长春市三甲医院临床护理人员循证实践相关能力调查与分析
摘要
循证护理是近年来我国护理领域的热点问题,它先进的临床思维理念和科学的工作方法使护理决策更加规范化、科学化、人性化。随着研究的深入,循证护理给社会、护理学科、病患以及护士带来的益处也逐渐被人们所认识。循证护理的实践将使护理学科面临一个崭新的时代,即将护理研究与护理实践有机结合,使传统的经验式护理得以改变,使护理真正成为一门以研究为基础的学科。护理人员是实施循证护理的主体,因此,在促进循证护理实践的诸多因素中,临床护理人员本身的能力很重要,护理人员是否具备相关的能力来实践循证护理是影响循证护理发展的“内因”,即护理人员的相关能力高低直接决定了循证实践能否顺利进行。本文对长春市三甲医院临床护理人员循证实践相关能力中的认知能力、评判性思维能力、信息能力和科研能力进行调查,分析我市护理人员循证护理的相关能力现状,并提出建议,为今后进一步在临床推广循证护理的人员培训和继续教育提供依据和指导,为更多院校开展循证护理教育提供方向和参考,也为循证护理早日在我省开展提供理论依据。
Background: EBN emphasizes the obtainment of latest evidence and a combination of nurses’experience with patients’needs to achieve more scientific and humanized nursing decisions.The benefits of evidence-based nursing on governments and nursing displine,nurses and patients have been recognized by more with the deeping of related study,more and more nurses eager to use this new concept of effective care to improve the quality of nursing. Nurses are the perpetrators of Evidence-based Practice,so their related ability is the key to develop EBN.
Objectives: To survey clinical nurses’cognitive skills, critical thinking ability, scientific research, information capacity in EBN-related capacity , Through investigation,we analyze the present situation of nurses’EBN-related capacity,and propose measures to provide a theoretical basis for the development of EBN in our city in the future.
Methods: Self-making a questionnaire by combining the domestic and overseas EBN-related medical documents and the suggestions of experts,then carried out an investigation to determine the current status of evidence-based practice of nurses in top-ranked hospitals of Changchun.
Results and suggestions:
1、The results suggest that nurses’abilities of EBN are not promising.
1.1 The cognitive ability toEBN is poor. There were significant differences among different titles, duties, different levels of hospital nurses .
1.2 Critical thinking ability overall is not positive,and only open thinking is positive and the remaining dimensions are not positive.
1.3 Most nurses are poor in English; In the information age, the nurses also gained the information by colleague's mutual exchanges; there are many difficulties in the collection and use of information, the biggest difficulty is the lack of time to find information.
1.4 The level of scientific research is lower, teaching hospital is high level of scientific research in the three hospitals.
2、Suggestions:
2.1 Worked-out strategies on the training of clinical include: integrating the conception of EBN into nurse training project; promoting EBN continuing education to make all to know EBN knowledge; improving the nurses’EBN related capacity in effective way; reducing the work load of nurses, and striving for administrative support .
2.2 On the education to school students include: changing the students’concepts, and training students Critical Thinking; training EBN capacity of students; strengthening the integration of theory and practice; improving the professional quality of teachers.
Background: EBN emphasizes the obtainment of latest evidence and a combination of nurses’experience with patients’needs to achieve more scientific and humanized nursing decisions.The benefits of evidence-based nursing on governments and nursing displine,nurses and patients have been recognized by more with the deeping of related study,more and more nurses eager to use this new concept of effective care to improve the quality of nursing. Nurses are the perpetrators of Evidence-based Practice,so their related ability is the key to develop EBN.
Objectives: To survey clinical nurses’cognitive skills, critical thinking ability, scientific research, information capacity in EBN-related capacity , Through investigation,we analyze the present situation of nurses’EBN-related capacity,and propose measures to provide a theoretical basis for the development of EBN in our city in the future.
Methods: Self-making a questionnaire by combining the domestic and overseas EBN-related medical documents and the suggestions of experts,then carried out an investigation to determine the current status of evidence-based practice of nurses in top-ranked hospitals of Changchun.
Results and suggestions:
1、The results suggest that nurses’abilities of EBN are not promising.
