三级甲等医院临床护士伦理行为认知与实践现状研究

目的了解临床护士伦理行为认知与实践现状及影响因素,为医院及学校加强护理伦理教育提供依据。方法制定临床护士伦理行为认知及实践情况调查问卷,对甘肃省3所三级甲等医院的313名护士进行调查。结果临床护士伦理行为认知及实践总分分别为(215.37±10.64)分、(193.63±24.13)分,认知总分显著高于实践总分(P0.01);认知情况各维度得分依次为合作、自身权益维护、慎独、审慎、情感、公正、尊重;实践情况各维度得分依次为合作、审慎、慎独、情感、公正、尊重、自身权益维护;影响认知与实践的因素有性别、学历(P0.05,P0.01)。结论临床护士伦理行为的认知情况好于实践情况,应针对性地加强临床护士的护理伦理行为教育和监督,使其成为日常自觉行为。     

护士安全文化认知现状及影响因素分析

目的了解三甲医院临床护理人员安全文化认知现状及其影响因素、各维度权重,为提升临床护士安全意识的干预提供参考。方法采用改进后的患者安全文化调查问卷,对某三甲医院共1 502名护士进行调查,采用因子分析法确定安全文化各维度权重。结果护士安全文化总分为(3.69±0.35)分,各维度分别为安全文化现状(3.40±0.35)分,上司/护士长安全文化态度(3.86±0.55)分,安全信息沟通及交流情况(3.84±0.48)分,不良事件报告情况(3.60±0.81)分,患者安全评估(3.45±0.85)分,医院安全氛围(3.94±0.50)分。不同护龄、职称、学历、科室、是否接受过安全培训的护士,其安全文化总分差异有统计学意义(P0.05,P0.01)。不良事件报告情况(0.257)、医院安全氛围(0.159)和安全消息沟通与交流(0.158)3个维度权重较大。结论护士的安全文化认识较积极,但仍存在问题,应针对影响因素及不良事件报告情况予以干预,全方位营造医院安全文化氛围,保障患者安全。     

咸阳市医院护理工作环境与护士安全行为的相关性研究

目的了解咸阳市医院护理工作环境及护士安全行为现状,探讨护理工作环境与护士安全行为的关系,旨在为提高患者安全提供参考。方法采用一般情况调查表、护理工作环境量表、护士安全行为问卷对咸阳市7所综合医院护士816人进行调查。结果护理工作环境总均分为(2. 90±0. 40)分,护士安全行为总均分为(4. 12±0. 57)分。护理工作环境与护士安全行为呈正相关(P 0. 01)。多因素回归分析显示,医院等级、护理工作环境是护士安全行为的主要影响因素(均P 0. 01)。结论咸阳市综合医院护理人员安全行为水平较高,护理工作环境与护士安全行为相关。医院管理者可以通过改善护理工作环境,加强护士对安全行为认识的培训等,提高护理人员安全行为,保障患者安全。     

护士工作场所欺凌与自杀风险的关系研究

目的 探讨护士工作场所欺凌不同维度及不同类别与自杀风险的关系,为构建针对性干预方案降低自杀风险提供参考。方法 采用方便抽样法从山东省4所三甲医院中选取3 026名护士作为研究对象。采用负性行为问卷-修订版和自杀行为问卷-修订版评估护士的工作场所欺凌情况及自杀风险。结果 护士工作场所欺凌总分为(31.17±14.48)分,自杀总分为(4.16±2.22)分。工作场所欺凌总分及组织不公维度与自杀风险呈正相关(均P<0.05)。共识别出工作场所欺凌的5个类别,即低欺凌组(52.25%)、中欺凌组(9.35%)、高欺凌组(17.02%)、超负荷组(10.67%)和不匹配组(10.71%)。与低欺凌组相比,中欺凌组(OR=6.096)、高欺凌组(OR=5.832)、超负荷组(OR=3.668)和不匹配组(OR=3.391)护士自杀的风险更大。结论 护士遭受的工作场所欺凌存在不同类别,且与自杀风险关系密切,医院管理者应重视护士的工作环境,减少工作场所欺凌。     

护士信息素养与创新行为的相关性研究

目的了解临床护士信息素养与创新行为现状及两者的相关关系,为临床护士创新培训提供依据。方法采用信息素养问卷及创新行为量表对1所三甲医院的490名临床护士进行问卷调查。结果护士创新行为平均得分为(4.08±0.32)分;护士信息素养得分为(3.29±0.38)分,各维度均分分别为:信息意识(3.90±0.53)分,信息能力(2.95±0.45)分,信息知识(3.32±0.19)分,信息道德(3.28±0.30)分。信息素养能力与创新行为呈正相关(P0.05,P0.01)。结论临床护士创新行为处于较高水平,护士的信息素养与创新行为呈正相关,增强护士的信息素养,可激发创新行为,提高创新能力。     

