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Objective:To establish a graded post management system for specialist nurses in medical institutions, so as to provide a reference for the selection, stratification, employment, and promotion of specialist nurses in China.Methods:Through literature review and brainstorming, the primary screening indicators of the graded post indicator management system for specialist nurses were constructed. Two rounds of Delphi method were used to consult 25 experts to construct the graded post management system for specialist nurses.Results:The effective recovery rates for two rounds of consultation were 100% and 96%, respectively, with expert authority coefficients of 0.86 and 0.89, and Kendall harmony coefficients of 0.31 and 0.54. The final establishment of a specialist nurses graded post management indicator system included 8 first level indicators, 31 second level indicators.Conclusions:The graded post management indicator system for specialist nurse could provide theoretical support for the management of specialist nurse. It was conducive to clarifying the admission standards and hierarchical framework for specialist nurses, standardizing the establishment of positions and responsibilities, and improving the competition and incentive mechanism.
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Objective:To explore the effect of knowledge-clinical-sharing (KCS) model in humanistic care training of pediatric nurses.Methods:A total of 182 specialist nurses who were trained in Hunan Children's Hospital from June 2019 to December 2019 were selected as the research objects. Among them, 102 specialist nurses from June 2019 to August 2019 were selected as the control group, and 80 specialist nurses from September 2019 to December 2019 were selected as the intervention group. The Jefferson empathy scale was used to compare the effect of humanistic training before and after the implementation. SPSS 22.0 statistical software was used, measurement data were test by F-test and t-test, and the counting data were analyzed by Chi-square test. Results:After the implementation of humanistic care training based on KCS model, the empathy ability score of the intervention group was higher than that of the control group [(80.23±5.33) vs. (78.14±4.37)], and the difference was statistically significant ( P < 0.01). There was no significant difference between neonatal and pediatric specialist nurses before and after the training. Conclusion:The phased humanistic training based on KCS model can improve the empathy ability of pediatric nurses and enhance their confidence in the clinical implementation of humanistic care. However, the humanistic training mode of pediatric nurses should be improved according to the hospital's own situation, so as to adapt to the development of nursing industry.
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Objective:To evaluate the effects of objective feedback teaching applied in the specialist nurses training of digestive endoscopy.Methods:Six-eighty nurses participating in the training of specialist nurses of digestive endoscopy in Chongqing were recruited in the study, among which, 30 trainees in 2019 were assigned to the observation group, taking objective feedback teaching, and 38 trainees in 2018 were assigned to the control group, receiving traditional teaching. After the training, the two teaching methods were assessed through theoretical results, operation skills and comprehensive evaluation, and meanwhile a self-designed satisfaction questionnaire on the satisfaction of trainees was conducted. SPSS 25.0 was used to perform t-test, Chi-square test and Mann-Whitney U test. Results:The operation skills (84.90±4.92) and comprehensive quality (86.30±4.62) of observation group were higher than those of the control group [(82.39±4.10), (83.86±5.10)], with statistically significant differences ( P<0.05), while there was no significant difference in theoretical knowledge [(85.80±5.63) vs. (83.68±4.51), P>0.05]. Trainees were satisfied with the new training mode. Conclusion:The objective feedback teaching mode can improve the training effect especially on operation skills and comprehensive quality of the specialist nurses of digestive endoscopy, and insure the satisfaction of specialist nurses with the training.
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Objective:To investigate the effect of standardized training mode in the training of vascular specialist nurse.Methods:A total of 110 nurses in Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University were selected for taking the training from June 2020 to June 2021, and they were randomized into the observation group (55 cases) and the control group (55 cases). The observation group adopted standardized training mode, while the control group adopted routine training mode. The results of theoretical knowledge assessment, clinical practice operation and satisfaction rate of training were compared between the two groups. SPSS 22.0 was performed for t test and chi-square test. Results:The scores of professional theoretical knowledge assessment and clinical practice operation in the observation group were respectively (88.45±1.52) points and (87.64±1.97) points, which were significantly higher than (81.45±1.42) points and (80.24±1.57) points in the control group ( P<0.05). The satisfaction rate of training in the observation group was 100.00%, which was significantly higher than 90.91% in the control group ( P<0.05). Conclusion:The application of standardized training mode in the training of vascular specialist nurses can significantly improve the scores of nurses' professional theoretical knowledge and clinical practical operation, as well as their satisfaction with training, which is worthy of promotion.