1.1 The cognitive ability toEBN is poor. There were significant differences among different titles, duties, different levels of hospital nurses .
1.2 Critical thinking ability overall is not positive,and only open thinking is positive and the remaining dimensions are not positive.
1.3 Most nurses are poor in English; In the information age, the nurses also gained the information by colleague's mutual exchanges; there are many difficulties in the collection and use of information, the biggest difficulty is the lack of time to find information.
1.4 The level of scientific research is lower, teaching hospital is high level of scientific research in the three hospitals.
2、Suggestions:
2.1 Worked-out strategies on the training of clinical include: integrating the conception of EBN into nurse training project; promoting EBN continuing education to make all to know EBN knowledge; improving the nurses’EBN related capacity in effective way; reducing the work load of nurses, and striving for administrative support .
2.2 On the education to school students include: changing the students’concepts, and training students Critical Thinking; training EBN capacity of students; strengthening the integration of theory and practice; improving the professional quality of teachers.
引文
1. 王佳良.循证医学[M].北京:人民卫生出版社,2005,3
2. 李峻,吴红梅,董碧蓉等.循证临床实践者[J].中国循证医学杂志,2005,5(7):568-573
3. Sackett DL.etal.Evidence-based medicine:What it is and What it isn’t[J].British Medical Journal,1996(312):71-73
4. 胡 雁 . 正 确 认 识 循 证 护 理 推 动 护 理 实 践 发 展 . 中 华 护 理 杂 志 ,2005,40(9):714-713
5. DiCenso A,Collum N,Ciliska D.Implementing evidence-based nursing:some misconceptions[J].Evi Based Nurs,1998,1:38-40
6. 马玲,钟玉杰,周艳.从近年循证护理论文发表情况分析我国循证护理的发展[J].护理研究,2007,21(5A):1209-1210
7. 冯先琼,成翼娟,李继平等.循证护理:护理发展新动向[J].实用护理杂志,2001,17(6)∶1-2
8. 张文红,张秀云,朱爱珍等.高血压病的循证护理[J].实用护理杂志,2003,19(8):1-2
9. 沈洁 ,董晓萍,周军.循证护理在产后尿潴留患者护理实践中的应用[J].解放军护理杂志,2003,20(11):61-62
10.刘新.循证护理在烧伤气管切开病人中的运用[J].护理研究,2006,20(10A):2597-2598
11. 杨芝芳,李学军,陈瑶琨.谈护理的新概念———循证护理[J].中国疗养医学,2003,12(6):445
12. 余咏,胡华,范珊红等.循证护理———临床护理发展的必然[J].西北国防医学杂志,2003,24(4):305-306
13. 洪军,郝艳会,盖学良.循证医学与循证护理[J].国外医学·护理学分册,2004,23(1):43-47
14. Allery LA,Owen PA,Robling MR.Why general practitioners and Consultants change their clinical practice:a critical incidentstudy.BMJ,1997,314(7084):8702874
15. Profetto-Mc,Grath J.Critical thinking and evidence-based practice.J Prof Nurs,2005,21(6):364-371
