重症监护室新进护士心理压力源的调查研究

[目的]了解重症监护室(ICU)新进护士工作中主要的压力源,为减轻ICU新进护士工作压力提供依据。[方法]采用问卷调查法对40名ICU新进护士的工作压力源进行调查分析。[结果]护理专业操作技能方面的问题、工作环境及仪器设备使用问题和病人基础生活护理方面的问题等使ICU新进护士感到压力较大。学历大专及以上护士,随着个性的成熟,压力相对较小。[结论]建议管理者减少或消除压力源,并对新进护士进行业务培训和心理压力承受训练,以减轻其工作压力。     

重症监护室新进护士心理压力源的调查研究

[目的]了解重症监护室(ICU)新进护士工作中主要的压力源,为减轻ICU新进护士工作压力提供依据.[方法]采用问卷调查法对40名ICU新进护士的工作压力源进行调查分析.[结果]护理专业操作技能方面的问题、工作环境及仪器设备使用问题和病人基础生活护理方面的问题等使ICU新进护士感到压力较大.学历大专及以上护士,随着个性的成熟,压力相对较小.[结论]建议管理者减少或消除压力源,并对新进护士进行业务培训和心理压力承受训练,以减轻其工作压力.     

急诊护士工作压力源及身体健康状况调查分析

目的了解急诊护士与病房护士工作中的主要压力源和心理压力及身体健康状况,减少压力以便提高工作质量及身心健康水平。方法采用问卷调查法对87名急诊护士、83名病房护士进行工作压力源、心理压力和身体健康状况调查。结果在工作压力源中的病人护理方面存在差异(P<0.05);心理方面和身体方面均比病房护士差。结论建议管理者减少或消除护士压力源,并对护士进行业务培训和心理压力训练以减轻工作压力。     

急诊护士工作压力源及身体健康状况调查分析

目的 了解急诊护士与病房护士工作中的主要压力源和心理压力及身体健康状况,减少压力以便提高工作质量及身心健康水平.方法 采用问卷调查法对87名急诊护士、83名病房护士进行工作压力源、心理压力和身体健康状况调查.结果 在工作压力源中的病人护理方面存在差异(P＜0.05);心理方面和身体方面均比病房护士差.结论 建议管理者减少或消除护士压力源,并对护士进行业务培训和心理压力训练以减轻工作压力.     

ICU护士工作压力源、心理健康状况及应对方式的研究

目的　了解当前ICU病房护士的工作压力源、心理健康状况及应对方式,以便护理管理者找到合理的工作方法,改善管 理,维护护士的心理健康水平,提高护理工作效率。方法　对北京7所三级医院102名ICU病房护士进行问卷调查收集。 结果　ICU病房护士压力主要来自护理专业、工作量及工作时间方面,压力源与年龄、护龄、职称、负担程度呈正相关。ICU病 房护士的抑郁分值为(50.50±10.25)分,抑郁情绪的发生率为52.9%,应对方式以积极应对为主。抑郁与总压力源、护理专 业、工作量及时间分配等方面的问题呈正相关,且与消极应对方式呈正相关。结论　护理管理者应注意缓解护士的工作压 力,重视护士的心理健康状况,努力创造轻松愉快的工作氛围,更多地给予护士理解和支持。     

ICU护士工作压力源调查

目的 探讨ICU护士工作压力源水平及应对的措施,以便护理工作者找到合理的工作方法,调整好心态,维护好健康,提高护理工作效率.方法 采用工作压力源表随机抽取ICU护士30名、普通病房护士20名进行问卷调查.结果 ICU护士的工作压力源远远大于病房护士,主要来源于工作时间、工作量、工作环境.其中工作量太大、上班时护理人员太少、上班时间太长分值最高,抑郁与压力源是呈正相关.结论 护理人员应注意缓解工作压力,努力创造轻松愉快的工作氛围,护理管理者更多地给予护士理解与支持.     

