本文選題：能力素質(zhì)冰山模型 + 兒科��； 參考：《南方醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的運(yùn)用能力素質(zhì)冰山模型對(duì)人素質(zhì)的分類方法,分析2014年兒科護(hù)理不良事件發(fā)生的“人”方面因素,依據(jù)能力素質(zhì)冰山模型理論及不良事件發(fā)生原因,制訂并實(shí)施提升護(hù)士“冰山以下”素質(zhì)的培訓(xùn)方案。探討基于能力素質(zhì)冰山模型的培訓(xùn)在提升護(hù)士“冰山以下”素質(zhì),預(yù)防兒科護(hù)士不良事件發(fā)生的作用。方法組織某三甲醫(yī)院兒科護(hù)理骨干6名,成立護(hù)理安全管理小組,收集2014年及2015年兒科所有住院患兒病歷資料,收集所有護(hù)士的年齡、職稱、工作年限等資料,采用事件回顧性資料分析及與不良事件責(zé)任人訪談的方法,運(yùn)用能力素質(zhì)冰山模型全面分析2014年護(hù)理不良事件發(fā)生“人”方面的原因。小組人員依據(jù)不良事件發(fā)生原因,制訂和實(shí)施了基于能力素質(zhì)冰山模型的培訓(xùn)方案,于2015年對(duì)全體護(hù)士進(jìn)行為期1年的培訓(xùn)干預(yù)。主要內(nèi)容包括:①責(zé)任心、愛(ài)心、良好職業(yè)素養(yǎng)的培養(yǎng);②溝通技巧的培訓(xùn);③營(yíng)造安全文化,培養(yǎng)風(fēng)險(xiǎn)防范意識(shí);④宣教方法的培訓(xùn);⑤其他人文素質(zhì)內(nèi)容的培訓(xùn)等。2015年年底對(duì)培訓(xùn)護(hù)士通過(guò)考核評(píng)價(jià)干預(yù)效果,考核內(nèi)容包括理論和操作考試及護(hù)理安全管理小組對(duì)全體護(hù)士的能力素質(zhì)考核,并與2014年的考核結(jié)果進(jìn)行統(tǒng)計(jì)對(duì)比,計(jì)數(shù)資料采用卡方檢驗(yàn),計(jì)量資料的均數(shù)比較采用t檢驗(yàn),以P0.05為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果2014年20位不良事件責(zé)任護(hù)士有16位工作年限在5年或5年以內(nèi),4位在5年以上,不良事件所涉及的操作均較簡(jiǎn)單,不良事件“人”方面的主要原因?yàn)槿狈ω?zé)任心等“冰山以下”素質(zhì)。2015年理論和操作考核的平均成績(jī)均比2014年高,差異有統(tǒng)計(jì)學(xué)意義(理論:t=2.034,P=0.047;操作:t=2.348,P=0.023);2015年護(hù)士核心能力評(píng)估分?jǐn)?shù)均較2014年高(P0.05)。2014年與2015年發(fā)生的護(hù)理不良事件分別為30例和12例,差異有統(tǒng)計(jì)學(xué)意義(χ2=7.707,P=0.005),2014年與2015年護(hù)理糾紛例數(shù)分別為13例和4例,差異有統(tǒng)計(jì)學(xué)意義(χ2=4.794,P=0.029),2015年年平均滿意度較2014年上升了4%。護(hù)士對(duì)護(hù)理安全管理培訓(xùn)的認(rèn)可度較高,71.7%的護(hù)士認(rèn)為自己收獲很大。結(jié)論護(hù)理不良事件發(fā)生的“人”方面原因主要與護(hù)士“冰山以下”能力素質(zhì)的欠缺有關(guān),這些素質(zhì)主要包括責(zé)任心、安全意識(shí)、風(fēng)險(xiǎn)評(píng)估能力、溝通能力等多個(gè)方面。經(jīng)過(guò)1年的培訓(xùn)和考核,包括對(duì)責(zé)任心、愛(ài)心、職業(yè)素養(yǎng)、自信心、溝通技巧、安全文化、風(fēng)險(xiǎn)防范意識(shí)、宣教方法、人文素質(zhì)等的培訓(xùn),能有效提升護(hù)士綜合素質(zhì),預(yù)防不良事件的發(fā)生,提升患者滿意度。
[Abstract]:Objective to analyze the "human" factors of adverse events in paediatric nursing in 2014, and to analyze the causes of adverse events according to the theory of iceberg model of ability quality and the causes of adverse events. Develop and implement training programs to improve nurses' quality below the iceberg. To explore the role of training based on competency iceberg model in improving nurses'"below iceberg" quality and preventing adverse events of pediatric nurses. Methods A nursing safety management group was set up to collect the medical records of all pediatric hospitalized children in 2014 and 2015, and to collect the age, title and working years of all nurses. By means of retrospective data analysis of events and interviews with persons responsible for adverse events, the causes of adverse events in 2014 were analyzed by using the iceberg model of ability quality. According to the causes of adverse events, the team developed and implemented a training program based on the iceberg model of competency quality, and carried out a one-year training intervention to all nurses in 2015. The main contents include: 1) training of responsibility, love and good professional accomplishment; (3) training of communication skills; (3) training of safety culture; training of awareness of risk prevention; (4) training of missionary methods; (5) training of other humanistic quality contents. The intervention effect of training nurses was evaluated through assessment at the end of 2015, including theoretical and operational examination and nursing safety management group's ability and quality assessment of all nurses. And compared with the results of 2014 statistical analysis, counting data using chi-square test, the average of measurement data using t test, with P0.05 as the difference was statistically significant. Results among the 20 nurses responsible for adverse events in 2014, 16 nurses had a working life of 5 years or less, and 4 nurses had a working life of more than 5 years. The operations involved in adverse events were all relatively simple. The main cause of adverse events is lack of responsibility and other "below iceberg" qualities. The average results of theoretical and operational examinations in 2015 were higher than in 2014. The difference was statistically significant (theoretical 1: t0. 034 / P0. 047; Operation: t = 2. 348 / P0. 023; the assessment scores of nurses' core competencies in 2015 were significantly higher than those in 2014; the adverse nursing events in 2014 and 2015 were 30 and 12, respectively. The difference was statistically significant (蠂 ~ 2 / 7.707 / P ~ (0.005), and the number of nursing disputes in 2014 and 2015 were 13 and 4, respectively. The difference was statistically significant (蠂 ~ 2 / 4.794 / P ~ (0.029), and the annual average satisfaction degree in 2015 was 4 times higher than that in 2014. 71.7% of nurses thought that they had gained a great deal from the recognition of nursing safety management training. Conclusion the causes of adverse nursing events are mainly related to the deficiency of nurses' ability of "below the iceberg". These qualities mainly include responsibility, safety awareness, risk assessment ability, communication ability and so on. After one year's training and examination, including training on responsibility, love, professionalism, self-confidence, communication skills, safety culture, risk prevention awareness, teaching methods, humanistic quality, etc., it can effectively improve the comprehensive quality of nurses. To prevent the occurrence of adverse events and improve patient satisfaction.
【學(xué)位授予單位】：南方醫(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)】：R47

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