设定下一个生命体征观察间隔作为基于模拟的护理教育的学习目标:一个前性的探索性观察性研究
Keisuke Endo1, Kazumi Kubota2, Kenji Karino3
1Department of Nursing, Shimane University Hospital, 89-1 Enya-cho, Izumo 693-8501, Shimane, Japan.
Nursing reports (Pavia, Italy)
|December 24, 2025
概括
护士的经验,而不仅仅是高级培训,影响了重新检查生命体征的决定,以早期检测患者的恶化. 模拟训练可以增强这种临床判断.
科学领域:
- 护理教育 护理教育
- 临床判断 临床判断
- 患者安全 患者安全
背景情况:
- 异常的生命体征是医院内临床恶化的关键指标.
- 在检测出异常后,护士重新检查生命体征的决策过程尚不清楚.
- 了解这些决定可以为基于模拟的教育提供信息.
研究的目的:
- 调查护士特征 (经验,培训) 如何影响在检测异常值后为下一次生命体征观察设置的间隔.
- 探索使用"设置下一个观察间隔"作为模拟学习目标的潜力.
主要方法:
- 对27名护士进行前性观察性研究,使用患者模拟器在三个场景 (正常,低紧急,中等风险) 中进行.
- 护士们指出了下一次生命体征观察的适当间隔 (以小时为单位).
- 统计分析 (曼-惠特尼U,多重回归) 探索了护士特征和观察间隔之间的关联.
主要成果:
- 在中等风险情景中,更大的临床经验和先前识别恶化的经验与较短的观察间隔有关.
- 高级生命支持 (ALS) 培训与低紧急情况的间隔更短有关,但在中等风险情景中并非独立存在.
- 临床经验和先前的恶化识别经验独立地与适度风险场景的调整模型中较短的间隔相关.
结论:
- 缩短生命体征观察间隔的决定受到临床判断的体验方面的影响.
- 基于模拟的教育,包括"设置下一个观察间隔",可以提高护士的临床判断力,以早期识别恶化.
- 研究结果表明,在护理教育中需要进一步进行确认性研究和课程开发.
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