护士组织承诺及影响因素的调查研究

目的 了解护士组织承诺情况及其影响因素,提出可行性建议,以提高护士整体组织承诺,促进医院健康发展.方法 采用调查问卷对武汉市某三级甲等医院315名在职护士进行问卷调查.结果 护士组织承诺总分为(60.24±11.32)分;机会承诺为(14.48±2.92)分,感情承诺为(12.49±2.85)分,经济承诺为(11.51±2.77)分,理想承诺为(11.08±3.44)分,规范承诺为(10.68±2.54)分.组织承诺各维度受学历、年龄、婚姻状况、工作年限及科室等因素的影响(P＜0.05,P＜0.01).结论 护士组织承诺处于中等偏下水平,需营造和谐的医院文化、建立合理的选人用人制度及公平合理的薪酬体系,以有效提高护士组织承诺和医院服务质量.     

护士道德困境与工作满意度相关性分析

目的分析护士道德困境与工作满意度的相关性,旨在为护理管理者提供依据,提高护士工作满意度。方法采用中文版护士道德困境量表(MDS-R)和明尼苏达工作满意度问卷(MSQ),对济南市3所三级甲等医院的189名临床护士进行问卷调查。结果护士道德困境总分为(38.86±8.26)分,道德困境频率和强度条目平均得分分别为(1.07±0.45)分和(1.04±0.63)分,均处于较低水平;工作满意度总分为(51.95±10.73)分;工作满意度各维度与道德困境的总分呈负相关(均P0.01)。结论护士道德困境与工作满意度关系密切,医院管理者应重视临床护士所面临的道德困境,提供各种支持措施,缓解道德困境给护士带来的工作压力,从而提高护士工作满意度。     

ICU护士镇静评估知识与行为的相关性研究

目的调查ICU护士镇静评估知识与行为现状及两者的相关性。方法采用自制的ICU护士镇静评估知识及评估行为问卷调查广州市5所三级甲等医院的182名ICU护士。结果ICU护士镇静评估知识与评估行为标准分分别为(58.91±12.82)分和(74.57±15.14)分,两者呈正相关(P0.01),评估知识维度与相应的评估行为维度呈正相关(P0.05,P0.01)。结论 ICU护士镇静评估知识与行为处于中等水平,镇静评估知识掌握较好的护士能正确进行镇静评估,管理者应鼓励ICU护士努力学习镇静评估相关知识,以提升其镇静评估行为。     

ICU护士工作满意度与创新行为的相关性研究

目的了解ICU护士工作满意度与创新行为的现状、影响因素及其相互关系。方法选取哈尔滨市4所三级甲等医院的340名ICU护士为研究对象,采用护士工作满意度和创新行为量表进行调查。结果 ICU护士工作满意度评分为(124.71±20.22)分,护士职称和劳动人事关系情况为主要影响因素(均P0.01);ICU护士的创新行为得分为(4.09±0.85)分,护士学历和职称为主要影响因素(均P0.01);ICU护士工作满意度得分及5个维度(家庭/工作平衡,工资及福利,成长及发展,工作被认可,管理)与创新行为总分呈正相关(P0.05,P0.01)。结论 ICU护士满意度略低但创新行为较好,提高护士的工作满意度,有利于促进其创新行为。     

授权型领导与临床护士创新行为的相关性研究

目的探讨授权型领导与临床护士创新行为之间的关系,为临床护理管理提供参考。方法采用一般资料调查表、授权型领导量表及护士创新行为量表对南昌市3所三甲医院工作的1 031名临床护士进行问卷调查。结果临床护士感知的护士长授权型领导总分为(44.84±10.50)分,创新行为总分为(34.72±7.63)分,授权型领导与临床护士创新行为呈正相关(r=0.498,P<0.01)。结论授权型领导与临床护士创新行为处于中等水平,两者呈正相关关系。护理管理者可发挥授权型领导风格的积极作用,促进护士创新行为产生,从而提升组织创新绩效。     

Psychosocial safety climate and supportive leadership as vital enhancers of personal hope and resilience during the COVID-19 pandemic

This study aimed to investigate the effects of supportive leadership and psychosocial safety climate on personal hope and resilience among nurses during the pandemic. Conservation of resource theory was employed to explain the effects of psychosocial safety climate and supportive leadership on nurses' hope and resilience. A cross-sectional design was employed to collect data. Six-hundred and twenty-three nurses across 68 hospitals who were in direct contact with COVID-19 patients during the fifth wave of the pandemic in Iran were recruited. Hierarchical Linear Modelling (HLM) and Structural Equation Modelling using Amos were used to analyze the data. Results revealed that both psychosocial safety climate and supportive leadership improved personal resilience through personal hope. Findings showed that the positive relationship between supportive leadership and personal hope was stronger when the hospital-level psychosocial safety climate was high. To improve personal hope and resilience among nurses during critical times, hospital management must ensure consistent supportive leadership and establish policies, practices and procedures that support nurses' psychosocial health and safety at the hospital level.     