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Objective:To explore the practical effect of PICC catheterization in breast cancer patients by a multidisciplinary team led by specialist nurses.Methods:Choose Affiliated Tumor Hospital, Xinjiang Medical University in March 2018 to January 2020, 120 cases of breast cancer patients undergoing chemotherapy, according to the random number method, 60 cases were divided into control group and test group, control group given routine nursing care, experimental group on the basis of conventional nursing to the specialist nurses as the leading multidisciplinary team management mode to compare two groups of patients with a success rate of puncture complications patients satisfaction and unscheduled decannulation rate before and after the implementation of the multidisciplinary model nurse satisfaction.Results:The one-time puncture success rate, unplanned extubation rate, incidence of mechanical phlebitis, medical adhesion-related skin injury, puncture point infection, and catheter blockage rate were 98.3% (59/60), 10.0% (6/60), 8.3% (5/60), 1.7% (1/60), 10.0% (6/60), and 10.0% (6/60), respectively. The control group was 88.3% (53/60), 20.0% (12/60), 20.0% (12/60), 13.3% (8/60), 18.3% (11/60) and 21.7% (13/60), respectively. The difference was statistically significant ( χ 2 values were 4.821-14.911, P<0.05). The satisfaction scores of patients in the experimental group were (17.05±1.43), (17.13±1.28) and (4.38±0.56) points respectively in the three dimensions of nurse skill level, nursing service experience and health education guidance, while those in the control group were (14.53±2.10), (15.03±1.38) and (3.10±0.75) points respectively, the difference was statistically significant ( t values were 0.576, 0.623, 0.699, P<0.001). Nurse satisfaction after the implementation of the multidisciplinary model on the professional ability, job security, teamwork, self-assessment score four dimensions, respectively (12.73±1.02), (24.00±3.52), (16.42±2.06), (13.00±1.83) points, not the implementation of the multidisciplinary model its satisfaction each dimension score (9.69±1.49), (7.88±2.07), (11.92±1.32), (8.88±1.18) points, improved from the previous implementation, the difference was statistically significant ( t values were 0.576-0.798, P<0.001). Conclusions:The multidisciplinary team management model led by specialist nurses is applied to the PICC management of breast cancer patients, which not only reduces the incidence of catheter complications, but also improves the quality control level of PICC and the satisfaction of patients and nurses, in order to further promote intravenous treatment. Specialized development provides guidance.