县级医院急诊护士与病房护士工作压力源的调查分析

目的 :了解县级医院急诊科护士与病房护士工作中主要的压力来源 ,为减轻护士的压力提供科学的依据 ,以便提高护士的身心健康水平。方法 :采用问卷调查法 ,对急诊科和普通病房各 5 0名护士的工作压力源进行了调查。结果 :护理专业及工作方面的问题 ,工作量及时间分配问题 ,病人护理方面的问题护士感到压力程度较高 ;环境及资源方面的问题 ,管理及人际关系方面问题压力程度一般。对于环境及资源方面的问题 ,急诊科护士与病房护士相比压力程度差异有显著性意义(P <0 .0 5 )。建议 :提出减轻护士压力源的措施 :①改善急诊科不良的工作环境 ;②合理编设病房护理人员 ;③减少病房护士的书面工作 ;④护理管理者应加强对护士的关怀 ,增强应对压力的能力     

ICU护士压力源与身心健康状况调查分析及对策

目的：调查分析ICU护士压力源与身心健康状况,并提出相关应对措施。方法：采用工作压力源量表和自制的身心健康状况调查表对ICU病房80名护士进行问卷调查。结果：特殊工作环境、长期精神紧张、超负荷工作量、患者、家属及社会对护理工作的偏见和高期望等,成为ICU护士主要的工作压力源。结论：患者护理方面的问题及护理专业及工作方面的问题是ICU护士工作主要压力源,护理管理应针对具体情况进行减压,采取个体化措施。     

“医生跟着病人走”新模式病房护士压力源及应对方式调查

目的：了解＂医生跟着病人走＂新模式病房护士工作压力源和常用的应对方式,以期帮助护士采取积极的应对方式缓解工作压力,维护护士身心健康。方法：采用问卷调查法对79名＂医生跟着病人走＂新模式病房护士工作压力源和应对方式进行调查。结果：新模式病房护士工作压力源依次为：护理专业及工作方面的问题、时间分配及工作量的问题、病人护理方面的问题、工作环境及仪器设备的问题、管理及人际方面的问题。＂医生跟着病人走＂新模式病房护士常采用的应对方式为积极应对。结论：新模式病房护理管理者应减少护士工作压力源,帮助护士积极应对压力。     

综合性医院ICU护士工作压力来源的调查研究

目的:了解重症监护病房(ICU)护士工作中的压力来源,探讨相应的对策,以便使医院管理者及护理人员正确认识工作压力,并尽可能减轻压力,最大限度地调动护士的工作积极性,提高护理质量和患者满意度。方法:采用问卷调查法,对某三级甲等医院各科相应的重症监护病房护士的工作压力来源进行调查分析,并与普通病房护士作对比,运用PEMS 3.1统计学软件进行统计处理。结果:护士工作年限越长压力相对较小,ICU护士的压力比普通病房护士相对较高,其中最主要的压力源在患者护理方面,而在管理及人际关系方面两者无差异。结论:提供适当的压力应对策略,改进护理制度,相应增加护士编制,加强与患者之间的沟通,以便有效减轻护士压力,提高护士工作效率。     

纵横双向层级责任制在ICU护理管理中的应用

[目的]建立纵横双向层级责任制,实现重症监护病房(ICU)护士专业核心能力及护理岗位能力培训有机结合,提升ICU护士综合能力,保证护理质量及护理安全。[方法]通过对各级护士的职级评定,制订各层级护士的岗位职责和工作流程,将护士和床位分组,每组护士由不同层级的护士组成,形成上级对下级护士逐级负责制的层级系统化管理模式,并将2011年1月—2011年12月与2010年1月—2010年12月护理质量、专业技术考核、护理服务满意率进行对比。[结果]通过实施纵横双向责任制管理模式后,护理质量、专业技术考核指标、护理服务满意率均有不同程度的提高,差异具有统计学意义(P<0.05)。[结论]纵横双向层级责任制,使各层级岗位职责及各层级护士核心能力培训得到有效落实,保证ICU各时段、各环节护理质量,减少护士缺陷。     

Recurrent changes in the work environment, job resources and distress among nurses: a comparative cross-sectional survey