护士对医院伦理气氛认知现状调查分析

目的了解护士对医院伦理气氛的认知现状并对其影响因素进行分析,为医院管理部门提高护士伦理气氛认知水平提供参考。方法采用伦理气氛认知量表(ECQ)对衡阳市某三甲医院348名注册护士进行调查。结果护士伦理气氛认知总均分为81.64±8.20,不同人事关系、第一学历、护龄及月收入的护士伦理气氛认知得分比较,差异有统计学意义(均P<0.05);护士对医院伦理气氛的认知受其月收入、第一学历的影响。结论医院管理者可通过增加护士人员编制,提高薪金待遇,加强在职人员伦理培训,从而提高护士对医院伦理气氛的认知水平。     

格林模式培训促进低年资护士胰岛素规范化注射行为

目的 提高低年资护士胰岛素注射知识,规范其胰岛素注射行为.方法 采用格林模式对93名低年资护士进行胰岛素规范化系统培训.采用问卷、现场观察、深入访谈方式调查低年资护士对胰岛素认知和注射行为状况,分析影响低年资护士胰岛素规范化注射行为形成的倾向、促成和强化因素;相应给予规范化的胰岛素知识和技能培训;完善流程和制度、提供学习资源和技术的支持;采用自评、持续督导和及时反馈等一系措施.结果 培训后低年资护士胰岛素认知总分及胰岛素保存、胰岛素基本知识、注射知识和低血糖防治知识等各维度得分均提高（均P＜0.01）;胰岛素保存、胰岛素注射步骤、注射部位规范检查、低血糖防治等胰岛素注射相关行为正确率显著提高（均P＜0.01）.结论 格林模式指导下的培训能提高低年资护士胰岛素注射知识,规范其胰岛素注射行为,提高胰岛素治疗的有效性和安全性.     

三级医院护士开展“互联网+护理服务”意愿及需求的质性研究

目的了解三级医院护士开展"互联网+护理服务"意愿及需求,为完善该护理服务模式提供参考。方法自拟提纲对1所三级医院的13名临床护士进行一对一深入访谈,采用Colaizzi现象学研究法分析资料、提炼主题。结果提炼出4个主题:有较强的开展"互联网+护理服务"意愿;人身安全与执业安全保障需求;护理服务医疗风险控制需求;合理收费需求。结论三级医院护士对"互联网+护理服务"有较强的意愿,安全保障、相关规范标准及合理收费是当前主要需求。相关管理部门应尽快加以建设和完善,以促进"互联网+护理服务"良性发展。     

护士医院安全文化认知的调查研究

目的了解护士对医疗护理安全文化的认知情况,为针对性地对护士进行医院安全文化教育提供依据。方法采用经修改后的医疗安全问卷（内容包括与安全有关的病房组织文化、医院组织文化和差错事故报告系统）对233名护士进行调查。结果护士对医疗安全知识认知总分为170．58土9．63,对病房组织文化、医院组织文化、医疗差错事故报告系统的认知评分分别为78．82±6．26、43．96士5．10、57．39士5．33。不同职称、科室护士对医疗差错事故报告系统的认知水平比较,差异有统计学意义（均P〈0．05）;不同科室、学历、年龄、工龄、职称的护士对病房组织文化认知水平比较。差异无统计学意义（均P〉0．05）。不同特征（学历、科室除外）护士对医院组织文化的认知水平比较,差异有统计学意义（均P〈0．05）。结论护士对安全文化认知度低,需要加强护士医疗安全的相关意识．构建积极的医院安全文化。     

糖尿病联络护士在非糖尿病病区护理风险管理中的作用

目的探讨糖尿病联络护士在非糖尿病病区护理风险管理中的作用。方法于全院各病区选取护士1～2人共63人组成糖尿病联络护士小组,其接受系统培训后由其对本病区护士进行再培训,对患者进行健康教育和管理。结果干预后全院护士对糖尿病相关知识及操作技能掌握程度显著提高(均P<0.01),非专科住院糖尿病患者对糖尿病相关知识掌握情况显著改善(均P<0.01),糖尿病护理缺陷从2008年6起下降至2011年0起。结论糖尿病联络护士的设立有利于提高非专科的糖尿病护理水平。     

