-15.9％ of them was not qualified in some certain skills.The observation group required shorter time for completion of the exam and had less patients' rejections or dissatisfactions than the control group (P＜0.01 for both).Nurses' and teachers' satisfaction with the new examination was achieved 88.6％-100％.Conclusion On-site tracer activity and rnini-CEX is objective,effective and acceptable for assessing nurse's overall clinical competence.