ISSN 1672-9234　CN 11-5289/R
主管：中国科学技术协会　主办：中华护理学会
出版：中华护理杂志社
收录：中国科学引文数据库（CSCD）来源期刊
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　　　中国核心期刊（遴选）数据库
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中华护理教育

中华护理教育 ›› 2023, Vol. 20 ›› Issue (2): 199-204.doi: 10.3761/j.issn.1672-9234.2023.02.013

• 继续教育 • 上一篇    下一篇

OSCE在心血管科护士危重患者转运能力评价中的应用

冯洁惠(),徐建宁,周杏慧,俞超,李旭芳,潘英,范宁,朱旭菁   

  1. 311000 杭州市 浙江大学医学院附属第一医院（冯洁惠，周杏慧，俞超，李旭芳，潘英，范宁，朱旭菁）；浙江中医药大学（徐建宁）
  • 收稿日期:2022-03-15 出版日期:2023-02-15 发布日期:2023-02-20
  • 作者简介:冯洁惠：女，硕士，主任护师，E-mail：<email>1503026@zju.edu.cn</email>
  • 基金资助:
    浙江省医药卫生科技计划项目(2023KY711);浙江大学医学院附属第一医院护理学科建设科研项目(2022ZYHL010)

The effects of objective structured clinical examination on the transport competence for critical patients of nurses in cardiovascular departments

FENG Jiehui(),XU Jianning,ZHOU Xinghui,YU Chao,LI Xufang,PAN Ying,FAN Ning,ZHU Xujing   

  • Received:2022-03-15 Online:2023-02-15 Published:2023-02-20

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摘要： 目的 探讨客观结构化临床考试（objective structured clinical examination，OSCE）用于心血管科护士危重患者转运能力评价的设计方法与效果。方法 以心血管科护士危重患者转运能力评价为核心，转运实践过程为主线，转运病例库为依托，通过德尔菲法设计OSCE方案，包括转运前评估分级、转运前沟通及准备、转运中动态监护、转运中应急处置、转运后规范交接、反馈评价6个考站。对36名心脏大血管外科、心血管内科护士进行考核和评价。结果 在考评体验方面，护士对OSCE的实施评价和教学效果的认可度较高。在OSCE方案的质量评价方面，平均成绩为（73.25±4.29）分，呈正态分布；各考站难度系数为0.60~0.83，平均为0.73；考试成绩的Cronbach’s α系数为0.79，内部一致性较好。在临床成效方面，实施OSCE后，护士的转运前评估分级准确率、转运前沟通有效率、转运前准备合格率、转运中监护治疗达标率、转运后交接规范率与实施前比较差异有统计学意义（P<0.05）。结论 客观结构化临床考试比较全面、科学地评价了心血管科护士危重患者转运能力，为危重患者转运教学及考核提供了参考依据。

关键词: 在职培训, 护理, 心血管疾病, 危重患者转运, 客观结构化临床考试, 能力评价

Abstract:

Objective To explore the effect of the objective structured clinical examination（OSCE） on evaluating the transport ability of critically ill patients of nurses in cardiovascular departments. Methods The OSCE training program was designed through Delphi technique based on the evaluation of nurses’ transport ability of critically ill patients，the transport practice process as the main line，and the transport cases bank as the basis. Six examination stations were established including pretransport assessment and grading，pretransport communication and preparation，dynamic monitoring during transport，emergency disposal during transport，standardized handover after transport，feedback and evaluation. The examination was conducted in 36 nurses in department of cardiovascular surgery and department of cardiovascular medicine. Results In terms of evaluation experience，nurses had a high degree of recognition for the effect of the OSCE. In terms of OSCE program quality evaluation，the average score was （73.25±4.29），with normal distribution. The difficulty coefficients of each station ranged from 0.60 to 0.83，with an average of 0.73. The Cronbach’s α coefficient of test scores was 0.79，indicating good internal consistency. In terms of clinical effectiveness，the transport ability of nurses was improved after OSCE assessment:the accuracy of assessment and grading before transport，the efficiency of communication before transport，the qualified rate of preparation before transport，the rate of compliance with monitoring and treatment during transport，and the standard rate of handover after transport were statistically significant compared with those before OSCE（P<0.05）.Conclusion The OSCE evaluated the transport capacity of nurses in cardiovascular departments comprehensively and scientifically，which could provide a reference for the teaching and assessment of the transport of critically ill patients.

Key words: Inservice Training, Nursing, Cardiovascular Diseases, Transport of critically patients, Objective structured clinical examination, Capability evaluation