Construction Of A Training Program To Improving Clinical Decision-making Ability For Junior Nurses In Critical Care

Objectivethe purposes of this study were to investigate the current status and influencing factors of clinical decision-making ability of junior nurses in critical care,and to construct a training program of clinical decision-making ability,so as to provide reference for the training and improve the clinical decision-making ability of the junior nurses in the critical care.Method1.Questionnaire survey:the convenience sampling method was carried out.In April 2019,482 junior nurses in critical care from 8 hospitals were selected as the research subjects,who participated in data questionnaire and the investigation of the Clinical Decision Making in Nursing Scale.Frequency and percentage were adopted to make descriptive statistics on the general demographic data.The measurement data were expressed with mean± standard deviation,t tests were adopted with independent samples of the two categorical variables,one-way ANOVA was adopted for multi-classification variables,and multi-factors linear regression was adopted for multiple-factor analysis.The statistical test significance level is of statistical significance,expressed with P<0.05.2.Delphi expert consultation:17 experts in the fields of nursing management,acute and severe clinical nursing,and nursing education were invited to provide consultation services by means of e-mail and WeChat from November 2019 to January 2020,involving two rounds through the expert opinion consultation form for training program for clinical decision-making ability of junior nurses in the critical care,which were integrated,sorted out,analyzed and revised to determine the training program finally.Results1.The average total score of the decision-making ability of junior nurses in the critical care was(141.02±14.50)points,at a medium level.The lowest score for finding alternatives was 34.25±4.07 points,and the highest evaluation or multiple evaluation results were 36.73± 4.83 points;The results of single factor analysis suggested that the years of working,education,professional title,confidence in coping with emergent and severe nursing work,and participation in continuing education and training of emergency and severe cases nursing exerted an impact on the clinical decision-making ability of junior nurses(P<0.05);The results of multiple-factor analysis suggested that the years of working,confidence in coping with emergent and severe nursing work,and participation in continuing education and training of emergency and severe cases nursing were independent factors that exerted an impact on the clinical decision-making ability of junior nurses(P<0.05).2.The average age of experts was 42.47±7.81(33?57)years old;The average working period was 20.06±8.39(11?36)years,mainly with master degree or above(76.47%).The positive coefficient of the two rounds of expert consultation was 100%;The authoritative coefficient of expert consultation was 0.87;The Kendall coordination coefficients of the two rounds of expert consultation were 0.331 and 0.471 respectively,the difference was of statistical significance(P<0.001);After two rounds of expert consultation,the variable coefficient of the importance of each index was 0.00 to 0.19,and both were less than 0.3.A training program for clinical nursing decision-making ability of junior nurses in the critical care was established eventually,covering training objectives,content,organization,implementation,hours,and appraisal.The training implementation consisted 6 parts,that is,training module,specific training structure,time schedule,content,form and number of trainers.The training module consisted of 4 parts,that is,training preparation,scenario simulation,guiding feedback and post-training reflection.Conclusion1.The clinical decision-making ability of junior nurses in the critical care was at a medium level and needed to be further improved.2.The main factors influencing the clinical decision-making ability of junior nurses in the critical care included years of working,education,professional title,confidence in coping with emergent and severe nursing work,and participation in continuing education and training of emergency and severe cases nursing.3.A scientific and reliable training program for clinical decision-making ability of junior nurses in the critical care was established based on literature and theoretical research through two rounds of expert consultation.The content of training program covered training objectives,content,organization,implementation,hours,and appraisal,providing a reference basis for the on-the-job training of the clinical decision-making ability of junior nurses in the critical care.