目的 探讨重症护理亚专业管理模式下ICU专科护理人才的培养与实践效果。方法 以重症护理关键技术为核心,于2015年1月在西安交通大学第一附属医院ICU辖区设立重症营养、重症皮肤、重症静脉治疗、重症气道、重症康复、重症血液净化、静脉血栓预防与管理7个护理亚专业组,并实施重症护理亚专业管理模式,从专科人才培养、专科质量提升及科研产出方面评价其实施效果。结果 重症护理亚专业管理模式建立了院级—省级—国家级专科护士阶梯式成长体系及ICU专科护士人才库,提升了重症专科护理质量,促进了重症护理亚专业的持续发展。结论 实施重症护理亚专业管理模式能够满足ICU护士职业发展需求,明晰其职业发展路径,推动重症护理人才专业化培养,深化重症护理专科内涵,提高重症护理技术水平,提升ICU护士职业价值。
Objective To explore the training and practical effect of ICU specialized nursing talents under the sub-specialty management mode of critical care nursing. Methods Based on the key technologies of critical care nursing,seven nursing sub-specialty groups were set up in the ICU area of the First Affiliated Hospital of Xi ‘an Jiaotong University from January 2015,including critical nutrition,critical skin,critical intravenous therapy,critical airway,critical rehabilitation,critical blood purification,and venous thrombosis prevention and management,and the critical nursing sub-specialty management model was implemented. The implementation effect was evaluated from the training of specialized talents,the improvement of specialized quality and the scientific research output. Results The critical nursing sub-specialty management model has established a hospital- provincial-national specialized nurse ladder growth system and ICU specialized nurse talent pool,which improves the quality of critical nursing and promotes the sustainable development of critical nursing sub-specialty. Conclusion The implementation of critical nursing sub-specialty management model can meet the career development needs of ICU nurses,clarify the career development path,promote the professional training of critical nursing talents,deepen the connotation of critical nursing specialty,improve the level of critical nursing technology,and enhance the professional value of ICU nurses.
[1] 黄彩云,庞杰媚,蒋林洪,等. 重症医学科亚专科护理模式构建与实施效果[J]. 护理管理杂志,2021,21(5):355-359.
Huang CY,Pang JM,Jiang LH,et al.Construction and implementation of sub-specialty nursing model in critical care[J]. J Nurs Adm,2021,21(5):355-359.
[2] 卫生健康委关于印发《全国护理事业发展规划(2021-2025年)》的通知[J]. 中华人民共和国国务院公报,2022(23):57-63.
Notice of the National Health Commission on the Issuance of the National Nursing Development Plan(2021-2025)[J]. Gaz State Council People's Repub China,2022(23):57-63.
[3] 黄彩云,朱新青,何舒瑾,等. 基于柯氏模型的双向六环护理培训模式在重症医学科呼吸机亚专科小组培训中的应用[J]. 护士进修杂志,2022,37(13):1201-1204.
Huang CY,Zhu XQ,He SJ,et al.Application of two-way six-ring nursing training model based on Coriolis model in ventilator sub-specialist group training in critical medicine department[J]. J Nurses Train,2022,37(13):1201-1204.
[4] 沈婷,蒋玲,朱月琴,等. 基于精细化护理构建危重新生儿亚专科护理小组及评价[J]. 护理管理杂志,2021,21(2):136-140.
Shen T,Jiang L,Zhu YQ,et al.Construction and effect of subspecialty nursing team for critically ill newborns based on refined nursing[J]. J Nurs Adm,2021,21(2):136-140.
[5] Greer DM.The case for broad subspecialty training[J]. Crit Care Med,2019,47(11):1648-1649.
[6] Labeau S,Chiche JD,Blot S.Post-registration ICU nurses education:plea for a European curriculum[J]. Int J Nurs Stud,2012,49(2):127-128.
[7] 杨毅,邱海波. 推动重症医学亚专科建设构筑学科新未来:中华医学会第七次全国重症医学大会精髓解析[J]. 中华医学信息导报,2013,28(9):9.