多学科糖尿病管理团队对联络护士培训的中期效果评价

目的评价医院多学科糖尿病管理团队对联络护士培训的中期效果。方法对入选某三级甲等综合医院多学科糖尿病管理团队的65名非内分泌专科糖尿病联络护士分阶段进行培训,第1年行资格认定短期强化培训,之后3年行继续在职培训,比较培训前、短期培训、继续在职培训后联络护士的糖尿病知信行水平。结果继续在职培训后联络护士知识、态度、行为维度得分显著高于培训前(均P0.01);相比短期强化培训,联络护士接受继续在职培训后知识维度得分显著降低(P0.01),态度维度得分水平显著提升(P0.05),但行为维度得分差异无统计学意义(P0.05)。结论多学科糖尿病管理团队对联络护士进行继续在职培训,能显著提高非内分泌专科糖尿病联络护士的糖尿病态度水平,维持短期强化培训后行为水平。提示在制订糖尿病联络护士培训计划时,需根据培训目标分阶段进行有针对性的培训,以达到理想培训效果。     

Pressure injury prevention and management practices among nurses: A realist case study

The prevention and management of a pressure injury is a nurse‐sensitive quality indicator in hospitals. Prevention and management of pressure injury practices have been found to be suboptimal despite the availability of interventions. Currently, there is a poor understanding of the mechanisms behind these interventions. The aim of the study was to explain a realistic portrayal of nurses' current practices to prevent and manage pressure injuries in one public hospital in Singapore. A realistic case study design was adopted. Twenty‐four nurses were recruited. Audio‐recorded interviews were transcribed verbatim to facilitate thematic analysis. Prevention and management was generally facilitated through the timely escalation of care, effective communication, support from the wound nurses, and bridging of the knowledge‐practice gap. However, factors such as nurses' intrinsic characteristics and organisational support may affect the outcomes of these facilitators. Overall, nurses strive to achieve patient safety, where pressure injuries are prevented to the best of their abilities. This study provides causal links between contextual factors, mechanisms of the prevention and management, and the outcomes achieved. Further refinement and testing of the specific mechanisms are needed and will contribute to a better understanding of how nurses prevent and manage pressure injuries.     

Knowledge,attitude, and practice of nurses in intensive care unit on preventing medical device–related pressure injury: A cross‐sectional study in western China

The knowledge, attitude, and practice of nurses in intensive care units (ICUs) are determinants for the efficacy of preventing the medical device–related pressure injury (MDRPI). The aim of this study was to determine the level and factors of knowledge, attitude, and practice of nurses'' ICUs on preventing medical MDRPI in western China. An annual cross‐sectional study was conducted in hospitals of western China from May 2020 to September 2020. Nurses'' knowledge and attitudes were assessed using Clinical Nurses Prevention MDRPI of Critically Ill Patients for the Knowledge, Attitude, Practice Assessment Scale. SPSS software version 25.0 and independent t‐test, Chi‐square, Fisher exact, one‐way analysis of variance, and multiple linear regression tests were used for data analysis. A total of 1002 nurses in ICUs from 37 hospitals in Gansu Province, China, participated in this study. The scores of overall KAP, knowledge, attitudes, and practice were 149.17 ± 24.62, 53.83 ± 12.23, 37.24 ± 6.35 and 58.10 ± 9.83, respectively. There was a positive and significant relationship between three variables. Findings revealed that nurses'' knowledge score in the Tertiary hospital was higher than scores of other hospitals as 3.840 units. Moreover, the knowledge score and practice score of nurses with bachelor''s degree or above were higher than other nurses and are 0.978 and 1.106 units, respectively. Based on the findings, practice of nurses increased by 0.992 units, with a 1‐year increase in work experience of nurses in the ICU. The levels of knowledge, attitude, and practice of nurse in ICUs on preventing MDRPI were acceptable. The findings of the study highlight that a comprehensive approach should be conducted for raising the level of knowledge, attitude, and practice of nurses'' ICUs on preventing medical MDRPI, as well as improving the quality of care for critically ill patients.     

基于单元的综合安全项目对手术室护士髋关节假体产品应用安全的影响

目的 探讨基于单元的综合安全项目的实施对手术室护士人工全髋关节置换术中髋关节假体产品应用安全的影响。方法 将骨科手术间的49名手术室护士按照区域分为对照组24名,试验组25名。对照组实施常规安全管理模式,试验组实施基于单元的综合安全项目对护士髋关节假体产品应用进行安全管理,3个月后对两组护士髋关节假体产品应用知识水平及安全态度得分进行评价,选取两区域各320例患者比较髋关节假体产品应用实际错误/堵漏事件发生率。结果 试验组护士髋关节假体产品应用知识测评成绩与安全态度得分显著高于对照组(均P<0.05),应用髋关节假体产品实际错误/堵漏事件发生率显著低于对照组(P<0.05)。结论 基于单元的综合安全项目的应用能够促进单元内安全文化的建立,提高单元内护士髋关节假体产品应用安全水平。