摘要
目的采用情景模拟给药查对方法改善应届新护士的临床给药核对规范执行率，提高护理隐患把关辨别能力。方法选择上海交通大学医学院附属仁济医院2016届应届毕业新护士75人，按照随机数字表法分为试验组39人和对照组36人，试验组采用情景模拟案例教学，对照组实施传统护理安全查对培训方法，收集培训后2组的课程满意度和自信心、3个月临床实际给药核查行为、6个月给药核对相关护理差错、隐患及把关情况。结果2组培训后试验组总满意度得分（23.62 ± 2.02）分，对照组得分（21.39 ± 1.98）分，差异有统计学意义（t=4.818，P〈0.01）；试验组学生自信心总得分（35.67 ± 2.92）分，对照组（33.83 ± 2.80）分，差异有统计学意义（t=2.768，P〈0.01）。培训后3个月临床实际给药核对行为观察显示，试验组新护士执行操作前的药物浓度、执行时间查对人数分别为33、30人，与对照组的8、12人比较差异有统计学意义（χ^2=29.406、14.436，P〈0.05）；操作中、后的床号、姓名、药名、剂量、浓度、方法查对人数与对照组比较差异有统计学意义（χ^2=5.080-29.545，P〈0.01或0.05）；试验组培训3个月后护理隐患、把关人数和培训后6个月的护理把关人数分别为33、2、10人，与对照组的18、1、3人比较差异有统计学意义（χ^2=50.591、23.658、3.914，P〈0.05），护理隐患和差错发生无差异。结论情景模拟给药查对案例针对新护士进入临床工作的初始阶段，将基本且核心的查对制度转化为临床实景案例，提高了新护士的学习自信心、临床实际的给药三查七对执行率和规避护理隐患风险能力。
ObjectiveTo improve fresh nurses′ implementation rate of standard clinical administration checking by applying situational simulation method, and enhancetheir ability of identifying hidden perils in nursing.MethodsTotally 75 fresh nurses who graduated in 2016 were enrolled and divided into two groups （36 in control group and 39 in experimental group） according to randomized digital table method. Situational simulation method was applied in the experimental group, while the control group applied traditional nursing safety check training method. Then both groups′ satisfaction rate of lessons and self-confidence after training were recorded. Besides, their clinical administration checking behaviors after 3 months, the errors, hidden perilsand examining situations related to administration checking after 6 months, were also evaluated.ResultsSignificant statistical differences were shown in satisfaction score （23.62±2.02 in experimental group vs. 21.39±1.98 in control group, t=4.818, P〈0.01） and self-confidential evaluating score （35.67±2.02 in experimental group vs. 21.39±1.98 in control group, t=2.768, P〈0.01）. Observation of clinical administration checking behaviors 3 months after training had indicated significant differences in the number of nurses who check drug concentration （33 vs. 8, χ^2= 29.406, P〈0.05） and executing time （30vs. 12, χ^2=14.436, P〈0.05）.Statistical differences （χ^2= 5.080-29.545, P〈 0.01 or 〈 0.05） were also observed in the number of nurses checking bed number, patient name, drug name, dose, drug concentration and methods in and after operation. The potential nursing perils identified, and the number of nurses who identify hidden nursing perils 3 months and 6 months after training were significantly larger （χ^2= 50.591, 23.658, 3.914, P〈 0.05） in experimental group （33, 2, 10） than in control group （18, 1, 3）,and there were no significant differences in the rate of potential perils and nursing error between both groups.ConclusionSituational method of administration, which is applied for fresh nurses in their initial working phase, transforms the basic and core checking system into clinical real-situation cases. It also shows an advantage of boosting their self-confidence of learning, improving the implementation rate of standard clinical administration checking and the ability of avoiding potential nursing perils.
作者
郑微艳
季梦婷
赵爱平
杨艳
李文婷
Zheng Weiyan;Ji Mengting;Zhao Aiping;Yang Yan;Li Wenting(Department of Intensive Care Unit, Affiliated Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China)
出处
《中国实用护理杂志》
2018年第15期1167-1172,共6页
Chinese Journal of Practical Nursing
基金
上海交通大学医学院护理科研基金项目（Jyh1604）
关键词
护士
给药查对
情景模拟
Nurses
Medication error
Simulation