16. 陈向韵.成人高等护理教育中循证能力的培养[J].护理研究,2004,18(1):174-175
17. 黄金月.遵循科学证据促进循证护理实践中国循证医学杂志,2004,4(12):817-820
18. Shorten A,Wallace MC. Developing information literacy: a key to evidence-based nursing[J]. International Nursing Review,2001(48):86-92
19. 傅蓉,程云.临床护理人员循证护理认知水平的调查与分析[J].上海护理,2005,5(2):19-21
20. 彭美慈,汪国成,陈基乐等.批判性思维能力测量表的信效度测试研究[J].中华护理杂志,2004,39(9):644-647
21. 詹蓓,郭健,徐凤等.护士在循证中的信息能力及应对措施[J].中华护理杂志,2005,40(5):377-379
22. 万丽红,林吟,梁嘉定.广东省循证护理现状分析及对策[J].中华护理杂志,2004,39(4):270-272
23. 周敏,夏晓清,陈丽莉等.护理人员循证护理认知现状调查[J].护理研究,2006,20(8B):2093-2094
24. 曹力.批判性思维在护理工作中的应用[J].国外医学·护理学分册,2002,21(4):162
25. Facione NC,Facione PA,Giancario C.California Critical Thinking Disposition Inventory(CCTDI).Millbrae:California Academic Press,2001
26. Betsy SP,Gloria M. Clarifying the concept of critical thinking in nursing[J].The Journal of Nursing Education,1993,32(9):425-428
27. 嵇艳,崔焱.护理人员循证实践基本素质构成的研究[J].中国实用护理杂志,2007,23(2B):6-8
28. 郭瑞红. 评判性思维的态度倾向性及影响因素[J]. 中华护理教育,2006,3(3):135-137
29. Shorten A,Wallace MC,Crookes PA. Developing information literacy: a key to evidence-based nursing .International Nursing Review, 2001, (48):86-92
30. 詹蓓,郭健,徐凤等.护士在循证中的信息能力及应对措施[J].中华护理杂志,2005,40(5):377-379
31. Fineout-Overholt E,Johnston L.Teaching EBP: A Challenge for Educators in the 21St Century[J]. Worldviews on Evidence-Based Nursing,2005,3:37-39
32. 张宏,朱光君.循证护理研究进展[J].国外医学护理学分册,2002,21(4):154-156
33. 周庆环,徐炎,路阳.北京大学人民医院专科医师规范化培训模式的实践与研究[J].中华医院管理杂志,2006,10(22):655 一 656
34. 吕世伟,孙亚林,王向东.循证医学在国内外医疗卫生领域的研究现状[J].中国卫生事业管理,2001,(5):218
35. Colyer H,Kamath P.Evidence-based practice:a philosophical and political a nalysis:some matters forconsi deration by professional prac-titioners[J]. Journal of Advanced Nursing,1999,29(1):188-193
36. 王芳.培养 ICU 护士评判性思维的实践与体会[J].护理管理杂志 2006,6(4):28-29
37. 吕卓人.循证医学应该成为 21 世纪医学教育的重要内容[J].中国循证医学杂志,2003,3(4):277 一 278
38. Melnyk B,Fineout-Overholt E.Nurses' Perceived Knowledge,Beliefs, Skills,and Needs Regarding Evidence-BasedPractice:Implicatons for Accelerating theParadigm Shift[J].Worldviews on Evidence-Based Nursing, 2004,1(3):185 一 193
39. Retsas A. Barriers to using research evidence in nursing practice. J Advnurs,2000,31(3):599-606
40. 张美芬,尤黎明,刘可等“导师制”在护理本科生科研实践中的实施与成效[J] .中国实用护理杂志,2006, 22(4A):71-72
1. 宋锦平,成冀娟. 循证护理学[J].护士进修杂志.2003,18(4):292-293
2. 姜海宁.护理发展新趋势—循证护理[J].护理研究,2005,19(2B):360-361
3. 杨冬梅.循证护理及其应用[J].护理研究,2003,17(8A):877-878
4. 陈燕华,王惠珍.循证护理研究状况调查分析[J].护士进修杂志,2005,20(10):934-935