BACKGROUND AND OBJECTIVES: Occupational stress in nursing has frequently been considered in nursing literature. The operationalization of job demands in different work settings and its relation to distress have been discussed to identify significant interactions with job resources. In this study, job demands were defined as recurrent changes in the work environment of nurses (i.e. changing colleagues, supervisors, workplaces, working hours and tasks). In particular, we focused on the 'negative appraisal' (i.e. 'threat') of these changes. The interaction between 'threat' and job resources (i.e. timing control, method control and supervisor support) and its relation to distress among Registered Nurses was examined. METHODS: The study was part of a larger cross-sectional survey among 7863 (response rate 51%) employees belonging to 10 general hospitals in Belgium. The results are based on self-administered questionnaires of 1094 Registered Nurses employed in intensive care units (ICU) (n = 416) and surgery/medical wards (non-ICU) (n = 678). General Linear Modelling was used to test the moderating effects. RESULTS: In both study samples, 'threat' was positively associated with distress (P < 0.001). However, in contrast with non-ICU nurses, ICU nurses only considered 'supervisor support' as a significant moderator in the positive relationship between 'threat' and distress (P = 0.023). 'Timing and method control', instead of supervisor support, moderated this relation among non-ICU nurses (P = < 0.001 and 0.018, respectively). CONCLUSION: These findings provide additional evidence to consider negative appraisal of recurrent changes as occupational specific stressor in nursing. Moreover, the buffering effects which were found between 'threat' and the measured job resources in relation to distress, and the difference of these interactions in ICU and non-ICU health care settings, confirmed the suggestion to consider particular job characteristics in job stress research. Finally, the findings of our study may be of importance for nursing administrators who are dealing with distress among nurses.     

Remote nursing training model combined with proceduralization in the intensive care unit dealing with patients with COVID-19

The shortage of personal protective equipment and lack of proper nursing training have been endangering health care workers dealing with coronavirus disease 2019 (COVID-19). In our treatment center, the implementation of a holistic care model of time-sharing management for severe and critical COVID-19 patients has further aggravated the shortage of intensive care unit (ICU) professional nurses. Therefore, we developed a short-term specialized and targeted nursing training program to help ICU nurses to cope with stress and become more efficient, thus reducing the number of nurses required in the ICU. In order to avoid possible human-to-human spread, small teaching classes and remote training were applied. The procedural training mode included four steps: preparation, plan, implementation, and evaluation. An evaluation was conducted throughout the process of nursing training. In this study, we documented and shared experiences in transitioning from traditional face-to-face programs to remote combined with proceduralization nursing training mode from our daily work experiences during the COVID-19 pandemic, which has shown to be helpful for nurses working in the ICU.     

Development of a comprehensive scoring system to measure multifaceted nursing workloads in ICU

A new scoring system, the comprehensive nursing intervention score (CNIS), was developed to quantify the overall workload of diverse nursing activities in the intensive care unit (ICU). A total of 88 nursing items were listed. With the cooperation of 20 skilled ICU nurses, a three-round Delphi survey was conducted to assign a four-grade workload score to each item from five aspects: number of nurses required, muscular exertion, mental stress, skill, and intensity. After the survey, 15 unnecessary items were deleted. Appropriateness of the assigned scores was confirmed by surveying 118 nurses in other ICU. Within-individual reproducibility, examined in 44 nurses, was summarized as a mean kappa-coefficient of 0.65. Time required for each job was recorded and added as the sixth aspect of the workload. Thus, final CNIS gave six subscores (0-3) plus one overall score (3-18) to each of the 73 job items. The CNIS was confirmed as truly representing overall nursing workload by applying it to the daily care of 107 patients.     

Discharge from intensive care: a view from the ward.

Relocation stress is a common phenomenon in patients discharged from an intensive care unit (ICU) to a ward. A variety of nursing interventions, initiated by intensive care nurses, have been introduced following research in this area. Ward nurses are ideally situated to minimize stress in this patient population, yet their contribution has not been considered. The aim of this study was to identify the experience of the ward nursing staff when receiving a patient from the ICU. An exploratory pilot study was conducted over a 6-month period. The sample group comprised nursing staff in two wards, who regularly received ICU patients. Data collection methods were triangulated and involved the use of open-ended questionnaires and semi-structured interviews. Thirty-six questionnaires were sent, yielding a 36.1% (n = 13) response rate. Seven staff of various grades were interviewed. Data analysis was undertaken using Burnard's (1991) Thematic Content Analysis. Four major categories were identified in the analysis of the data. These were emotions; problems; communication; and interventions. However, the experience of ward staff receiving patients from intensive care differed according to grade.     