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Objective@#To explore the application effect of a specialized team consisting of specialist nurses and some emergency care′s or intensive care′s head nurses of critically ill patients in the hospital.@*Methods@#From 2016 to 2018, the Critical Care Professional Group of implemented a provincial and above specialist nurses and the backbone of the specialist care departments of the acute and critical departments. A total of 23 members were composed of core members. A total of 56 liaison officers from each ward were selected to participate. The training and assessment activities presided over by the core staff of the professional group; at the same time, the professional group liaison officer is also the leader of the critical care quality control team in this ward, and implements the quality control of critical care patients; the core members are responsible for the guidance of the nursing care of critical patients in the hospital. The liaison staff carries out the training and assessment of the intensive care knowledge, skills and related nursing standards, norms, as well as the sharing of new technologies and new projects or research topics for acute and critical care, and the training of intensive care posts in the hospital. Before and after the operation of the specialized nursing team, the quality control scores of critically ill patients in 2015-2018, the satisfaction survey of nursing, the number of patents published by nurses in 2-25 years, the mortality rate of patients, and the results of unplanned extubation in 2016-2018 Compare.@*Results@#The quality control scores of critical care patients in 2015-2018 were 93.91±1.23, 94.07±1.38,94.33±1.24, 95.42±1.56. The difference was statistically significant (F=49.597, P < 0.01). Satisfaction survey scores were 94.92±2.28, 97.08±1.37, 97.82±1.52, 97.94±1.68, the difference was statistically significant (F=30.882, P < 0.01); work 2-20 years The number of nurses was 678, 809, 853, and 925 respectively. The number of patents published was 76, 119, 147, and 237, respectively. The difference was statistically significant (χ2=36.77, P < 0.01). 2016-2018 unplanned extubation rate was 4.98‰(127/25 517), 4.01‰(115/28 713), 3.25‰(112/34 493), the difference was statistically significant (χ2=10.958, P <0.01).@*Conclusions@#The professional nursing team operation mode can improve the core ability and comprehensive quality of nursing staff's intensive care, improve the quality of care management of critically ill patients, ensure patient safety, and achieve continuous improvement of nursing quality.
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Objective@#To explore the effect of case management mode on self-management ability of enterostomy patients.@*Methods@#A total of 104 cases of enterostomy patients were divided into 54 cases in control group and 50 cases in experimental group according to admission time.Used Enterostomal Therapist(ET) as the leading organization of the experimental group to establishing personal files by coordinating team psychological counselors, dietitians, specialists and nurses for individualized nursing services. Patients would receive a three-month nursing practice of case management. The control group would be given nursing intervention and health guidance according to the standardized nursing procedure for enterostomy. After discharge, the nurse-in-charge followed up patients′ treatment completion status. The incidence of enterostomy complications and self-management ability of the stoma in two groups were evaluated at 3 months after surgery.@*Results@#In experimental group,the nursing management score of enterostomy was 33.48±4.90, the score of information management was 12.84±2.21, thesymptom observation score was 12.36±1.55, the daily life management score was 30.00±3.40, the psychological management score was 11.64±1.55. Meanwhile,in control group, the nursing management score of enterostomy was 29.74±8.34, the score of information management was 12.10±1.74, the symptom observation score was 11.25±2.56, the daily life management score was 26.59±5.22, the psychological management score was 10.74±2.59. Nursing management score of enterostomy, symptom observation, daily life management, psychological management score between two groups showed significant difference(t=1.529-2.808, P<0.01 or 0.05). The incidence of peristomal dermatitis was 8.0% (4/50) in the experimental group, much lower than that in the control group which was 27.8%(15/54).The difference was statistically significant (χ2=6.801, P<0.05).@*Conclusions@#Nursing practice of case management can improve the life quality and accelerate the social adaptability of enterostomy patients.
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Objective@#To study the correlation between job satisfaction and work effectiveness of ICU specialist nurses, to clarify the baseline level and influence factors, to increase the efficiency and satisfaction of the work, and to stabilize the ICU nurse team, to improve the quality of care.@*Methods@#The convenience sampling method was used to select 116 specialist nurses from the 3 three grade ICU hospitals in Guangzhou. Through the questionnaire survey of nurses′ general situation, work efficiency and job satisfaction, the methods of descriptive statistics, average number, standard deviation analysis, simple linear regression model analysis and multiple linear regression analysis were adopted to reveal the relationship between work effectiveness and job satisfaction of specialist nurses.@*Results@#The overall empowerment of ICU specialist nurses was 3.37 ±0.68. In the 6 dimensions of work efficiency, the average score of formal authorization was the lowest (3.01±0.93) and that of informal authorization was the highest (3.73±0.77). Multiple linear regression analysis showed that job satisfaction of nurses increased linearly with the increase of the scores of formal authorization and informal authorization (t=2.32, 3.78,P < 0.05). The total score of satisfaction was 55.03± 8.30. The work status dimension score was 35.16± 5.94, in the middle level limit; the work interpersonal relationship dimension score was 19.87 ± 2.82, in the high level. The work status satisfaction lagged behind the work interpersonal relationship satisfaction. Simple linear regression model analysis showed that the total score of satisfaction increased linearly with the average score of work efficiency, showing a positive linear correlation (t=9.891,P < 0.01). The regression equation was: y=27.12+8.273.@*Conclusions@#Because of the linear positive correlation between job efficacy and total score of satisfaction, nursing administrators should fully grasp the various factors affecting job efficacy in clinical management, and take targeted measures to improve the work efficiency of ICU specialist nurses, and ultimately improve the job satisfaction of nurses.
