儿科危重症护理情景模拟教学
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摘要
目的通过探讨在不同时间点对儿科危重症护士实施情景模拟教学,并评价其对护理人员岗位胜任力培养、能力维系的效果,为今后发展临床护理教育提供借鉴。方法抽取PICU护士共30人分为A、B两组参与研究。分别对两组学员的基线成绩(T0)、课程开展第2个月(T1)、第4个月(T2)、第6个月(T3)、第8个月(T4)和第14个月(T5)前后6次的技能型、非技能型能力得分、理论知识前测与后测的成绩进行比较分析,并对测试得分的影响因素进行分析。结果两组学员在模拟教学开展前各项能力均无差异性。重复测量方差分析显示两组学员的各项能力在开展模拟教学后每一阶段均有显著提高。多元逐步回归结果显示技能型能力得分仅与非技能型能力得分呈正相关关系(R=0.882),而与案例的危重度、护理人员工作年限均无相关关系。结论短期连续的情景模拟教学能有效培养和提高护理人员的胜任能力,但长期定期的能力维系培训也同样值得重视。
Objective To explore the simulation training for pediatric ICU( PICU) nurses and evaluate its effects on the cultivation and maintenance of nurses' competency,so as to create pediatric critical care nursing simulation curriculum in the future. Methods A total of 30 PICU nurses were selected and divided into group A and B to participate in the study. A total of 6 times,including skill and non-skill scores,were obtained by testing the baseline scores( T0) of the two groups and the second month( T1); the fourth month( T2); the sixth month( T3); the eighth month( T4) and the 14 th month( T5) of the course. Also students' theoretical knowledge was tested via the pre-test and post-test and comparison was made. Multiple regression analysis was carried out on the influencing factors of the simulation test score. Results There was no difference in the ability of the two groups before the simulation teaching.Repeated measures showed that the ability of students in both groups improved significantly in each stage after the simulation teaching.The results of multiple stepwise regression showed that the score of skill-ability was positively correlated with the score of non-skill-ability( R = 0.882),but was not correlated with the severity of the case and the length of service of the nursing staff. Conclusion Short-term continuous simulation training can effectively cultivate and improve comprehensive skills of nursing staff,but long-term discontinuous ability maintenance training is also worthy of attention.
Objective To explore the simulation training for pediatric ICU( PICU) nurses and evaluate its effects on the cultivation and maintenance of nurses' competency,so as to create pediatric critical care nursing simulation curriculum in the future. Methods A total of 30 PICU nurses were selected and divided into group A and B to participate in the study. A total of 6 times,including skill and non-skill scores,were obtained by testing the baseline scores( T0) of the two groups and the second month( T1); the fourth month( T2); the sixth month( T3); the eighth month( T4) and the 14 th month( T5) of the course. Also students' theoretical knowledge was tested via the pre-test and post-test and comparison was made. Multiple regression analysis was carried out on the influencing factors of the simulation test score. Results There was no difference in the ability of the two groups before the simulation teaching.Repeated measures showed that the ability of students in both groups improved significantly in each stage after the simulation teaching.The results of multiple stepwise regression showed that the score of skill-ability was positively correlated with the score of non-skill-ability( R = 0.882),but was not correlated with the severity of the case and the length of service of the nursing staff. Conclusion Short-term continuous simulation training can effectively cultivate and improve comprehensive skills of nursing staff,but long-term discontinuous ability maintenance training is also worthy of attention.
引文
[1]高恒妙.儿科急诊和危重症医学的临床研究进展[J].中国急救医学,2014,34(1):21-25.
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[3]梁菊,李瑛.模拟医学教育:医学教学发展的必然趋势[J].肾脏病与透析肾移植,2015,24(3):266-269.
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[6]陆国平.儿童急重症生命支持技术培训进展[J].中国小儿急救医学,2012,19(1):9-12.
[7]Cole Edmonson,Alex Klacman,Josh Tippy.Nurse Leaders as Disruptive Innovators in Cardiopulmonary Resuscitation Competency[J].Nurse leader,2016(6):191-194
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[9]郭红霞,陈红.仿真模拟教学在我国护理教育中的应用现状[J].护理研究,2013,27(9):2939-2940.
[10]Cant RP,Cooper SJ.simulation-based learning in nurse education:systematic review[J].J Adv Nurs,2010,66(1):3-15.
[11]Tonya Rutherford-Hemming,Carla Nye,Cathy Coram.Using Simulation for Clinical Practice Hours in Nurse Practitioner Education in The United States:A Systematic Review[J].Nurse Education Today,2016,37(2):128-135.
[12]Mary E.W.Dankbaar,Jelmer Alsma Els H,Jansen JG,et al.An experimental study on the effects of a simulation game on students’clinical cognitive skill and motivation[J].Adv in Health Sci Educ,2016(21):505-521
[13]张慧,绳宇,张欣,等.模拟教学在护理学基础课程教学中的实施与效果[J].护理管理杂志,2012,9(12):650-652.
[14]Knudson J D,Neish S R,Cabrera A G,et al.Prevalence and outcomes of pediatric cardiopulmonary resuscitation in the United States:an analysis of the Kid’s Inpatient Database[J].Critical Care Med,2012,40(11):2940-2944.
[15]Lopez-Herce J,Del Castillo J,Matamoros M,et al.Factors associated with mortality in pediatric in hospital cardiac arrest:a prospective multicenter multinational observational study[J].Intensive Care Med,2013,39(2):309-318.