5. 王艳,成冀娟.循证护理学[J]. 护士进修杂志,2003,18(1):4-6
6. 孙柳.循证护理的展望[J].循证医学,2004,4(3):174-177
7. 胡雁.正确认识循证护理,推动护理实践发展[J].中华护理杂志,2005,40(19):714-717
8. 张文红,张秀云,朱爱珍等.高血压病的循证护理[J].实用护理杂志,2003,19(8):1-2
9. 沈洁 ,董晓萍,周军.循证护理在产后尿潴留患者护理实践中的应用[J].解放军护理杂志,2003,20(11):61-62
10. 刘新.循证护理在烧伤气管切开病人中的运用[J].护理研究,2006,20(10A):2597-2598
11. 陈佳钦,杜智梅.循证护理在小儿病毒性脑炎护理质量控制中的应用[J].现代护理,2006,12(21):2021-2022
12. 邓小梅,张静平,黄海珊.国内开展循证护理的困境分析[J].中国实用护理杂志,2006,22(10A):57-59
13. 李珊.循证护理在基层医院开展过程中的障碍及应对措施[J].解放军护理杂志,2005,19(2B):366-367
14. 杨玉娟.循证护理在临床工作中的应用现状[J]. 护理研究,2003,17(7):760-761
15. 喻娇花,任小英,王桂兰等.临床循证护理现状调查 [J].护理学杂志,2003,18(4):254
16.李亚洁,蔡文智,李瑛等.护理人员循证护理认识现状调查与启示[J].中华护理杂志,2004,39(8):627-629
2. 李峻,吴红梅,董碧蓉等.循证临床实践者[J].中国循证医学杂志,2005,5(7):568-573
3. Sackett DL.etal.Evidence-based medicine:What it is and What it isn’t[J].British Medical Journal,1996(312):71-73
4. 胡 雁 . 正 确 认 识 循 证 护 理 推 动 护 理 实 践 发 展 . 中 华 护 理 杂 志 ,2005,40(9):714-713
5. DiCenso A,Collum N,Ciliska D.Implementing evidence-based nursing:some misconceptions[J].Evi Based Nurs,1998,1:38-40
6. 马玲,钟玉杰,周艳.从近年循证护理论文发表情况分析我国循证护理的发展[J].护理研究,2007,21(5A):1209-1210
7. 冯先琼,成翼娟,李继平等.循证护理:护理发展新动向[J].实用护理杂志,2001,17(6)∶1-2
8. 张文红,张秀云,朱爱珍等.高血压病的循证护理[J].实用护理杂志,2003,19(8):1-2
9. 沈洁 ,董晓萍,周军.循证护理在产后尿潴留患者护理实践中的应用[J].解放军护理杂志,2003,20(11):61-62
10.刘新.循证护理在烧伤气管切开病人中的运用[J].护理研究,2006,20(10A):2597-2598
11. 杨芝芳,李学军,陈瑶琨.谈护理的新概念———循证护理[J].中国疗养医学,2003,12(6):445
12. 余咏,胡华,范珊红等.循证护理———临床护理发展的必然[J].西北国防医学杂志,2003,24(4):305-306
13. 洪军,郝艳会,盖学良.循证医学与循证护理[J].国外医学·护理学分册,2004,23(1):43-47
14. Allery LA,Owen PA,Robling MR.Why general practitioners and Consultants change their clinical practice:a critical incidentstudy.BMJ,1997,314(7084):8702874
15. Profetto-Mc,Grath J.Critical thinking and evidence-based practice.J Prof Nurs,2005,21(6):364-371
16. 陈向韵.成人高等护理教育中循证能力的培养[J].护理研究,2004,18(1):174-175
17. 黄金月.遵循科学证据促进循证护理实践中国循证医学杂志,2004,4(12):817-820
18. Shorten A,Wallace MC. Developing information literacy: a key to evidence-based nursing[J]. International Nursing Review,2001(48):86-92
19. 傅蓉,程云.临床护理人员循证护理认知水平的调查与分析[J].上海护理,2005,5(2):19-21
20. 彭美慈,汪国成,陈基乐等.批判性思维能力测量表的信效度测试研究[J].中华护理杂志,2004,39(9):644-647
21. 詹蓓,郭健,徐凤等.护士在循证中的信息能力及应对措施[J].中华护理杂志,2005,40(5):377-379
22. 万丽红,林吟,梁嘉定.广东省循证护理现状分析及对策[J].中华护理杂志,2004,39(4):270-272
23. 周敏,夏晓清,陈丽莉等.护理人员循证护理认知现状调查[J].护理研究,2006,20(8B):2093-2094
24. 曹力.批判性思维在护理工作中的应用[J].国外医学·护理学分册,2002,21(4):162
25. Facione NC,Facione PA,Giancario C.California Critical Thinking Disposition Inventory(CCTDI).Millbrae:California Academic Press,2001