重症病人护理相关技能培训方法及效果

目的：探讨对高年资护师实行ICU轮转培训的方法与效果。方法：对普通病房的34名高年资护师分批在ICU进行系统化的重症病人护理技能培训,通过技能考核成绩,培训前后的重症护理技能自我评价分数及护士长满意度评价培训效果。结果：34名参训护师考核成绩均达标,培训后自我评价分数和护士长满意度较培训前有显著提高,差异有统计学意义（P〈0．001）;学员所主管病人中重症病人和一级护理病人的护理质量检查结果平均分为（98．5±1．1）分。结论：通过系统化的ICU轮转培训,高年资护师的重症病人护理技能明显提高,在普通病房能够胜任危重病人护理工作,从而保证护理质量。     

重症监护病房护理人员培训需求的调查研究

目的通过调查重症监护病房(ICU)护理人员对专业培训的需求,为合理设置ICU护士专科培训及继续教育课程提供参考依据。方法 2011年1—2月采用自行设计的问卷,调查上海某3级甲等医院ICU护士130名,内容包括综合专业能力培训需求、ICU护士培训现状等。结果 ICU护士进入ICU工作前缺乏相对培训;进入ICU后培训不系统、无层次;ICU护士对综合能力和专业技能方面的培训需求较高;不同工作年限的ICU护士对培训需求的程度不同。结论为提高ICU护理人员的专科业务能力与操作技能,开展高质量、多层次和全方位的培训尤为重要,需要尽快建立ICU护士规范的培训体系,有助于推动医院ICU的护理质量。     

ICU护士对镇静镇痛集束化护理知信行的现状调查

目的 了解ICU护士镇静镇痛集束化护理知信行现状,分析影响在临床中开展镇静镇痛集束化护理策略的因素。方法 2018年3月—6月,采用自编问卷对北京市5所三级甲等医院的ICU护士进行横断面调查,问卷内容包括ICU护士镇静镇痛集束化护理的知识、态度和行为（42个条目）,满分42分,以及获得知识的来源及影响因素（2个条目）,问卷总内容效度为0.906。结果 共回收调查问卷282份。知识、态度、行为的得分分别为（6.01±2.06）分、（6.78±2.60）分和（11.40±3.64）分,总分为（24.18±5.72）分。不同职称护士知识得分差异具有统计学意义（P<0.05）;不同ICU类型护士态度得分差异具有统计学意义（P<0.05）;不同年龄、职称、受教育程度、护理工作年限、ICU类型及ICU工作年限的护士行为得分差异具有统计学意义（P<0.05）。多元线性回归分析显示,护理工作年限和护士所在ICU类型是ICU护士镇静镇痛集束化护理知信行总分的影响因素（P<0.05）。结论 ICU护士镇静镇痛集束化护理知识水平偏低,对镇静镇痛集束化护理的态度较积极,镇静镇痛集束化护理行为尚欠缺,神经重症ICU护士和护理工作年年限少于5年的ICU护士镇静镇痛集束化护理知信行总体水平高于其他护士,护理管理者应建立和完善镇静镇痛集束化护理培训体系,强化ICU护士的知识和行为,通过培训提高其镇静镇痛集束化护理的知信行水平。     

ICU护士培训需求及对策分析

目的:探究重症监护病房(ICU)护士培训需求,提出ICU护士培训对策,为各项培训工作的进行提供科学参考。方法:择选本院ICU护士为研究对象,通过自设问卷调查方法,从一般资料、ICU培训现状、专业综合能力需求、以及专科技能需求程度4个方面,调查ICU护士培训需求。结果:问卷调查结果显示,目前ICU护士普遍缺少系统的培训,进入ICU后培训也存在不完善、缺少层次等问题。ICU护士的培训需求主要集中在综合能力培训和专业技能培训两个方面,同时工作年限不同的ICU护士在培训需求方面存在不同的表现。结论:目前ICU护士培训仍存在不完善的问题,需根据ICU护士培训需求,重点围绕综合能力、专业技能培训等内容进行完善,以建立系统的ICU护理培训体系,综合提高ICU护士素质。     

护理人员对经口气管插管口腔护理认知状况的研究

经口气管插管是救治严重呼吸衰竭患者的重要措施,为临床医生针对呼吸衰竭的各种病因治疗争取时间并创造条件,但是插管又容易引发重症监护病房(intensive care unit,ICU)重要的医院感染问题———机械通气性肺炎(ventilated associated pneu-monia,VAP)的发生。VAP是指机械通气4