本文關(guān)鍵詞： 護(hù)理本科 臨床實(shí)習(xí) 基礎(chǔ)護(hù)理技能操作 影響因素　出處：《山西醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討本科護(hù)生實(shí)習(xí)后基護(hù)技能操作考核成績(jī)的影響因素,為護(hù)理本科生基礎(chǔ)護(hù)理技能的教學(xué)改革提供依據(jù)。方法:本研究共分為四個(gè)部分1護(hù)理本科生實(shí)習(xí)后基護(hù)技能操作成績(jī)影響因素的質(zhì)性研究運(yùn)用現(xiàn)象學(xué)的研究方法,對(duì)18名實(shí)習(xí)結(jié)束,且參加了實(shí)習(xí)后的基礎(chǔ)護(hù)理技能操作的本科護(hù)生進(jìn)行深入訪談,收集影響護(hù)理本科生實(shí)習(xí)后基礎(chǔ)護(hù)理技能操作成績(jī)的因素,采取Colaizzi七步分析法對(duì)訪談資料進(jìn)行分析。2護(hù)理本科生實(shí)習(xí)后基礎(chǔ)護(hù)理技能操作成績(jī)影響因素的調(diào)查問卷研制依據(jù)國(guó)內(nèi)外文獻(xiàn)回顧、質(zhì)性研究和課題組討論,制訂調(diào)查問卷初稿,通過專家咨詢和預(yù)調(diào)查,形成“護(hù)理本科生實(shí)習(xí)后基礎(chǔ)護(hù)理技能操作成績(jī)影響因素的調(diào)查問卷”。3 17項(xiàng)基礎(chǔ)護(hù)理技能操作項(xiàng)目的難度系數(shù)評(píng)定在已有的“護(hù)理操作技術(shù)難度評(píng)價(jià)體系”的基礎(chǔ)上設(shè)計(jì)調(diào)查問卷,選擇100名護(hù)理專家或骨干進(jìn)行調(diào)查,對(duì)我校考核的17項(xiàng)基礎(chǔ)護(hù)理技能操作項(xiàng)目進(jìn)行難度評(píng)定。4護(hù)理本科生實(shí)習(xí)后基礎(chǔ)護(hù)理技能操作成績(jī)影響因素的調(diào)查研究采用目的抽樣的方法,抽取參與了實(shí)習(xí)后基護(hù)技能操作考核的本科護(hù)生進(jìn)行問卷調(diào)查,通過統(tǒng)計(jì)分析,探討護(hù)理本科生實(shí)習(xí)后基礎(chǔ)護(hù)理技能操作考核成績(jī)的影響因素,為護(hù)理教育質(zhì)量的提高,提供理論依據(jù)。結(jié)果:1質(zhì)性研究通過對(duì)18名本科護(hù)生的半結(jié)構(gòu)訪談,分析影響本科護(hù)生實(shí)習(xí)后基礎(chǔ)護(hù)理技能操作考核成績(jī)的因素,歸納出六大主題:(1)護(hù)生個(gè)人因素;(2)實(shí)習(xí)醫(yī)院因素;(3)實(shí)習(xí)科室輪轉(zhuǎn)因素;(4)臨床帶教老師因素;(5)考核操作項(xiàng)目學(xué)校教學(xué)和臨床實(shí)踐的差異因素;(6)考核操作項(xiàng)目臨床培訓(xùn)、實(shí)踐和考核因素。2問卷研制本研究自制了護(hù)理本科生實(shí)習(xí)后基礎(chǔ)護(hù)理技能操作成績(jī)影響因素的調(diào)查問卷,共30個(gè)條目,問卷內(nèi)容效度為0.978。3難度系數(shù)的評(píng)定17項(xiàng)基護(hù)技能操作項(xiàng)目的難度系數(shù)分別為:吸痰術(shù)1.37、女性患者導(dǎo)尿術(shù)1.33、密閉式靜脈輸液1.21、皮內(nèi)注射1.21、心肺復(fù)蘇術(shù)1.34、鋪麻醉床0.97、生命體征測(cè)量0.94、簡(jiǎn)易呼吸器和吸氧1.19、肌內(nèi)注射術(shù)1.08、大量不保留灌腸1.23、鼻飼術(shù)1.29、口腔護(hù)理1.19、臥位患者更換床單位法1.02、密閉式靜脈輸血1.36、男性患者導(dǎo)尿術(shù)1.36、無(wú)菌技術(shù)操作1.26、穿脫使用過的隔離衣1.12。4調(diào)查研究發(fā)放問卷591份,回收有效問卷576份,有效回收率為97.46%。576名護(hù)生的實(shí)習(xí)后基礎(chǔ)護(hù)理技能操作成績(jī)?yōu)?4.61-130.71(96.73±15.15)分,實(shí)習(xí)后護(hù)生間基護(hù)技能操作考核成績(jī)差異大。經(jīng)過單因素分析和有序logistic回歸分析,實(shí)習(xí)前基護(hù)技能操作考核成績(jī)、實(shí)習(xí)時(shí)間、考核項(xiàng)目學(xué)校教學(xué)和臨床實(shí)踐用物和流程差異程度、考核項(xiàng)目示教規(guī)范程度、臨床帶教老師指導(dǎo)頻次對(duì)護(hù)理本科生實(shí)習(xí)后基護(hù)技能操作的成績(jī)有影響(p0.05,p0.01)。結(jié)論:1質(zhì)性研究影響本科護(hù)生實(shí)習(xí)后基礎(chǔ)護(hù)理技能操作考核成績(jī)的因素:(1)護(hù)生個(gè)人因素;(2)實(shí)習(xí)醫(yī)院因素;(3)實(shí)習(xí)科室輪轉(zhuǎn)因素;(4)臨床帶教老師因素;(5)考核操作項(xiàng)目學(xué)校教學(xué)和臨床實(shí)踐的差異因素;(6)考核操作項(xiàng)目臨床培訓(xùn)、實(shí)踐和考核因素。2問卷研制本研究自制的護(hù)理本科生實(shí)習(xí)后基礎(chǔ)護(hù)理技能操作成績(jī)影響因素的調(diào)查問卷,內(nèi)容效度好,適用于調(diào)查護(hù)生的基護(hù)技能操作考核成績(jī)影響因素。3難度系數(shù)的評(píng)定本研究評(píng)定的17項(xiàng)基護(hù)技能操作項(xiàng)目的難度系數(shù),適用于本研究,能夠確�？己朔�?jǐn)?shù)的公平性和研究結(jié)果的可靠性。4調(diào)查研究實(shí)習(xí)后護(hù)生間基護(hù)技能操作考核成績(jī)差異大。護(hù)理本科生實(shí)習(xí)前基護(hù)技能操作考核成績(jī)?cè)胶?則實(shí)習(xí)后成績(jī)?cè)胶?考核項(xiàng)目學(xué)校教學(xué)和臨床實(shí)踐用物和流程差異程度越高,則實(shí)習(xí)后基護(hù)技能操作考核成績(jī)?cè)降?考核項(xiàng)目臨床帶教護(hù)士示教規(guī)范程度越高、實(shí)踐指導(dǎo)越頻繁,則實(shí)習(xí)后基護(hù)技能操作考核成績(jī)?cè)礁?護(hù)生實(shí)習(xí)時(shí)間越長(zhǎng),則實(shí)習(xí)后基礎(chǔ)護(hù)理技能操作成績(jī)?cè)胶�。建議重視護(hù)生實(shí)習(xí)前的基護(hù)技能操作教學(xué)和考核;學(xué)校和臨床實(shí)踐教學(xué)定期交流,革新操作用物和流程,縮小兩者差異;選拔和培訓(xùn)臨床帶教老師,提高帶教質(zhì)量;建立護(hù)生基礎(chǔ)護(hù)理技能操作學(xué)習(xí)檔案,提高教學(xué)效率,實(shí)現(xiàn)學(xué)校和臨床實(shí)踐教學(xué)的有效銜接。