26. Betsy SP,Gloria M. Clarifying the concept of critical thinking in nursing[J].The Journal of Nursing Education,1993,32(9):425-428
27. 嵇艳,崔焱.护理人员循证实践基本素质构成的研究[J].中国实用护理杂志,2007,23(2B):6-8
28. 郭瑞红. 评判性思维的态度倾向性及影响因素[J]. 中华护理教育,2006,3(3):135-137
29. Shorten A,Wallace MC,Crookes PA. Developing information literacy: a key to evidence-based nursing .International Nursing Review, 2001, (48):86-92
30. 詹蓓,郭健,徐凤等.护士在循证中的信息能力及应对措施[J].中华护理杂志,2005,40(5):377-379
31. Fineout-Overholt E,Johnston L.Teaching EBP: A Challenge for Educators in the 21St Century[J]. Worldviews on Evidence-Based Nursing,2005,3:37-39
32. 张宏,朱光君.循证护理研究进展[J].国外医学护理学分册,2002,21(4):154-156
33. 周庆环,徐炎,路阳.北京大学人民医院专科医师规范化培训模式的实践与研究[J].中华医院管理杂志,2006,10(22):655 一 656
34. 吕世伟,孙亚林,王向东.循证医学在国内外医疗卫生领域的研究现状[J].中国卫生事业管理,2001,(5):218
35. Colyer H,Kamath P.Evidence-based practice:a philosophical and political a nalysis:some matters forconsi deration by professional prac-titioners[J]. Journal of Advanced Nursing,1999,29(1):188-193
36. 王芳.培养 ICU 护士评判性思维的实践与体会[J].护理管理杂志 2006,6(4):28-29
37. 吕卓人.循证医学应该成为 21 世纪医学教育的重要内容[J].中国循证医学杂志,2003,3(4):277 一 278
38. Melnyk B,Fineout-Overholt E.Nurses' Perceived Knowledge,Beliefs, Skills,and Needs Regarding Evidence-BasedPractice:Implicatons for Accelerating theParadigm Shift[J].Worldviews on Evidence-Based Nursing, 2004,1(3):185 一 193
39. Retsas A. Barriers to using research evidence in nursing practice. J Advnurs,2000,31(3):599-606
40. 张美芬,尤黎明,刘可等“导师制”在护理本科生科研实践中的实施与成效[J] .中国实用护理杂志,2006, 22(4A):71-72
1. 宋锦平,成冀娟. 循证护理学[J].护士进修杂志.2003,18(4):292-293
2. 姜海宁.护理发展新趋势—循证护理[J].护理研究,2005,19(2B):360-361
3. 杨冬梅.循证护理及其应用[J].护理研究,2003,17(8A):877-878
4. 陈燕华,王惠珍.循证护理研究状况调查分析[J].护士进修杂志,2005,20(10):934-935
5. 王艳,成冀娟.循证护理学[J]. 护士进修杂志,2003,18(1):4-6
6. 孙柳.循证护理的展望[J].循证医学,2004,4(3):174-177
7. 胡雁.正确认识循证护理,推动护理实践发展[J].中华护理杂志,2005,40(19):714-717
8. 张文红,张秀云,朱爱珍等.高血压病的循证护理[J].实用护理杂志,2003,19(8):1-2
9. 沈洁 ,董晓萍,周军.循证护理在产后尿潴留患者护理实践中的应用[J].解放军护理杂志,2003,20(11):61-62
10. 刘新.循证护理在烧伤气管切开病人中的运用[J].护理研究,2006,20(10A):2597-2598
11. 陈佳钦,杜智梅.循证护理在小儿病毒性脑炎护理质量控制中的应用[J].现代护理,2006,12(21):2021-2022
12. 邓小梅,张静平,黄海珊.国内开展循证护理的困境分析[J].中国实用护理杂志,2006,22(10A):57-59
13. 李珊.循证护理在基层医院开展过程中的障碍及应对措施[J].解放军护理杂志,2005,19(2B):366-367
14. 杨玉娟.循证护理在临床工作中的应用现状[J]. 护理研究,2003,17(7):760-761
15. 喻娇花,任小英,王桂兰等.临床循证护理现状调查 [J].护理学杂志,2003,18(4):254
16.李亚洁,蔡文智,李瑛等.护理人员循证护理认识现状调查与启示[J].中华护理杂志,2004,39(8):627-629