病人急救與照護之標準化流程與護理能力模組化課程及教學設計之研究
| 論文名稱(中/英文) | 研究生 | 指導教授 |
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病人急救與照護之標準化流程與護理能力模組化課程及教學設計之研究 Emergency Nursing Care Competencies |
陳莉美 | 徐曼瑩博士 |
| [ 摘要 ] | ||
| 病房護理人員輪值三班是發現病人生命危急情況與第一個到達急救現場啟動急救的關鍵人物。要能掌握病人急救的黃金時間，護理人員對病人急救前情境線索的覺察能力與啟動急救工作的判斷能力是重要的關鍵。為了有效提升病房病人的急救成效，因此本研究以一般內外科病房為研究情境，目的在（一）建構與標準化病房護理人員急救與照護任務的執行流程，（二）整合急救與照護任務流程的執行能力，（三）設計急救與照護流程執行能力取向的模組課程與教學。整個研究經過三個階段；階段一在建構與標準化病房護理人員急救與照護任務的執行流程及確認其必備的執業技能。首先採用訪談法收集護理人員執行病人急救前的照護與急救任務之步驟，再透過文獻查證與焦點團體訪談法標準化急救與照護任務的執行流程、各步驟定義和步驟間關係之陳述。標準化的急救與照護任務執行流程依據研究小組十位成員確認出執行流程需具備的六類能力，訪談與分析內外科病房八位護理人員對該流程執行能力訓練需求之意見。階段二在模組化課程與教學。依據訓練需求將急救與照護流程的執行能力模組化為模組課程後，經過文獻查證與小組討論方式，採用樹狀結構設計出四個模組的學習目標、評值指標、教材大綱、呈現方式、多媒體教材、評值方式與評值工具。階段三在檢核與改進模組課程與教學設計的包裝，採用焦點團體訪談法與自設評值表分別檢核模組的學習目標、評值工具、急救與照護任務執行流程影片的品質以及提供學習內容意見等。研究結果包括：（一）內外科病房護理人員的急救與照護任務執行流程，（二）內外科病房護理人員急救與照護流程的執行能力，（三）四個模組課程與教材，（四）一份急救模組課程的自學手冊。此急救模組課程與教材可以應用於內外科病房新進護理人員執業訓練與學校應屆畢業護生的就業訓練。 | ||
| [ Abstract ] | ||
| Inpatient nursing staff are critical in identifying in-patients who are in life-and-death situations and need emergency care. They are also one the first people to arrive at the bedside of those patients and initiate emergency medical services. The nursing staff’s awareness of a patient’s condition before first aid is administered, and their ability to make responsible decisions is critical to their delivery of effective first aid services. This aims to improve the effectiveness of first aid administered to inpatients. With reference to medical and surgical wards as research scenarios, its goal is to (1) construct and standardize an implementation procedure for emergency nursing care to be delivered by nursing staff; (2) to establish the competencies required to execute emergency nursing care, and (3) to design a competency-oriented modular curriculum is for teaching purposes. The study comprises the following three stages. Stage I: To construct and standardize the procedure for implementing emergency nursing care for nursing staff who work in medical and surgical wards and to identify the skills required to deliver it. First, interviews with nursing staff were conducted to determine what steps they would take to treat their patients before first aid. Secondly, a literature-based verification and focus group interviews were conducted to standardize the procedure for emergency nursing care; define each step, and elaborate the relationships between successive steps. According to ten members of the research team, six competencies are necessary for implementing the procedure. Based on interviews conducted with eight nursing staff and analyses of their suggestions regarding training requirements, recommendations are made . Stage II: To design and teach the modular curriculum. Based on the training requirements, the competencies required to execute emergency nursing care are covered in curricular modules. Based on a literature review and team discussions, a tree diagram is used to establish learning targets, appraisal indicators, teaching material outlines, presentation methods, multi-media teaching materials, appraisal methods and appraisal tools for a total of four modules ). Stage III: To appraise and improve modular curricula and the design of teaching method). Focus group interviews and self-designed appraisal tables are used to appraise the learning targets, appraisal tools, and the quality of the video footage used in the four modules, as well as to extract opinions about the the quality of learning. The results of the study concern the following. (1) The procedure by which nursing staff on a medical or surgical ward deliver emergency nursing care. (2) The competencies required to execute emergency nursing care. (3) Four modular curricula and teaching materials. (4) A guide for self-learning to accompany the modular curricula. The modular curricula and teaching materials can be applied to on-the-job training of new nursing staff at medical and surgical wards, and used by fresh graduates who are entering the work force. |
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