[Abstract]:Objective: To explore the influence factors of undergraduate nursing students after basic nursing skills assessment results, provide the basis for the teaching reform of nursing skills of nursing undergraduate foundation. Methods: This study is divided into four parts research methods for the practice of nursing undergraduate nursing after 1 skill scores influence factors using qualitative research of phenomenology, the end the 18 student, and participated in the practice of fundamental nursing skills of undergraduate nursing students conducted in-depth interviews, factors of the impact of nursing students after practice to collect basic nursing skills grades, take the Colaizzi seven step method for the analysis of interview data of.2 practice of undergraduate nursing students after the influence of basic nursing skill score questionnaire development factors on the basis of literature review, qualitative research and group discussion, to formulate the first draft questionnaire, through expert consultation and pre survey, the formation of "nursing undergraduate Students after the practice of fundamental nursing skills influencing factors questionnaire ".3 17 basic nursing skills assessment in the operation of the project is to have a" nursing operation difficulty evaluation system on the basis of the design of the questionnaire, select 100 nursing experts or backbone for investigation, influence of basic nursing skill score factors the purpose of using sampling method, practice difficulty evaluation of undergraduate nursing students after.4 17 basic nursing skills project of our school examination, participated in basic nursing practice after extraction skills assessment of undergraduate nursing students conducted a questionnaire survey, through statistical analysis, to explore the influence factors of nursing undergraduates after basic nursing skills assessment results. To improve the quality of nursing education, and provide a theoretical basis. Results: 1 qualitative research interviews with semi-structured 18 undergraduate nursing students, analysis Influence factors of students after the basic nursing skills assessment scores of undergraduate nursing, summed up the six themes: (1) the personal factors of nursing students; (2) teaching hospital factors; (3) the practice department rotation factors; (4) the teacher factors of clinical teaching; (5) differences in the factors of school teaching and assessment of project operation clinical practice; (6) the operation of the project assessment of clinical training, practice and evaluation factors of.2 questionnaire developed in this study made a questionnaire of basic nursing skill score factors of nursing undergraduate internship, a total of 30 items, the contents of the questionnaire validity evaluation difficulty coefficient 0.978.3 difficulty coefficient 17 basic nursing skills in the operation of the project respectively. For suctioning 1.37, 1.33 female patients with catheterization, closed intravenous infusion of 1.21, intradermal injection 1.21, CPR 1.34, Pu anesthesia bed 0.97, vital signs were measured in 0.94 and 1.19, simple breathing oxygen, intramuscular injection of 1.08, a lot of Retention enema 1.23, nasal surgery 1.29, 1.19 patients with oral