改善護理新人自我調整學習病人急救與照護能力：情境覺察模組課程與教學鷹架之設計
| 論文名稱(中/英文) | 研究生 | 指導教授 |
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改善護理新人自我調整學習病人急救與照護能力：情境覺察模組課程與教學鷹架之設計 Patients’ Physiological and Vital Signs: Designs of Modular Curriculum and Instructional Scaffoldings |
黃俊朝 | 徐曼瑩博士 |
| [ 摘要 ] | ||
| 察覺病人病危情境而啓動急救是救活病人的關鍵，急救教學業務中並未包括病人急 救前情境覺察的訓練，護理新人通常自學而成。大多數的護理新人學習急救最困難的是 病人的變化線索的意義，此部份至今尚未納入教學業務中。急救是一個任務，因為需要 與醫師及其他專業人員協同合作，所以要將急救流程標準化。本研究目的在改善急救教學業務，重點在設計護理新人自我學習病人急救前生命/生理徵象變化的情境覺察模組 課程及克服學習困難的教學鷹架，研究目的包括(一)設計病人急救前生命/生理徵象變化 情境覺察模組課程及(二)設計有助於護理新人自我調整學習病人急救前生命/生理徵象 變化情境覺察模組課程的教學鷹架。以內外科病房護理新人依據情境執業模式為參考架 構，資料收集以考察文獻、焦點團體和臨床觀察等方法分三階段 12 步驟進行。研究結 果包括：(一)病人急救前生命/生理徵象變化情境覺察任務流程、(二)執行病人急救前三 天生命/生理徵象變化情境覺察流程須具備之能力、(三)內外科病房病人急救前三天生命/生理徵象變化情境覺察模組課程之教學設計、(四) 病人急救前生命/生理徵象變化情境 覺察模組課程學習困難及需要教學鷹架、(五) 教學鷹架對自我調整學習之成效、與(六)其他結果。建議在研究方面：(一)針對生命/生理徵象三期變化不同科別的病人進行測 試，持續研發各型圖卡、(二)採準實驗性研究，針對有接受與未接受訓練病房探討其救 活率之差異，以及繼續進一步研發其他任務照護能力；實務方面：(一)護理設置全院病 房病人資料統計之電腦畫面，以此作為領導、調班之參考，或作為優先巡房的依據；臨 床教育方面：(一)護理臨床教師教學能力的繼續教育，應加強行動研究法和護理工作任 務專業教學能力的教育訓練，以快速且有效地推動病人安全業務的改善。(二)設計其他 更多工作任務教學鷹架，幫助護理新人自我調整學習以克服學習困難。 | ||
| [ Abstract ] | ||
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Perceiving critical condition of patient dying and activating resuscitation is the key to save patient’s life. Resuscitation instructional program doesn’t incloud situational awarerness, and new nurses usually gain experience via self learning. New nurses describe the most difficult part is unstandarding the meaning of change of patient viatal and physicalogal signs, and this part has not yet been incorporated into the instruction program. Resuscitation is a Job Task because it requires collaboration with physicians and other professionals, so it should standardize the the resuscitation process. This study aims to improve the resuscitation instructional program, with emphasis on the design of self-learning situational awareness of change of patient’s prior resuscitation vital and physiological signs, and instructional scaffoldings for coping learning difficulties. The two purposes are: (1) design situational awareness modular curriculum, and (2) design instructional scaffoldings to assist new nurse self-regulated learning situational awareness modular curriculum. Base on situational practice mode, data collection via reviewing literature, focus group and clinical observation in three stages 12 steps on medical and surgical ward new nurses are practitioners. The findings include: (1) situational awareness job task flow chart; (2) competence of performing situational awareness job task; (3) instructional design of patient resuscitation situational awareness in medical and surgical ward; (4) the learning difficulties and instructional scaffoldings; (5) the affect of self-regulated learnig and outcome; (6) others. Further study could: (1) test in different ward and continuing develop relevent tools; (2) develop different job tasks and RCT in different wards; (3) set technological information for leading and reliefing nursing staffs; (4) strengthen action research and job tasks for preceptor training; (5) design more instructional scaffoldings for other job tasks. |
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