Study On The Issues And Countermeasures Of Continuing Education In Chongqing Grass-root Nurses

Objective: To investigate the continuing education status and demand of grass-root nurses with the nurses working in the sub-district public grass-root medical institutions in Tongliang District of Chongqing as objects,analyze the issues and propose the corresponding suggestions and countermeasures,so as to provide a reference and experience for optimizing the continuing education plan.Methods: From October 2018 to May 2019,270 nurses were selected for a questionnaire survey who were from the sub-district public grass-root medical institutions in Tongliang District of Chongqing,including 5 community health service centers and 23 township hospitals.Besides,10 gross-root nurses,5 gross-root doctors,5 head nurses,5 patients from the gross-root medical institutions and 3 leaders of gross-root medical institutions were randomly selected for depth interview,and the leaders in the Continuing Education Competent Department of Tongliang Health Commission were interviewed.SPSS version 21 software was used for statistical analysis:(1)the descriptive statistical analysis of qualitative data was performed using frequency and percentage;(2)for the two issues of the satisfaction of nursing staff with continuing education and whether they have participated in continuing education activities in the past three years,Chi-square test was used to compare demographic and work-related information of satisfied and dissatisfied groups,participating and non-participating groups,respectively,and the factors related with the participation of continuing education were analyzed by binary logistic regression.Results:1.Implementation status of the continuing nursing education in the gross-root medical institutions: The implementation pattern mainly included hospital training(77.0%)and distance education(62.0%).The implementation contents mostly involved new basic theoretic knowledge(71.5%)and new nursing techniques(62.0%).The continuing education funds were supported by the work units in 61.3% nurses and by the individuals in 21.3% nurses;the time of each continuing education activity was mainly ?1 day(53.5%).In the questionnaire answerers,20.6% nurses never had participated in the continuing nursing education;the participants of continuing nursing education had a low satisfaction to the implementation efficacy,i.e.,67.8%.The factors influencing the continuing education participation of nurses were mainly busy work(54.8%),followed by rigid pattern(21.7%)and high costs(20.7%).2.Implementation demand of the continuing nursing education in the gross-root medical institutions: The pattern of continuing education was expected to be consistent with the actual implementation status,but there was a higher demand proportion in distance education(69.7%);the contents of continuing nursing education were expected to be coincident to the actual implementation status in the general framework,but there was no highly targeted contents,thus incompletely meeting the actual demand.The continuing education funds were expected to be supported completely by the work units in nearly 70% questionnaire answerers,and jointly supported by the work units and individuals in nearly 30% questionnaire answerers;the short-term training of ?3-4 days was preferable for each continuing education activity(73.4%).3.Recognition of work units and individuals to the continuing nursing education: The overall support rate of work units to the continuing education of nurses was 83.6%.About 93.0% nurses answering the questionnaire believed that it was necessary to participate in the continuing education.The main purpose of participating in the continuing education was acquiring the professional knowledge(68.4%),improvement of operation skills(58.8%)and assessment of professional title(33.2%).4.One-factor analysis results: Based on the analysis by chi-square test,the work unit(p=0.019)and organizational affiliation(p=0.015)of nurses might be the factors influencing the satisfaction of continuing nursing education,and the factors related with the participation of continuing nursing education in the past three years included work unit(p=0.004),organizational affiliation(p<0.001),age(p<0.001),and professional title(p<0.001).5.Regression analysis results: The factors related with the participation of continuing nursing education in the past three years were work unit(p<0.001),organizational affiliation(p<0.001),and hospital policies(p=0.008).6.Interview results: 100% interviewees supported the participation of nurses in the continuing education.For the implementation of continuing education,the nurses expressed that the continuing education contents had a gap to the actual work demand and thus were not practical,and they expected the issuance of incentive measures concerning the salary,leaves & holidays,professional title,and professional promotion.The gross-root doctors and patients had the biggest expectation to the operation skills and service awareness of nurses,and the gross-root head nurses wished improving the technical level and safety risk management of nurses.The institution leaders presented that a certain difficulty existed actually in implementing the continuing nursing education,for example,there was a heavy load of gross-root nursing work,insufficient labor,and several part-time jobs of staffs responsible for the continuing education in the medical institutions.Conclusion: The nurses and leaders in the grass-root medical institutions have a positive attitude to the participation of continuing education and affirmed the importance of continuing nursing education.At present,there are the following issues about the participation of grass-root nurses in the continuing education:(1)there is few grass-root nurses,and there are heavy work tasks and the prominent conflicts between working and learning;(2)some nurses have not participated in the continuing education in the past three years,indicating the uneven distribution of training recourses and insufficient supply;(3)the continuing education is implemented according to the conventional procedures,lacking focalization and with rigid contents;(4)there is single credit assessment and thus no sufficient incentive mechanism;(5)there are no complete continuing education management system and insufficient organizational support.Therefore,the organizations shall provide effective policy support for continuing education,complete the incentive mechanism,enrich the training resources and make the diversified training plan with the demand as orientation and by integrating the suggestions of nurses,doctors,patients and gross-root leaders and fully combining Internet technology,and utilize the modern learning tools to realize the maximization of continuing education participation.The individuals shall change the learning idea and establish a life-long learning view,actively acquire the learning resources in multiple pathways and forms,adjust the learning time,and break through the working-learning conflicts,so as to continuously improve the overall service quality.