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Objective To explore the effect of case management mode on self-management ability of enterostomy patients. Methods A total of 104 cases of enterostomy patients were divided into 54 cases in control group and 50 cases in experimental group according to admission time.Used Enterostomal Therapist(ET) as the leading organization of the experimental group to establishing personal files by coordinating team psychological counselors, dietitians, specialists and nurses for individualized nursing services. Patients would receive a three-month nursing practice of case management. The control group would be given nursing intervention and health guidance according to the standardized nursing procedure for enterostomy. After discharge, the nurse-in-charge followed up patients′ treatment completion status. The incidence of enterostomy complications and self-management ability of the stoma in two groups were evaluated at 3 months after surgery. Results In experimental group,the nursing management score of enterostomy was 33.48 ± 4.90, the score of information management was 12.84 ± 2.21, thesymptom observation score was 12.36 ± 1.55, the daily life management score was 30.00 ± 3.40, the psychological management score was 11.64 ± 1.55. Meanwhile,in control group, the nursing management score of enterostomy was 29.74 ± 8.34, the score of information management was 12.10 ± 1.74, the symptom observation score was 11.25 ± 2.56, the daily life management score was 26.59 ± 5.22, the psychological management score was 10.74 ± 2.59. Nursing management score of enterostomy, symptom observation, daily life management, psychological management score between two groups showed significant difference (t=1.529-2.808, P<0.01 or 0.05). The incidence of peristomal dermatitis was 8.0% (4/50) in the experimental group, much lower than that in the control group which was 27.8%(15/54).The difference was statistically significant (χ2=6.801, P<0.05). Conclusions Nursing practice of case management can improve the life quality and accelerate the social adaptability of enterostomy patients.
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Development of medical alliances can provide patients of wound ostomy with cost-effective, safe and effective continuing specialized care at their community, gradually homogenizing hospital-community specialized care. By means of establishing a nurse advice referral and specialist nurses consultation mechanism, Shenzhen Luohu Hospital Group has achieved to share specialist nursing resources between hospitals and social health centers.This practice can reduce re-hospitalization rate of these patients, reduced their economic burden, save medical resources and improve patient satisfaction as well.
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Objective To study the correlation between job satisfaction and work effectiveness of ICU specialist nurses, to clarify the baseline level and influence factors, to increase the efficiency and satisfaction of the work, and to stabilize the ICU nurse team, to improve the quality of care. Methods The convenience sampling method was used to select 116 specialist nurses from the 3 three grade ICU hospitals in Guangzhou. Through the questionnaire survey of nurses′general situation, work efficiency and job satisfaction, the methods of descriptive statistics, average number, standard deviation analysis, simple linear regression model analysis and multiple linear regression analysis were adopted to reveal the relationship between work effectiveness and job satisfaction of specialist nurses. Results The overall empowerment of ICU specialist nurses was 3.37 ±0.68. In the 6 dimensions of work efficiency﹐the average score of formal authorization was the lowest (3.01±0.93) and that of informal authorization was the highest (3.73±0.77). Multiple linear regression analysis showed that job satisfaction of nurses increased linearly with the increase of the scores of formal authorization and informal authorization (t=2.32, 3.78,P<0.05). The total score of satisfaction was 55.03± 8.30. The work status dimension score was 35.16± 5.94, in the middle level limit; the work interpersonal relationship dimension score was 19.87 ± 2.82, in the high level. The work status satisfaction lagged behind the work interpersonal relationship satisfaction. Simple linear regression model analysis showed that the total score of satisfaction increased linearly with the average score of work efficiency, showing a positive linear correlation (t=9.891,P<0.01). The regression equation was: y=27.12+8.273x. Conclusions Because of the linear positive correlation between job efficacy and total score of satisfaction, nursing administrators should fully grasp the various factors affecting job efficacy in clinical management, and take targeted measures to improve the work efficiency of ICU specialist nurses, and ultimately improve the job satisfaction of nurses.