care, supine replacement bed unit 1.02, closed intravenous transfusion of 1.36 male patients with urethral catheterization, 1.36, aseptic operation 1.26, wear gowns used 1.12.4 survey of 591 questionnaires, 576 valid questionnaires recovered, the effective recovery rate was 97.46%.576 nursing students after the practice of fundamental nursing skills score of 54.61-130.71 (96.73 + 15.15), after the practice of nursing students between basic nursing skills assessment results of operations. The difference by univariate analysis and ordinal logistic regression analysis, before the practice of basic nursing skills assessment results, practice time, and the difference degree assessment process project teaching and clinical practice, assessment of project teaching norms of the degree of influence the clinical teachers frequency on clinical practice of undergraduate nursing students in basic nursing skills after grades (P0.05, P0.01). Conclusion: 1 qualitative research. Factors affecting undergraduate nursing students after basic nursing skills assessment results: (1) the personal factors of nursing students; (2) teaching hospital factors; (3) the practice department rotation factors; (4) the teacher factors of clinical teaching; (5) the operation project of school teaching and clinical practice (the difference of factors; 6) the operation of the project assessment of clinical training, questionnaire of influence of basic nursing skill score factors of practice and assessment factors.2 the research development of self-made questionnaire of undergraduate nursing students, the content validity is good, suitable for the investigation of nursing students affect the basic nursing skills assessment evaluation factors.3 difficulty coefficient of this study assessed 17 groups nursing skills in the operation of the project is suitable for this study, factor, investigation of the.4 to ensure the reliability of the assessment scores of fairness and the results after the practice of nursing students between basic nursing skills assessment results. The difference of undergraduate nursing students before practice Basic nursing skills assessment results is better, after the practice performance assessment project; school teaching and clinical practice and process the difference degree is higher, then after the practice of basic nursing skills assessment scores lower; project appraisal of clinical nurse teaching norms of higher level, practice more frequently, then after the practice base nursing skills assessment results of higher nursing students; the longer it after the practice of fundamental nursing skills better. We should pay attention to practice the basic nursing skills teaching and assessment of nursing students; clinical practice teaching school and regular communication with material and process innovation operation, reduce the difference between the teacher and the selection; the clinical training, improve the quality of teaching; the establishment of nursing students of fundamental nursing skills learning files, improve teaching efficiency, to achieve effective convergence of school and teaching in clinical practice.

【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：G642.4;R47-4

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