| ObjectiveIn present study,we investigated the working situation of specialist nurses in third-class comprehensive military hospital to understand the common problems in the process of clinical application and management among specialist nurses.With the application of Focus group interview and Delphi method,we explored the definition of specialist nurses based on the situation of our country.Combined with the characteristics of functions and tasks of military hospitals,sets up the post setting scheme of specialist nurses in third-class comprehensive military hospital include configuration principle and basis of specialist nurses,job responsibilities,the form of treatment,and other aspects.The purpose of our research is to provide reference for military hospital in setting up specialist nurses,and in enhancing the level of specialized nursing and furthermore,to evaluate the strength of specific nursing in hospital more scientific.Methods1.Questionnaire survey The convenience sampling method was used to investigate 530 nurses in 30 military hospitals with specialist nurse training experience(hereinafter referred to as specialist nurses).Through the issues exsisted in the clinical application and management,this study could provide a clear direction for later studies.2.Literature research By consulting literature concerned with the post setting of specialist nurses from CNKI,VIP,WANFANG and PubMed,etc.We analyzed the developing situation of specialist nurses in home and abroad,and combined with our national condition,refer to The Army Medical Work Conditions and Hospital Nursing Management System and Post Responsibility,we established a setup scheme of specialist nurses for third-class comprehensive military hospital initially.3.Focus group interview we invited eight experts on nursing management,clinical care and related area to discuss and amend the proposed scheme.On this basis,we designed the expert consultation questionnaire for the first round.4.Delphi method We evaluated the post setting scheme of specialist nurses in third-class comprehensive military hospital using Delphi method.By convenient sampling method,selected 31 experts take part in the research,from 14 provinces Shandong,Henan,Beijing,Shanghai,Guangdong,Chongqing,etc.According to expert opinions and suggestions to modify and perfect,and use the authority coefficient,mean,standard deviation,coefficient of variation coefficient to analysis the authority of experts,expert opinion concentration,coordination degree of experts,the final formation of expert opinion consistent scheme.Results1.Research on the current status of work of specialist nurses in third-class comprehensive military hospital:(1)81.31% of specialist nurses in the survey considered that there is no post for specialist nurse and there is no difference in the use and management between specialist nurses and other nursing backbone.(2)The job responsibilities of specialist nurses is unclear,89.86% of specialist nurses engaged in clinical general nursing work,no special nursing care function requirements,only 4.17% and 3.78% of specialist nurses to undertake specialist care clinics,internal and external nursing consultation and multidisciplinary joint consultation.(3)The ability of scientific research and critical thinking is low,of which standard-reaching rate is 4.17% and 3.78%,respectively.(4)It is widely believed that certification is of greatest importance to the acquisition of specialist nurse qualifications and 97.8% of them thought there should be a certification.(5)Specialist nurses surveyed had high degree of recognizing to their vocational development(mean value>4.2).2.Post setting scheme of specialist nurses in third-class comprehensive military hospital:(1)Using Delphi method,through two rounds of expert consultation,we set up a post setting scheme of specialized nurse includes 4 aspects and 37 specific content: description of definition of specialist nurses based on the situation of our country;basis of post setting scheme of specialist nurse;responsibility of specialist nurses;embodiment of treatment for specialist nurses.(2)Results of expert consultation: Effective recovery of the two expert consultation questionnaire was 100%,96.77%,respectively.In the first round,18 experts made 31 comments,indicated that enthusiasm of the experts is high.The expert authority score of two rounds were 0.89,0.90,indicated that the authority of the experts is high.Concentration degree analysis of expert opinion indicated that reasonable assignment mean was 4.40~4.97(mean value>3.5),coefficient of variation was 0.04~0.18(cv<0.25)and the rate of experts agree was 83.3%~100%(agree rate>80%).Coordination degree analysis of expert opinion indicated that coordination coefficient of the two rounds of consultation were 0.15,0.23,respectively,after testing the statistical significance(P<0.01).This shows that the coordination is good and the result is reliable.Conclusions1.The overall developmental level of specialist nurse regime in the hospitals surveyed was low,the application and management of specialist nurse should be standardized.2.No full-time jobs for specialist nurse,no specific job duties and bad working treating had impact on the development of specialist nurse.3.Specialist nurse had not play a part in the task of military medical service support.4.According to the clinical investigation,on the basis of Focus group interview and pilot program,we built a post setting scheme of specialist nurse in third-class comprehensive military hospital using Delphi method.The results showed that the experts had identical ideas towards the program,that is to say,the program had high credibility.The program can provide evidence for the setting up of specialist nurse,and putting up platform for vocational development of them.Furthermore,the program facilitated the normalize of post management and clinical application of specialist nurse. |
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