基于能力素质冰山模型的培训对预防儿科护理不良事件发生的效果研究

发布时间：2018-04-28 06:28

本文选题：能力素质冰山模型 + 儿科　；参考：《南方医科大学》2017年硕士论文

【摘要】：目的运用能力素质冰山模型对人素质的分类方法,分析2014年儿科护理不良事件发生的“人”方面因素,依据能力素质冰山模型理论及不良事件发生原因,制订并实施提升护士“冰山以下”素质的培训方案。探讨基于能力素质冰山模型的培训在提升护士“冰山以下”素质,预防儿科护士不良事件发生的作用。方法组织某三甲医院儿科护理骨干6名,成立护理安全管理小组,收集2014年及2015年儿科所有住院患儿病历资料,收集所有护士的年龄、职称、工作年限等资料,采用事件回顾性资料分析及与不良事件责任人访谈的方法,运用能力素质冰山模型全面分析2014年护理不良事件发生“人”方面的原因。小组人员依据不良事件发生原因,制订和实施了基于能力素质冰山模型的培训方案,于2015年对全体护士进行为期1年的培训干预。主要内容包括:①责任心、爱心、良好职业素养的培养;②沟通技巧的培训;③营造安全文化,培养风险防范意识;④宣教方法的培训;⑤其他人文素质内容的培训等。2015年年底对培训护士通过考核评价干预效果,考核内容包括理论和操作考试及护理安全管理小组对全体护士的能力素质考核,并与2014年的考核结果进行统计对比,计数资料采用卡方检验,计量资料的均数比较采用t检验,以P0.05为差异有统计学意义。结果2014年20位不良事件责任护士有16位工作年限在5年或5年以内,4位在5年以上,不良事件所涉及的操作均较简单,不良事件“人”方面的主要原因为缺乏责任心等“冰山以下”素质。2015年理论和操作考核的平均成绩均比2014年高,差异有统计学意义(理论:t=2.034,P=0.047;操作:t=2.348,P=0.023);2015年护士核心能力评估分数均较2014年高(P0.05)。2014年与2015年发生的护理不良事件分别为30例和12例,差异有统计学意义(χ2=7.707,P=0.005),2014年与2015年护理纠纷例数分别为13例和4例,差异有统计学意义(χ2=4.794,P=0.029),2015年年平均满意度较2014年上升了4%。护士对护理安全管理培训的认可度较高,71.7%的护士认为自己收获很大。结论护理不良事件发生的“人”方面原因主要与护士“冰山以下”能力素质的欠缺有关,这些素质主要包括责任心、安全意识、风险评估能力、沟通能力等多个方面。经过1年的培训和考核,包括对责任心、爱心、职业素养、自信心、沟通技巧、安全文化、风险防范意识、宣教方法、人文素质等的培训,能有效提升护士综合素质,预防不良事件的发生,提升患者满意度。
[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.
【学位授予单位】：南方医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R47

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