| Objective To investigate the current status of clinical application of Traditional Chinese Medicine(TCM)nursing technical standards and the status of knowledge,attitude and practice(KAP)of nurses’ TCM nursing technical standards in secondary and tertiary TCM hospitals in Hubei Province.Combined with the results of interviews with nursing managers,to analyze the problems existing in the implementation of TCM nursing technical standards,and put forward suggestions to promote the clinical implementation of TCM nursing technical standards,in order to provide decision-making basis for TCM authorities at all levels and TCM medical institutions,and to provide references for the effective implementation of TCM nursing technical standards in TCM hospitals.Methods 1.Questionnaire survey: The method of stratified sampling was adopted to select head nurses and 2159 nurses in 300 departments from 28 second and third level TCM hospitals in Hubei Province as the survey subjects.Two self-designed questionnaires were used from July to August 2020 to investigate the current status of clinical application of TCM nursing technical standards and the status of nurses’ KAP of TCM nursing technical standards.Descriptive statistics were used to identify respondents’ characteristics;chi-square tests were used to compare count data;two independent samples t-test and ANOVA analysis were used to compare scores with participants’ demographic data;Pearson correlation analysis was used to analyze the correlation between nurses’ KAP regarding TCM nursing technical standards;and multiple linear regression models were used to examine association between participants’ scores regarding TCM nursing technical standards(outcome variables)and nurses’ demographic information(independent variables).2.Semi-structured interview:The phenomenological research method in qualitative research was used to conduct in-depth interviews with 12 nursing managers of Chinese medicine hospitals,and the interview data were analyzed using the Colaizzi seven-step analysis method.Results 1.Survey results:(1)Implementation of TCM nursing technical standards:18 TCM nursing technical standards are all implemented in the clinic,and the top three with high implementation rate are the acupoint application(88.33%),ear acupoint pressing(84.00%),Chinese medicine acupoint sticking(83.33%).New addition and optimization of TCM nursing technical standards: 81.67% of the departments have newly-added TCM nursing technical standards,and the reference basis is mainly TCM books(78.67%)and clinical experience(68.00%);the departments that optimize the standards account for 66.67%;the contents optimized by the departments are based on "basic operations methods" are the most(79.33%);departments with standardized formulation and optimization processes account for 52.33%.Training status of TCM nursing technical standards: 65.33% of the departments conduct training once a month,and the training methods are mainly based on theoretical teaching(93.33%)and operation drills(89.67%).(2)The scores of each dimension of nurses’ KAP of TCM nursing technical standards were(14.31±4.22),(48.42±8.91)and(45.62±5.96).The influencing factors of the knowledge score of TCM nursing technical standards include age,length of employment,hospital level,and whether they have received systematic TCM knowledge training;the influencing factors of attitude scores include monthly income and whether they have received systematic TCM knowledge training;the influencing factors of behavior scores are: Length of employment and whether he has received systematic training in Chinese medicine knowledge.The correlation coefficients between knowledge and attitude,knowledge and practice,attitude and practice were 0.310(P<0.01),0.428(P<0.01),0.417(P<0.01).2.Through interviews with nursing managers,three themes are finally summarized:(1)Factors promoting the implementation of TCM nursing technical standards: standardizing TCM nursing behaviors,providing basis for nursing management,and avoiding nursing operation risks;(2)Factors hindering the implementation of TCM nursing technical standards: limitations of the standards,lack of TCM literacy among nurses,Weak awareness of operation standardization;(3)Recommendations to promote the implementation of TCM nursing technical standards: optimizing training resources,continuous quality control and supervision,continuous optimization of clinical standards,and formulating objective effect evaluation standards.Conclusions 1.The secondary and tertiary TCM hospitals in this survey all implemented 18 TCM nursing technical standards,and there were problems such as low clinical implementation rate of some standards and inconsistent formulation and revision procedures.It is suggested that the revision of TCM nursing technical standards should be based on literature research,evidence-based practice and other processes.In the future,with the help of TCM characteristic nursing clinics and the internet continuous nursing platform,the scope of standards will be continuously expanded.2.TCM nurses have a positive attitude towards the technical standards of TCM nursing,they don’t have enough knowledge,and their behaviors need to be improved.It is recommended that hospitals strengthen training and quality control,while adopt traditional training methods and explore innovative training methods based on hospital conditions,attach importance to the mastery of nurses’ TCM nursing theory and the improvement of TCM connotation during training.3.There are problems such as evidence-based basis and lack of effect evaluation standards in the clinical implementation of TCM nursing technical standards.It is suggested that the relevant competent departments should establish and improve a scientific and reasonable technical specification system of standard formulation and revision,standard training and standard implementation evaluation,and further optimize the TCM nursing technical specifications with the guidance of clinical application demand and the support of evidence-based research,Continuously improve the ability of TCM nursing service,and promote the development of TCM nursing standardization. |
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