[16]Lowry A W,Knudson J D,Cabrera A G,et al.Cardiopulmonary resuscitation in hospitalized children with cardiovascular disease:estimated prevalence and outcomes from the kids’inpatient database[J].Pediatric Critical Care Med,2013,14(3):248-255.
[17]Alonge O,Hyder AA.Reducing the global burden of childhood unintentional injuries[J].Arch Dis Child,2014,99(1):62-69.
[18]Kochanck P M,Carney N,Adelson P D,et al.Guidelines for the acute medical management of severe traumatic brain injury in infants,children,and adolescents[J].Pediatric Crit Care Med,2012,13(Suppl 1):S1-82.
[19]Christensen R,Voepel-Lewis T,Lewis I,et al.Pediatric cardiopulmonary arrest in the postanesthesia care unit:analysis of data from the American Heart Association Get With the Guidelines-Resuscitation registry[J].Paediatr Ansest,2013,23(6):517-522.
[20]Jesse Spurr,Jonathan Gatward,et al.Top 10 tips to get started with in situ simulation in emergency and critical care departments[J].Emerg Med J,2016,3(33):514-516
[21]Stine Gundrosen,Erik Solligard,Petter Aadahl.Team competence among nurse in an intensive care unit:The feasibility of in situ simulation and assessing non-technical skills[J].Intensive and Critical Care Nursing,2014,30(6):312-317.
[2]王莹,钱素云,李壁如.我国儿科高级生命支持的培训现状及推广意义[J].中国小儿急救医学,2014,19(2):189-191.
[3]梁菊,李瑛.模拟医学教育:医学教学发展的必然趋势[J].肾脏病与透析肾移植,2015,24(3):266-269.
[4]王荃,高恒妙,钱素云.场景模拟教学在医学生儿童高级生命支持培训的应用效果[J].中国小儿急救医学,2016,23(2):103-106.
[5]张京煜,梁涛,陈京立,等.模拟教学对护理专业教师的挑战和应对策略[J].中华护理教育,2011,5(8):236-237.
[6]陆国平.儿童急重症生命支持技术培训进展[J].中国小儿急救医学,2012,19(1):9-12.
[7]Cole Edmonson,Alex Klacman,Josh Tippy.Nurse Leaders as Disruptive Innovators in Cardiopulmonary Resuscitation Competency[J].Nurse leader,2016(6):191-194
[8]杨明,钱素云,杨军华,等.互动式教学在儿科高级生命支持培训中的实践与效果[J].中华医学教育杂志,2010,30(2):462-464.
[9]郭红霞,陈红.仿真模拟教学在我国护理教育中的应用现状[J].护理研究,2013,27(9):2939-2940.
[10]Cant RP,Cooper SJ.simulation-based learning in nurse education:systematic review[J].J Adv Nurs,2010,66(1):3-15.
[11]Tonya Rutherford-Hemming,Carla Nye,Cathy Coram.Using Simulation for Clinical Practice Hours in Nurse Practitioner Education in The United States:A Systematic Review[J].Nurse Education Today,2016,37(2):128-135.
[12]Mary E.W.Dankbaar,Jelmer Alsma Els H,Jansen JG,et al.An experimental study on the effects of a simulation game on students’clinical cognitive skill and motivation[J].Adv in Health Sci Educ,2016(21):505-521
[13]张慧,绳宇,张欣,等.模拟教学在护理学基础课程教学中的实施与效果[J].护理管理杂志,2012,9(12):650-652.
[14]Knudson J D,Neish S R,Cabrera A G,et al.Prevalence and outcomes of pediatric cardiopulmonary resuscitation in the United States:an analysis of the Kid’s Inpatient Database[J].Critical Care Med,2012,40(11):2940-2944.
[15]Lopez-Herce J,Del Castillo J,Matamoros M,et al.Factors associated with mortality in pediatric in hospital cardiac arrest:a prospective multicenter multinational observational study[J].Intensive Care Med,2013,39(2):309-318.
[16]Lowry A W,Knudson J D,Cabrera A G,et al.Cardiopulmonary resuscitation in hospitalized children with cardiovascular disease:estimated prevalence and outcomes from the kids’inpatient database[J].Pediatric Critical Care Med,2013,14(3):248-255.
[17]Alonge O,Hyder AA.Reducing the global burden of childhood unintentional injuries[J].Arch Dis Child,2014,99(1):62-69.
[18]Kochanck P M,Carney N,Adelson P D,et al.Guidelines for the acute medical management of severe traumatic brain injury in infants,children,and adolescents[J].Pediatric Crit Care Med,2012,13(Suppl 1):S1-82.
[19]Christensen R,Voepel-Lewis T,Lewis I,et al.Pediatric cardiopulmonary arrest in the postanesthesia care unit:analysis of data from the American Heart Association Get With the Guidelines-Resuscitation registry[J].Paediatr Ansest,2013,23(6):517-522.
[20]Jesse Spurr,Jonathan Gatward,et al.Top 10 tips to get started with in situ simulation in emergency and critical care departments[J].Emerg Med J,2016,3(33):514-516
[21]Stine Gundrosen,Erik Solligard,Petter Aadahl.Team competence among nurse in an intensive care unit:The feasibility of in situ simulation and assessing non-technical skills[J].Intensive and Critical Care Nursing,2014,30(6):312-317.