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Objective@#To investigate the cognition and intension of the enterostomal therapists for multi-sited practice, and explore the feasibility of the multi-sited practice among specialist nurses.@*Methods@#A questionnaire was developed and distributed in November 2017 to nurses qualified for enterostomal therapists and engaged in this work. 89.57% of the questionnaires were effectively recovered.@*Results@#The scorings of both the feasibility (3.78±0.97) and compliances (3.99±1.00) for enterostomal therapists to practice at multiple sites were higher than that (3.61±1.31) for feasibility of multi-sited practice of nurses at large. Around 95% of the respondents held that they could independently practice at multiple sites as enterostomal therapists, and two thirds of them proposed the regulatory authority for nurses′ multi-sited practice to be all the medical institutions or regional healthcare authorities which permit multi-sited practice of enterostomal therapists.@*Conclusions@#Specialist nurses represented by enterostomal therapists highly embrace nurses′ multi-sited practice, take a positive attitude towards their competence in this regard, and expect more stakeholders involved in setting up such a management system.
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Objective To estimate the effect of diversified training model in training nurses in operation room. Methods A total of 36 nurses during 2014-2016 were chosen by using diversified training model. The effect and degree of doctors′satisfaction were evaluated. Results After diversified joint training, the average specialist theoretical scores of orthopedic surgery specialist nurses in 2014, 2015, 2016 were 78.444±6.243,84.072±4.754,90.565±2.597; the operational skill scores were 79.444± 4.623, 84.472±2.922,90.118±2.713, the differences were statistically significant (F=58.156, 82.619,P＜0.05). Preoperative operating specification rates were 72.2% (26/36), 86.1% (31/36), 100.0% (36/36);intraoperative operating specification rates were 75.0% (27/36), 83.3% (30/36), 100.0% (36/36); surgical instrument operating specification rates were: 66.7% (24/36), 83.3% (30/36), 97.2% (35/36); surgical fit:72.2% (26/36), 88.9% (32/36), 97.2% (36/36), the differences were statistically significant(χ2=9.755-11.624, P＜0.05). Conclusions The diversified training model is a valuable method in training nurses in operation room.
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Training about master of nursing on professional degree and specialist nurse is the important part of nursing program in China. However, general education, lacking of specialized courses and the imperfect system of evaluation and certification is still exist. There is successful training and certification about them in American. The paper reviewed the educational status of master of nursing on professional degree and the certification standards, as well as authorities of nurse specialists in American. Hopefully, we can make reference for the future nursing field.
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Objective To investigate training effects of Shandong oncology specialist nurses. Methods A self-designed questionnaire about training effects was used to investigate 149 oncology specialist nurses in 48 hospitals in Shandong province. Results The total score of training effects was 202.075 ± 17.918. Differences were significant in human relations of training effects of oncology specialist nurses (F=3.439,P<0.05 ). 94.74％(126/133)of the oncology specialist nurses had no changeable in their work after training, 62.41％(83/133)served as skeleton staffs, only 22.56％(30/133)published in journals, 58.65％(78/133)of the specialist nurses had no chance to attend meeting and only 3.01％(4/133)had experiences to study for a month or more. Conclusions The training effects of Shandong oncology specialist nurses some abilities still need to be increased, the training contents need to be enriched, the use and management of the specialist nurses need to be further regulated, and the development of the oncology specialist nurses need to be further improved.
