临床护士的循证护理实践水平提升研究,护理硕士论文

临床护士的循证护理实践水平提升研究,护理硕士论文本篇论文目录导航：【第1部分】临床护士的循证护理实践水平提升研究【第2部分】【第3部分】【第4部分】【第5部分】【第6部分】【第7部分】摘要目的本研究旨在全面了解并比拟当前河南省三级医院临床护士的循证护理实践水平〔包括知识、态度、技能和行为〕及影响因素现在状况，明确护理人员在循证护理实践经过中的困难，为临床护理人员开展继续教育和循证护理教育的方向及管理提供理论根据，有效的提高河南省临床护士的循证素质，促进循证护理的发展。方式方法抽取河南省五所城市〔郑州市、开封市、洛阳市、新乡市、平顶山市〕，方便抽取5所三级医院，采用随机抽取符合研究条件的护士为研究对象。调查工具：调查问卷有一般人口学资料的调查问卷，包括年龄、科室、工作年限、婚姻状况、第一学历和最高学历、职称、职务、工作性质；杨如美等修订的循证实践知识、态度、行为问卷〔EBPQ〕〔中文版〕及循证实践影响因素问卷〔DEBPQ〕，EBPQ量表共24个条目，包括知识、实践和行为3个维度，按从不到经常采用7级计分法，分别赋予1分到7分，得分越高表示临床护理人员在护理经过中的知信行水平越强，总问卷及各维度Cronbach,s系数分别0.940、0.841、0.789、0.935;DEBPQ量表由26个条目4个维度组成，总问卷CronbachsB系数为0.930,量表及内部一致性较高，可用于评价国内护理人员EBN水平。调查方式方法：本课题组首先选定河南省的5个城市分别为郑州市、开封市、洛阳市、新乡市、平顶山市，然后在选中的城市中方便抽取5所三级医院，课题组成员与各医院护理部领导联络，获得同意并协助发放和收回问卷。采用随机抽取符合条件的护士为研究对象，被调查护理人员获得知情同意后采用无记名填写方式调查。统计学分析：应用SPSS17.0统计软件包对数据进行统计分析，P0.05为有统计学意义，均取双侧概率，对数据进行t检验、方差分析、Pearson相关分析等统计推断和统计描绘叙述。结果本研究共发放问卷550份，回收有效问卷521份，回收率94.72%.研究对象年龄分布范围为20~55岁，平均〔28.625.37〕岁。内科〔39.53%〕和外科〔30.13%〕为主，62.96%的被调查对象工作年限在10年以内；第一学历以中专和大专为主〔85.60%〕；最高学历为本科者占62.57%,初级职称的人数占62.38%.521名研究对象的EBPQ问卷总分均分为〔4.341.05〕分，实践行为、态度、知识各维度平均分分别为〔4.051.14〕分、〔4.641.13〕分、〔4.470.96〕分。不同科室EBPQ问卷调查调查发现，不同科室的循证知识技能和实践行为有统计学差异〔P0.05〕，急诊科护士的得分在实践行为维度高于其他科室〔P0.05〕，而ICU护士的得分在知识技能维度高于其他科室〔P0.05〕。不同年龄组的护士在循证实践行为、循证知识技能之间具有统计学差异〔P0.05〕，但态度得分无差异〔P0.05〕；华而不实30岁年龄组的得分低于31~40岁年龄组。不同工作年限在循证知识态度和行为上具有统计学差异〔P0.05〕，华而不实工作16~20年的护士在各维度上得分最高，其次是工作21年以上者。婚姻对循证护理的实践行为、态度和知识技能没有明显的影响〔P0.05〕。第一学历不同，研究对象的实践行为维度、知识技能维度存在统计学差异〔P0.05〕；最高学历不同，护士的实践行为维度、态度维度、知识技能维度得分存在统计学差异〔P0.05〕。高级职称的护士循证知识、态度和实践行为维度得分高于中级职称护士〔P0.05〕，中级职称护士的得分高于初级职称护士〔P0.05〕。采用Pearson相关分析，分析DEBPQ与EBPQ问卷实践行为各维度和总分之间的关系，具有统计学差异〔P0.05〕。结论急诊科室、高学历、高职称、工作年限的延长和年龄的增长均有利于临床护士循证护理的实践。循证实践的施行在知识来源、实践困难、支持情况和查找、评价证据的技能各维度均有影响。本文关键词语：循证护理，临床护士，实践水平，影响因素AbstractObjectiveThisstudyistorealizefullyandcomparethecurrentlevelofevidence-basednursingpracticeonTertiaryHospitalsinHenanprovince〔includingknowledge,attitudes,skillsandbehaviors〕，andinfluencingfactorsofthestatusofthenurses.Torealizethedifficultiesofevidence-basednursingpracticeintheprocess,tofindoutthedirectionandmanagementofevidence-basednursingeducationandprovideatheoreticalbasisofcontinuingeducationforclinicalnurses,whichcouldbeimprovethequalityofevidence-basedclinicalnurseeffectivelyinHenanProvince,andtopromotethedevelopmentofevidence-basedcare.MethodsInthispaper,withthemethodsofconvenientcampling,thestudyextractedfivecitiesinHenan〔Zhengzhou,Kaifeng,Luoyang,Xinxiang,Pingdingshan〕，easytoextractfiveTertiaryHospitals,theuseofqualifiednursesrandomlyselectedforthestudy.SurveyTool:Thisstudyissurveyquestionnairesincludingdemographicdata,includingage,department,workexperience,maritalstatus,education,andfinallythefirstdegree,title,Position,natureofwork.RumeiYoungamendmentstheevidence-basedpracticeknowledge,attitudes,behaviorquestionnaire〔EBPQ〕〔Chineseversion〕，andevidence-basedPracticeFactorsQuestionnaire〔DEBPQ〕，EBPQscalehave24entries.Includingknowledge,practicesandbehaviorofthethreedimensions,accordingtonevertoalwaysusingsevenscoringmethods,weregivenoneminutetosevenfractionalnumbers,thehigherthescoreindicatesthelevelofthenursesintheprocess,Theeachdimensionofthetotalquestionnairescronbach,scoefficientswere0.940,0.