新進護理人員執行靜脈注射技術 之教學設計、實施與成效評量
Development of the Instructional Design of Intravenous Injection Skill for New Nurses and Their

Implementation and Evaluation

本研究目的有二：（一）發展「靜脈注射技術多元教學模式」（二）探討新 進護理人員接受「靜脈注射技術多元教學模式」後之學習成效。採前實驗單組 後測研究設計，立意取樣，以台北市某區域教學醫院104年應屆畢業之新進護理 人員20位為研究對象，由研究者擔任新進護理人員學習靜脈注射技術的教學 者，運用「新進護理人員執行靜脈注射技術多元教學模式」，包括觀看教學影 片、運用假手臂練習技術及互相練習護病溝通技巧；另由一位資深護理臨床教 師擔任靜脈注射技術的評量者，採用自擬之直接觀察操作型技術評量表（Direct Observation of Procedural Skill, DOPS）「DOPS評量表」評量新進護理人員執行 靜脈注射技術之學習成效，該量表共10題，計分方式採3級分計分，每項的表現 以「沒有執行」（0分），「有執行但不符合標準」（1分），「有執行並符合 標準」（2分），分數總計為0-20分，再由研究者進行焦點團體訪談，瞭解新進 護理人員執行靜脈注射學習之經驗及感受。研究結果為：（一）整體得分Mean±SD  =18.00    ±    2.683分（N=16）;（二）新進護理人員接受「靜脈注射技 術多元教學模式」後，立即互相執行靜脈注射技術之學習經驗與感受為：1.學 會打針前如何與病人溝通，2.能選擇合適的靜脈血管，3.學會打針的小撇步，4.能體會病人沒一針被打上的感覺；一週後，新進護理人員至病房幫病人執行靜脈注射之經驗與感受為：1.逐漸產生與病人溝通的信心，2.能掌握下針的角度， 3.體會針尖穿刺到血管的感受，4.不再害怕On IC的技術，5.期盼能具備一針成 功的能力。期望此研究結果能提供護理教育者指導新進護理人員執行靜脈注射 技術之參考。

關鍵詞：靜脈注射技術、新進護理人員、多元教學模式

The purposes of this study were (1) to development of an instructional design of intravenous injection skills for new nurses；and (2) to implement and evaluate this instructional design. A pre-experimental design was adopted and purposive sampling was used to recruit 20 new graduates from a regional teaching hospital in Taipei. The instructional design included watching instructional videos, practicing intravenous injection skills on fake arms and exercising communication skills on patients, The researcher was the instructor of this project, while another senior clinical nursing teacher using the Direct Observation of Procedural Skill (DOPS) checklist to evaluate the new nurses intravenous injection skills. The DOPS checklist has 10 items. Each item on a 3-point Likert scale, o point for “no execute”, 1 point for “ execute but does not meet the criteria”, 2 points for “ execute and meet the criteria”. Thus, the total possible score on the DOPS checklist ranges from 0 to 20. The researcher then used group interviews to explore the new nurses learning experience and feeling. In this study, the new nurses’ overall mean score as measured by the DOPS Checklist was Mean±SD = 18  ±  2.683 (N=16). Four themes were categorized from the learningexperiences of new nurses rightafter the implementation and evalucation.which included (1) know how to communicate with patient before injection, (2) find the right vein, (3) earn more injection tips and (4). empathize with the patients if the injection did not get in for the first shot . Five themes were categorized after one week training period which included (1) gradually have more confidence to communicate with patients, (2) .can grasp needle angle easily, (3) experience the feeling when needle puncture into the vein, (4) no longer afraid of on IC technology, (5) Looking forward to give a successful injection in one shot . This study may be used as a reference for developing injection skill training courses for new nurses in Taiwan.