提升心臟外科新進護理師臨床照護技能正確率

Enhancing the Correct Rate of Clinical Care Skills for New Nurses in Cardiac Surgery

10.6540/NTJN.202203_24(1).0008

陳瑋儀(Wei-Yi Chen)；黃詠涵(Yung-Han Huang)；黃慧雯(Hui-Wen Huang)；熊道芬(Dao-Fen Hsiung)

心臟外科 ； 新進護理師 ； 臨床照護技能 ； cardiac surgery ； new nurse ； clinical care skills

新臺北護理期刊

24卷1期（2022 / 03 / 01）

95 - 107

繁體中文

新進護理師進入臨床前三個月需不斷學習各項知能，熟悉技術操作並反覆練習，降低醫療錯誤發生。從2019年1月1日至1月31日，透過“臨床照護技能正確性檢查表”針對六名心臟外科新進護理師進行調查，發現平均正確率僅49.2%，原因為：技術不純熟、儀器多操作複雜，專科專業知識不足、自學教材手冊未更新、學習時間不足、臨床教師指導內容不一致、口頭教學成效不彰、缺乏臨床照護前的實際演練、教材來源多是文字敘述且少有圖示影片說明，教學過多內容無法吸收，疾病種類複雜。提出之改善方案為：制定常見護理技術標準流程、製作多媒體教材、提供管路傷口照護教學模具使用、錄製常見儀器使用方法及步驟、舉辦儀器操作之在職教育、修訂自學教材手冊等混合式教學模式，結果顯示臨床照護技能操作平均正確率由49.2%提升至95.7%，有效改善新進護理師臨床照護技能。

The new nurses into the health facilities in a nursing career before the first three months requires continuous learning of various knowledge and abilities, familiarity with technical operations, and repetitive practice to improve competence and reduce the occurrence of medical errors. We surveyed six new nurses in cardiac surgery with our customized ＂Checklist for Correctness of Clinical Care Skills for New Nurses in Cardiac Surgery＂ from January 1 to January 31, 2019, The results showed that the average accuracy of clinical care for recruits was only 49.2%, and the reasons for the low accuracy of clinical care were no actual clinical care skills or technical immature, lack of specialized expertise, training before clinical practice, insufficient learning time, different ways of instructing by the preceptor, many devices and complicated surgeries, most of the textbooks being written narratives, few pictorial videos to explain, and self-learning materials manual without keeping pace with the times. To make improvement, it is recommended to develop common nursing technical standard procedures, make Multimedia teaching materials, provide the use of models for catheter and wound care, record the methods and steps of using equipment, organize on-the-job education of device operation, and revise self-learning materials and other mixed teaching modes for improvement. The result is that the accuracy of clinical skills has been increasing from 49.2% to 95.7%, which effectively improves the work skills of new nurses.

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