Research On The Construction And Application Of Emergency Nursing Training Scheme For New Nurses In Grade A General Hospital Based On Case Base

ObjectiveTo investigate the current situation of critical care core competence of newly recruited nurses in tertiary general hospitals and analyze its influencing factors and training needs,construct the case base of critical care resources and design the training program of critical care for newly recruited nurses in tertiary general hospitals based on the case base,and evaluate the implementation effect of the program,so as to provide some empirical reference for the training of critical care for newly recruited nurses in tertiary general hospitals in China.MethodsThis study is divided into two parts:Part Ⅰ:The construction of emergency nursing training program for new nurses in tertiary general hospitals based on nursing cases1.Study on the current situation of critical care core competence of new nurses in tertiary general hospitals405 new nurses from 6 tertiary general hospitals in Henan Province were selected by convenience sampling method.General information questionnaire and critical care core competence questionnaire were used to understand the current situation of critical care core competence and analyze the influencing factors.SPSS 22.0 was used to analyze the data.Statistical description,t-test,variance analysis and multiple linear stepwise regression analysis were used.2.Study on the training experience and expectation of emergency nursing for new nursesThe purpose sampling method was used to select 11 newly recruited nurses with low and high scores of critical care core competence in the questionnaire survey.The data were collected by semi-structured interviews,and the Colaizzi seven-step analysis method was used to analyze the data.The experience and demand of critical care training for newly recruited nurses were deeply excavated.3.Construct the case base of critical nursing resourcesThe case entry standard,compilation format,audit process and evaluation index were set through literature analysis and discussion of the research group.By screening the rescue cases in the emergency department of the hospital where the researcher was located from January 1,2019 to March 31,2021,the critical cases that met the standard were collected and compiled in a unified format.The case evaluation was scored according to the "evaluation index of nursing professional case".After revision and improvement by the expert meeting method,the case storage was compiled.4.Design a emergency nursing training program for newly recruited nurses in tertiary general hospitals based on case baseBased on the previously constructed case base,combined with literature review and the requirements of the training program for newly recruited nurses,and consulting the opinions of the research group,a preliminary draft of the emergency nursing training program for newly recruited nurses in tertiary general hospitals based on the case base was designed and formed.After further revision and improvement by the expert meeting method,the implementation plan of the emergency nursing training for newly recruited nurses in tertiary general hospitals based on the case base was formed.Part Ⅱ:Study on the application of emergency nursing training program based on case base for newly recruited nurses in tertiary general hospitalsA convenience sampling method was used to select 50 new nurses from the hospital where the researcher was located.The new nurses rotated in the emergency department from October to December 2020 were set as the control group(n=25),and the new nurses rotated in the emergency department from April to June 2021 were set as the experimental group(n=25).The control group received routine’ one to one’ follow-up rotation practice and regular theoretical teaching and skill training;the experimental group implemented the emergency nursing training mode based on case base on the routine rotation practice.The scores of critical care core competence,theoretical and practical assessment scores before and after training were compared between the two groups.To understand the training experience of new nurses in the experimental group in the form of satisfaction survey,micro-interview or symposium.ResultsPart Ⅰ1.Questionnaire survey:(1)The total score of critical care core competence of 405 newly recruited nurses was(125.39±47.54),and the average score of items was(2.41 ±0.91).There were 126 cases(31.1%)with low critical care core competence,185 cases(45.7%)with medium competence,and 94 cases(23.2%)with high competence.Each dimension score from high to low is:communication and coordination ability,critical thinking ability,management ability,professional practice ability,professional development ability.(2)Single factor analysis showed that there were statistically significant differences in the scores of critical care core competence of newly recruited nurses with different genders,marital status,education background,personnel type,length of rotation,opportunities for daily participation in emergency rescue,training experience in critical care,and emergency/severe rotation experience(P<0.05).(3)Multivariate analysis showed that the opportunity to participate in the rescue of critically ill patients during rotation,the length of rotation,whether to receive emergency nursing training,and the experience of emergency/severe rotation were the main factors affecting the core competence of newly recruited nurses in emergency nursing(P<0.05),which could explain 30.7%of the total variation.2.Interview results:(1)The newly-recruited nurses were not confident in their own critical care ability,and 5 themes were extracted:weak practical ability of critical care,insufficient communication ability with critical patients and their families,insufficient ability to control and manage rescue scenes,insufficient ability to observe critical conditions,and unclear learning objectives.(2)According to the training expectations of newly recruited nurses and the influencing factors of critical care ability,three themes and 13 sub-topics were extracted:specific expectations for the overall management of training activities,and specific expectations for clinical practice,Organizational environment support.3.A case database of critical care resources covering 10 systematic case themes,including circulation,respiration,nerve,acute trauma,digestion,endocrine,acute abdomen,acute poisoning,and pediatric emergencies,was preliminarily constructed,with a total of 38 cases.4.Through the expert group meeting,to build a case base based on the three general hospital new nurses emergency nursing training program,including training project objectives,training implementation strategy,eight training theme content and effect evaluation of four parts.Part Ⅱ1.Experimental study:After three-month rotation training,the scores of critical care core competence(145.60±8.10),theoretical assessment(87.52±4.32)and critical care practice assessment(86.04±4.74)in the experimental group were significantly higher than those before training(125.56±7.58),(78.20±5.17)and(75.72±6.63),And higher than the control group(132.84±8.96)points,(84.08±6.47)points and(82.52±6.01)points,the difference was statistically significant(P<0.05).2.Qualitative research:two themes and ten sub-topics related to the experience of new nurses participating in the case-base-based emergency nursing training were analyzed,namely,(1)the advantages of training program:promoting clear learning objectives,cultivating teamwork and clinical thinking,promoting the understanding and application of knowledge,cultivating emergency response ability,stimulating learning interest and improving professional self-confidence;(2)12Suggestions for trainees:arrange trainees to manage corresponding patients according to the training theme,effectively use online resources,increase phased practice assessment,and provide more opportunities to participate in the rescue of critically ill patients.ConclusionThe core competence of emergency nursing of new nurses in tertiary general hospitals is at a medium level and needs to be further improved.The critical care training program based on case base can effectively stimulate the learning interest of newly-recruited nurses,promote their professional practice,critical thinking,management,communication and coordination,professional development and other core competencies,and provide new ideas and basis for the critical care training of newly-recruited nurses in tertiary general hospitals in China.