Yang Y,Qiu HB.Promoting the sub-specialty construction of critical care medicine and building a new future—analysis of the essence of the seventh national congress of critical care medicine of Chinese medical association[J]. China Med Issues,2013,28(9):9.
[8] 刘远金. 重症医学亚专科护理模式的构建[J]. 中国护理管理,2019,19(S1):93-96.
Liu YJ.Construction of nursing mode in sub-specialty of critical care medicine[J]. Chin Nurs Manag,2019,19(S1):93-96.
[9] 田永明,徐禹,刘欢. ICU护士进阶培养的临床实践与效果[J]. 中国护理管理,2021,21(3):343-347.
Tian YM,Xu Y,Liu H.The practice and effects of advanced training of ICU nurses[J]. Chin Nurs Manag,2021,21(3):343-347.
[10] 么莉,冯志仙,朱宗蓝. 护理敏感质量指标实用手册2016版[M]. 北京:人民卫生出版社,2016:7.
Yao L,Feng ZX,Zhu ZL.Practical manual of nursing sensitive quality indicators 2016 edition[M]. Beijing:People's Medical Publishing House,2016:7.
[11] 李雯,张振宇,于义,等. 职业倦怠在ICU护士情绪劳动与离职意向间的中介效应分析[J]. 中华急危重症护理杂志,2023,4(8):741-746.
Li W,Zhang ZY,Yu Y,et al.Analysis of the mediating effect of burnout between intention to leave and emotional labor among ICU nurse[J]. Chin J Emerg Crit Care Nurs,2023,4(8):741-746.
[12] 和霞,林梅,杨清,等. 多学科协作诊疗模式下专科护士参与策略的研究进展[J]. 中华急危重症护理杂志,2020,1(6):549-553.
He X,Lin M,Yang Q,et al.Review on strategy of specialist nurse's participation in multidisciplinary team[J]. Chin J Emerg Crit Care Nurs,2020,1(6):549-553.
[13] 刘璐,屈云. 压力性损伤亚专业小组干预策略在预防重症肺炎合并呼吸衰竭机械通气患者面部压疮的应用[J]. 川北医学院学报,2023,38(7):999-1002.
Liu L,Qu Y.Application of subspecialty group on stress injuries intervention strategies in preventing facial pressure sores in patients with severe pneumonia com-plicated with respiratory failure undergoing mechanical ventilation[J]. J N Sichuan Med Coll,2023,38(7):999-1002.
[14] 吕传柱,罗善军,袁素平,等. 急诊医学学科发展与急诊急救大平台建设—也谈对急危重症护理的启发[J]. 中华急危重症护理杂志,2023,4(1):10-16.
Lü CZ,Luo SJ,Yuan SP,et al.Development of emergency medicine and construction of integrated emergency platform—inspiration for emergency and critical care nursing[J]. Chin J Emerg Crit Care Nurs,2023,4(1):10-16.
[15] 闵小彦,张赞华,蔡薇薇,等. ICU护理亚专科小组的构建及临床应用效果评价[J]. 中华现代护理杂志,2020,26(7):957-961.
Min XY,Zhang ZH,Cai WW,et al.Construction and clinical effects of ICU nursing subspecialty group[J]. Chin J Mud Nurs,2020,26(7):957-961.
[16] 田润,张蜜,郭利涛,等. 重症患者入住ICU前静脉血栓发生情况及其影响因素分析[J]. 实用心脑肺血管病杂志,2023,31(7):87-91.
Tian R,Zhang M,Guo LT,et al.Incidence and influencing factors of venous thrombosis in critically ill patients before admission to ICU[J]. Pract J Card Cereb Pneumal Vasc Dis,2023,31(7):87-91.
[17] 鲁华鹏,杨勤玲,肖奇贵,等. 临床护士科研能力发展与护理团队科研建设[J]. 中华医学科研管理杂志,2023,36(4):285-292.
Lu HP,Yang QL,Xiao QG,et al.Development of clinical nurses' scientific research ability and construction of nursing research teams[J]. Chin J Med Sci Res Manag,2023,36(4):285-292.