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Objective To construct an evaluation index system for the core competence of tumor chemotherapy specialist nurses in China and to provide standards for training of tumor chemotherapy specialist nurses.Methods Through literature research and expert meeting,the first draft of index system was established,and consultation questionnaire was compiled.Two rounds of consultation were conducted with 23 experts in China using Delphi method.AHP method was used to determine the weights of indicators at all levels.Results The effective rates of 2 rounds of expert consultation were 100％ and 73.91％,respectively.In the 2 rounds of consultation,the expert authority coefficients were 0.855 and 0.867,respectively.The coordination coefficient of first and second level indexes and expert opinions were 0.693 and 0.371 (P＜0.001),respectively.The final evaluation index system for the core competence of tumor chemotherapy specialist nurses included 5 first-level indexes (positive professional attitude,sufficient clinical practice ability,strong educational counseling ability,basic clinical research and evidencebased practice ability,and basic management ability),16 second-level indexes,and 59 third-level indexes.Conclusion The evaluation index system for chemotherapy specialist nurses based on core competence determined by expert consultation is scientific and reasonable,and can provide a powerful basis for training qualified chemotherapy specialist nurses.
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Objective To evaluate the outcomes after implementing gestational diabetes mellitus(GDM) specialist practice model. Methods GDM specialist practice model contained four modules(first visit,follow-up visit,hospital-ization,postpartum),eight aspects of practice contents which included specialist evaluation,diet & exercise survey, diet & exercise prescription,GDM health guidance,weight management during pregnancy. Pregnancy outcomes were compared before and after GDM specialist practice. Results GDM specialist practice model was able to signifi-cantly decrease insulin utilization rate,reduce number of hospitalized patients due to poor blood sugar control,short-en length of hospitalization. Conclusion GDM specialist practice model can effectively save medical costs,and GDM specialist nurses play an important role in management of women with GDM.
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For the purposes of meeting the needs of COPD patients for health education, decreasing times and costs of re-hospitalization, and increasing patient satisfaction and nurses' working enthusiasm. In 2011, our hospital established a specialist nursing clinic for chronic obstructive pulmonary disease (COPD), and two nursesentitled-deputy directorswith rich clinical experiences for more than fifteen years and strong communication skills were se-lected to take charge of the clinic, and they were responsible for nursing assessment, making individualized pul-monary rehabilitation plan, health guidance, long-term follow up, etc., for discharged stable COPD patients and COPD patients with no need for hospitalization. Patient satisfaction was improved from 83% to 96% after implemen-tation.
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Objective To investigate the current working situation of specialist nurses in China via questionnaire survey among 873 specialist nurses.Methods Eight hundred and seventy-three specialist nurses in 474 hospitals in 30 provinces(cities or autonomous regions) in China were investigated using a self-designed questionnaire on SO JUMP platform.Results One hundred and ninety-seven (22.6％) specialist nurses worked on nursing management positions.One hundred and fifty (17.2％) specialist nurses worked in other places besides their own wards,121 (13.9％) undertook nursing consultation work,58 (6.6％) worked in specialist nursing outpatient clinics,and 528 (60.5％) worked as clinical part-time teachers.One hundred and seventy(19.5％) specialist nurses undertook scientific research tasks,and 129(14.8％) published papers after attending the training courses.Conclusion Specialist nurse position is paying increasing attention to clinical practice;the working sites have been expanded,the working contents have been richened,and specialist working capacity has been improved.
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Comparing the definition,classification,quantity,core capacity construction and the supervision mode of Chinese and the United States specialist nurses,there was a gap between them.The training for the specialist nurses in China was at the initial stage.The advanced experience should be learned from America to provide the reference for building the core capacity and supervision mode of the specialist nurses.