| Objectives:1.According to the current situation of knowledge and skills of endoscopy cleaning and disinfection among endoscopy nurses in Jilin Province,the training program of cleaning and disinfection technology for flexible endoscopy was determined.2.Taking the Kirkpatrick Model as the theoretical basis of training effect evaluation,combining the characteristics of endoscopy nursing discipline and the background and actual situation of this training project,the training effect of flexible endoscopy cleaning and disinfection technology was evaluated by formulating and adopting corresponding evaluation methods.In order to provide reference for the development of relevant training,the evaluation of training effect and the application of Kirkpatrick Model in nursing field.Methods:It is a test-retest and quasi-experimental research design.The subjects were 157 endoscopic nurses from 79 medical institutions in 9 prefecture-level cities of Jilin Province.Participants need to participate in the training of cleaning and disinfection technology of flexible endoscopy in the whole process,and pass the examination of knowledge and skills before and after the training,and answer the questionnaire.The research process is divided into three stages.The first stage is the baseline survey.Before the training,the nurses were surveyed on general information,post competence and behavior attitude,and the relevant knowledge and skills of flexible endoscopy were tested.The second stage,training implementation: based on "regulation for cleaning and disinfection technique of flexible endoscope",combined with the basic core knowledge of relevant fields and the weak points of students' knowledge,as well as the requirements of endoscopic nursing staff's post ability and behavior attitude as intervention content;this training adopts the way of lecturing at all levels of Jilin Province,theoretical teaching and "hand-in-hand" practical teaching.In the third stage,the training effect evaluation: guided by the theory of Kirkpatrick model,157 endoscopy nurses were investigated from four levels.The reaction level was assessed by training project satisfaction questionnaire;the learning level was assessed and analyzed by flexible endoscopy cleaning and disinfection related knowledge and skills test papers;the behavior level was assessed by self-assessment and other evaluation questionnaires of post ability and behavior attitude;and the results level was assessed by the department flexible endoscopy cleaning and disinfection related work questionnaire.The questionnaires used in this study were designed by the researchers after consulting relevant experts,combining with the characteristics of the subject,and then the reliability and validity were tested.The data were input and analyzed by SPSS 19.0.The statistical methods used included descriptive statistical analysis,t-test,one-way ANOVA and Spearman correlation analysis.Results:1.Evaluation of the effect of reaction layer training: The satisfaction score of157 endoscopy nurses to the training project of flexible endoscopy cleaning and disinfection technology was 53-70,with an average score of 61.78±3.66.Among them,the dimension satisfaction of training teachers was the highest,and the dimension satisfaction of training perception was the lowest.There was significant difference in the satisfaction evaluation of endoscopy nurses at different regions and hospital levels(P < 0.05),and there was significant difference in the training arrangement and overall perception dimension satisfaction evaluation of endoscopy nurses at different hospital levels(P < 0.05).There was a significant difference in the satisfaction score of nurses' overall perception dimension in the training project between those who participated in the training of endoscopy cleaning and disinfection before the training project(P<0.05).2.Evaluation of learning level layer training effect: The theoretical knowledgequestionnaire scored 3-36 points,with an average score of 23.68±6.729,and the key time dimension of endoscopy cleaning and disinfection process had the highest scoring rate.The score of skill operation was 11-70,with an average score of 51.44±9.311,and the highest score was in disinfection operation.There were significant differences in the scores of theoretical knowledge and skills of endoscopy nurses before and after the training(P < 0.05).There were significant differences in the scores of theoretical knowledge and skills of endoscopy nurses before and after the training(P < 0.05).The difference of theoretical knowledge scores before and after training was negatively correlated(r=-0.335,-0.197,P < 0.05).There were significant differences in theoretical knowledge scores before and after training for endoscopy nurses at different hospital and academic levels(P < 0.05).3.Evaluation of the effect of behavior layer training: The score of post competence questionnaire was 15-51,with an average score of 38.51±6.084,and the highest self-awareness was related skill dimension.The score range of behavioral attitude questionnaire was 27-42,with an average score of 35.90±3.10,and the dimension of work attitude had the highest self-awareness.There were significant differences in self-evaluation scores of post competence and behavior attitude between prefecture-level city and hospital-level endoscopy nurses(P < 0.05).There were significant differences in self-evaluation scores of endoscopy nurses before and after training between post competence and behavior attitude self-evaluation and other evaluation scores before and after training.The difference was statistically significant(P < 0.05),and there was significant difference in self-assessment scores of post competence and behavior attitude before and after training.4.Results layer training effect evaluation: The greatest improvement in the management of cleaning and disinfection of endoscopes is the establishment and improvement of relevant working systems and processes.78.48% of managers believe that this training has a positive impact on the work of the trainees themselves and can affect other staff members.Conclusions:1.This training project of flexible endoscopy cleaning and disinfectiontechnology has improved the satisfaction evaluation,which can improve the theoretical knowledge,skill and operation mastery of the training endoscopy nurses,enhance the post ability,promote the change of behavior and attitude,and improve the related work of the department.2.Before the training project of cleaning and disinfection technology for soft endoscopy,the trainees should have a thorough assessment of training-related knowledge and a survey of training needs,and accordingly,the training courses should be set up and adjusted;In the selection of training objects,stratified training should be carried out according to learning experience,educational level,hospital level(or nature)and related knowledge mastery;In the teaching of skill operation,grouping training should be conducted according to different endoscopy structures and washing facilities,so as to avoid the trainees being unable to apply the training contents to clinical work due to the different and insufficient hardware resources of the work unit;At the end of the training,the medical institutions jointly participate in the training should promptly supervise and assess the relevant knowledge and skills of the trainees in order to promote the transfer of training content.3.The response level of Kirkpatrick mode,the training project satisfaction evaluation can be carried out at different stages after the training,and a comprehensive analysis can be made;The learning level,we should not regard the post-training achievement or the improvement of the post-training achievement as a single evaluation index and draw corresponding conclusions.We should make a thorough analysis of the evaluation results of the training effect in the light of the actual situation;The behavioral level,the changes of behavior and attitude of trainees can be understood more scientifically and deeply by increasing the objective evaluation of non-trainees or adopting psychological scale;The result level,the evaluation index should be formulated according to the characteristics of the subject and the training purpose... |
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