841,0.789and0.935;DEBPQscaleof48entriesandsixdimensions,withatotalquestionnairecronbachscoefficientwas0.930,higherscaleandinternalconsistency,couldbeusedtoevaluatethelevelofdomesticnurses.Surveymethodology:TheresearchteamfirstselectedfivecitiesfromHenanProvince,whichwereinZhengzhouCity,KaifengCity,LuoyangCity,XinxiangCity,PingdingshanCity,andthenselecthospitalsformextractioncitieseasily.Thegroupmemberscontactthenursingleadersofeachhospitals,withtheconsentandassistancetodisbursementandrecoverythequestionnaires.Usingaconvenientcamplingofnursesqualifiedforthestudy,whenthesurveyednursesknownwhattodoandthenfilloutthesurveybynonames.Statisticalanalysis:TostatisticalanalysisthenumbersbySPSS17.0statisticalsoftwarepackage,P0.05wasconsideredstatisticallysignificant,andwhichweretakenbilaterallyprobabilityofttest,analysisofvariance,Pearsoncorrelationanalysis,statisticalinferenceandstatisticaldescription.ResultsAtotalof550questionnairesweredistributedandwerereturned521validquestionnaires,returned94.72%.Theagedistributionoftherangeof20to55years,withanaverageageof〔28.625.37〕anditsmainlytheinternalmedicinedepartment〔39.53%〕andsurgicaldepartment〔30.13%〕。62.96%ofthosesurveyednurses,workexperiencewithin10years;themostfirstdegreeissecondaryschoolandcollege-based〔85.60%〕；highestdegreeisabacheloraccountedfor62.57%.thenumberofjuniortitlesaccountedfor62.38%.TheresearchsubjectsoftheEBPQquestionnairescoresweredividedinto4.341.05,theaveragedimensionsofPracticebehaviors,attitudes,knowledgewere4.051.14,4.641.13and4.470.96respectively.DifferentdepartmentsoftheEBPQquestionnairesurveyfoundthatthepracticeofevidence-basedknowledge,skillsandbehaviorsofdifferentsectionshadstatisticallysignificant〔P0.05〕，Emergencydepartmentnurseshadahigherscorethanotherdepartmentsinpracticeactsdimension〔P0.05〕，whileintheICUthenurseshadahigherscorethanotherdepartmentsdimensioninknowledgeandskills〔P0.05〕。Nursesindifferentagegroupshadasignificantdifferenceinconductevidence-basedpractice,evidence-basedknowledgeandskills〔P0.05〕，buthadnodifferenceinattitudescores〔P0.05〕；Whichbelow30yearsgrouphadlowerscorethanthe31to40agegroup.Differentworkexperiencewithevidence-basedknowledgeontheattitudesandbehaviorsstatisticallysignificantdifference〔P0.05〕，which16to20yearsofworkingnurseshadthehighestscoreoneachdimension,followedbymorethan21years.Marriagehadnoeffectsofevidence-basednursingpracticeacts,attitudesandknowledgeskills〔P0.05〕。Differentfirstdegreehadansignificantdifferencesofthestudy,Practicesandbehaviors〔P0.05〕；differenteducationalbackgroundhadastatisticaldifferentscoreinpracticenurses,dimensionbehavior,attitudesdimension,knowledgeandskills〔P0.05〕。Seniornurseshadahigherscoresinnursesevidence-basedknowledge,attitudesandpracticebehaviors〔P0.05〕，juniortitlesnursesscoredhigherthanothernurses〔P0.05〕。PearsoncorrelationanalysisoftherelationshipbetweenDEBPQPracticeactsandEBPQquestionnairescoresbetweeneachdimensionandhadasignificantdifference〔P0.05〕。ConclusionsEmergencydepartments,highlyeducated,highlytitle,yearsofevidence-basedpracticenursesareconducivetoevidence-basedcare.Implementationofevidence-basedPracticeinknowledgesources,Practicedifficultsituationandfindthesupport,skills,find