Development And Application Of Noninvasive Positive Pressure Ventilation Nursing Checklist

Part one The study on development of noninvasive positive pressure ventilation nursing checklistObjective: To creat a noninvasive positive pressure ventilation nursing checklist which prevents missing tasks and ensures continuous quality care with modified delphi method.Methods:Literature research,group discussions and clinical experience summary were used to design non-invasive positive pressure ventilation nursing checklist preliminary draft.Through the modified delphi method of questionnaire survey,non-invasive positive pressure ventilation checklist preliminary was modified to form a formal non-invasive positive pressure ventilation nursing checklist.Results:1 This study completed two rounds expert correspondence.The experts were selected from 22 level-? grade comprehensive hospital and 2 level-?grade specialist hospital.A total of 71 questionnaires were issued in the first round,and the recovery was 62 and the effective recovery rate was about87.30%.The second round issuance contained 62 questionnaires and recycled55 and the effective recovery rate was 88.71%.The average authority of the two rounds of experts was 0.88 and 0.88,respectively.2 In this study,the noninvasive positive pressure ventilation nursing checklist covered a total of 14 items of nursing tasks before and after ventilation and each item listed the corresponding specific nursing work contents and the importance of the experts' comments on all items and contents were>4 points.The identity on all items and contents(score 4 to 5points)were 83.33%~100%.The coefficient of variation was <0.2 after two rounds of consultation.The final generation of 14 items noninvasive positive pressure ventilation nursing checklist met the scientific and operational principles.Conclusion:This paper has developed a noninvasive positive pressure ventilation nursing checklist with improved delphi technology based on the literature search at home and abroad which has a good clinical guidance.Part two The study on application of noninvasive positive pressure ventilation nursing checklist in screening defectsObjective: To screen defects in nursing tasks of noninvasive positive pressure ventilation and provide reference for training program.Methods:The defects of 85 nurses were checked by the noninvasive positive pressure ventilation checklist.The checklist were filled out by the self-assessment method.The researchers analyzed the defects of different level nurses.Results:1 In the item of patient assessment(45.7%,28.75%,24.62%),health education(47.5%,27.6%,25.96%),pre-ventilation preparation(45.71%,29.17%,23.17%),monitoring of adverse events(34.57%,14.58%,16.15%)and alarm treatment(68.57%,20.83%,15.38%),the defect rate of N1 nursing staff was higher than N2,N3 nursing staff.The difference was statistically significant(P <0.05);2 In the item of close monitoring(35.98%,35.00%,18.57%),the defect rate of N2 and N3 nursing staff was higher than that of N1 nursing staff(P<0.05);3 In the item of equipment evaluations(37.82%,15.24%,20.14%),safety management(44.87%,28.57%,25.00%)and ventilator maintenance(53.84%,18.1%,31.94%),the defect rate of N3 nursing staff higher than N1,N2 nursing staff.The difference was statistically significant(P <0.05);4 In the item of maintenance of airway patency(54.29%,54.17%,46.15%),the defect rates of N1,N2 and N3 nursing staff were higher than 30%.All of the nurses were needed to train this item.Conclusion:There are shortcomings in the existing noninvasive positive pressure ventilation work.The noninvasive positive pressure ventilation nursing checklist provides a basis for clinical nurses training.Part three The study on training effect based on noninvasive positive pressure ventilation nursing checklistObjective: To analyze the checklist-oriented training effect and provide a feasible scheme for further development of noninvasive positive pressure ventilation training mode.Methods:According to the defects in noninvasive positive pressure ventilation nursing,the research team developed training programs for 85 nurses combined with the theory of nursing education.The defect items and cognitive evaluation score were compared before and after training.The measurement data was described by mean ± standard deviation(x ±s).The paired t test was used for statistical analysis.The count data comparison were analysed by ?2test.Difference was statistically significant when P<0.05.Results:1 The noninvasive positive pressure ventilation nursing cognitive score:the cognitive scores after training of N1,N2 and N3 nurses were higher than those before training,the difference was statistically significant(P <0.05);2 The Bloom classification of teaching target cognitive domain score :the scores after training in memory,understanding,application of NPPV care were higher than those before training,the difference was statisticallysignificant(P <0.05);3 The defect rates of N1,N2 and N3 were significantly lower than those before training,and the difference was statistically significant(P <0.05).Conclusion:Checklist provides a new scheme for nurses training in noninvasive positive pressure ventilation to improve training effectiveness.