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在模拟恶化患者事件中对护理学生最后一年的情境意识进行认知任务分析:混合方法研究
Nuala Walshe1, Jonathan Drennan2, Josephine Hegarty3
1Clinical Skills Simulation Resources Centre, School of Nursing and Midwifery, University College Cork, Cork, Ireland.
Nursing open
|April 12, 2024
概括
最后一年的护理学生在管理病情恶化的患者时表现出可变的情况意识. 培训和临床暴露需要改进,以提高提示识别和患者护理升级.
科学领域:
- 护理教育 护理教育
- 患者安全 患者安全
- 临床技能评估 临床技能评估
背景情况:
- 在急性护理环境中,对病情恶化的患者的有效管理至关重要.
- 护理学生的情况意识是及时和适当的患者护理的关键因素.
- 认知任务分析为理解复杂的临床决策提供了一个框架.
研究的目的:
- 描述最后一年的护理学生在识别,响应和升级对病情恶化的患者的护理方面的情况意识.
- 确定影响护理学生在病房环境中的情况意识的因素.
- 为提高护理教育和临床实践提供建议.
主要方法:
- 采用了混合方法认知任务分析与融合三角化设计.
- 数据包括33名护理学生在模拟恶化的患者场景和回顾性认知访谈中的观察.
- 过程跟踪识别了感知线索,线索集成,情境理解和影响因素.
主要成果:
- 中位数的暗示感知率为65.4% (医疗) 和57.6% (外科).
- 影响知觉的因素包括不完整的监测,有限的评估,被动扫描,不良的自动性和高的认知负载.
- 不完整的感知,糟糕的暗示集成和不发达的心理模型阻碍了情境理解,并指出了可变的临床暴露.
结论:
- 护理学生在管理病情恶化的患者方面的情境意识受到多种认知和环境因素的影响.
- 暗示感知和整合的不一致性会影响形成准确情境理解的能力.
- 建议加强培训和结构化的临床经验,以提高护理学生有效管理病情恶化的患者的能力.
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