手术室护士的患者安全胜任力分层培训方案构建及初步应用研究

doi:10.3761/j.issn.1672-9234.2025.10.010

摘要/Abstract

摘要：

目的构建手术室护士的患者安全胜任力分层培训方案并评价其初步应用效果。方法基于文献回顾、问卷调查结果拟定方案初稿。2024年12月—2025年1月，采用德尔菲法对16名相关领域专家进行2轮函询，形成分层培训方案。采用便利抽样法，于2025年4月—6月基于方案对重庆市某三级甲等综合医院某院区手术室的42名护士实施培训。分析护士综合量化考核结果和培训前后的患者安全胜任力自评得分变化，并调查其对培训的满意度。结果 2轮函询专家积极系数分别为94.1%和100.0%，专家权威系数分别为0.906、0.912，肯德尔和谐系数分别为0.319和0.329（均P<0.001）。最终方案分为基础培训方案和进阶培训方案两类，各包括培训对象、目标、内容、方法（式）、学时、师资、评价7个方面。基础培训组理论考核成绩为（89.23±3.85）分，技能考核一次性通过率为92%；进阶培训组案例分析报告和循证项目设计书合格率均为100%。培训后护士的患者安全胜任力自评得分高于培训前（P<0.001），护士对培训的总体满意度为98%。结论手术室护士的患者安全胜任力分层培训方案科学、可靠，有助于提升手术室护士的患者安全胜任力，获得了护士的认可。

关键词: 患者安全胜任力, 手术室护士, 培训方案, 分层培训

Abstract:

Objective To construct a hierarchical training program for patient safety competence of operating room nurses and evaluate its preliminary application effect. Methods The first draft of the program was formulated based on literature review and questionnaire survey. From December 2024 to January 2025，the Delphi method was used to conduct two rounds of consultation with 16 experts in related fields，and the program was formed. From April 2025 to June 2025，42 nurses in the operating room of a tertiary grade A general hospital in Chongqing were trained based on the program. The results of comprehensive quantitative assessment of nurses，the changes in self-assessed scores of patient safety competence before and after training，and their satisfaction with the training were analyzed. Results The positive coefficients of experts in the two rounds of letter consultation were 94.1% and 100.0% respectively，the authority coefficient were 0.906 and 0.912 respectively，and the Kendall's W coefficients were 0.319 and 0.329 respectively（all P<0.001）. The final program was divided into basic training program and advanced training program，each included seven modules：training objects，training objectives，training content，training methods，class hour arrangement，training instructors，and training evaluation. The theoretical assessment score of the basic training group was（89.23±3.85），and the one-time pass rate of the skill assessment was 92%；the pass rates of case analysis reports and evidence-based project design books in the advanced training group were both 100%. The self-assessed scores of nurses’ patient safety competence after training was higher than those before the training（P<0.001），and nurses’ satisfaction with the program was 98%. Conclusion The hierarchical training program for patient safety competence of operating room nurses is scientific and reliable，which helps to improve the patient safety competence of operating room nurses，and can provide reference，basis and practical guidance for hospitals to carry out patient safety training for operating room nurses.

Key words: Patient safety competency, Operating room nurses, Training programs, Stratified training

叶惠林, 唐维荣, 邬小容, 张颖嘉, 李跃荣. 手术室护士的患者安全胜任力分层培训方案构建及初步应用研究[J]. 中华护理教育, 2025, 22(10): 1210-1218.

YE Huilin, TANG Weirong, WU Xiaorong, ZHANG Yingjia, LI Yuerong. Construction and preliminary application of a stratified training program for patient safety competency of operating room nurses[J]. Chinese Journal of Nursing Education, 2025, 22(10): 1210-1218.

图/表 4

参考文献 16

[1]	刘璟, 肖明朝. 关于WHO提出全球患者安全行动计划的思考与启示[J]. 中国医院, 2021, 25(7):62-64.
	Liu J, Xiao MZ. Thinking and inspiration on the global patient safety action plan of WHO[J]. Chin Hosp, 2021, 25(7):62-64.
[2]	张永佳, 喻姣花. 患者安全胜任力框架及评估工具的研究进展[J]. 护理学杂志, 2021, 36(20):107-110.
	Zhang YJ, Yu JH. Research progress in patient safety compe-tency framework and assessment tools[J]. J Nurs Sci, 2021, 36(20):107-110.
[3]	Huh A, Shin JH. Person-centered care practice,patient safety competence,and patient safety nursing activities of nurses working in geriatric hospitals[J]. Int J Environ Res Public Health, 2021, 18(10):5169.
[4]	汪颖越. 临床护士患者安全教育效果与其患者安全胜任力的相关性研究[D]. 武汉: 华中科技大学, 2023.
	Wang YY. The correlation between the effect of patient safety education and patient safety competency among clinical nurses[D]. Wuhan: Huazhong University of Science and Technology, 2023.
[5]	Peñataro-Pintado E, Rodríguez E, Castillo J, et al. Perioperative nurses’ experiences in relation to surgical patient safety:a qualitative study[J]. Nurs Inq, 2021, 28(2):e12390.
[6]	国家卫生健康委办公厅关于印发患者安全专项行动方案(2023—2025年)的通知[EB/OL].[2024-10-11]. https://www.gov.cn/zhengce/zhengceku/202310/content_6908044.htm.
[7]	杨雪娇, 钟竹青, 秦宁, 等. 基于知识图谱的我国护士分层培训可视化分析[J]. 中国现代医药杂志, 2022, 24(4):33-38.
	Yang XJ, Zhong ZQ, Qin N, et al. Visual analysis of hierar-chical training of nurses in China based on knowledge graph[J]. Mod Med J China, 2022, 24(4):33-38.
[8]	梅花. 临床护士患者安全培训内容体系的研究[D]. 上海: 第二军医大学, 2012.
	Mei H. A Study on the development of patient safety training framework for clinical nurses[D]. Shanghai: Second Military Medical University, 2012.
[9]	卞薇, 吴燕, 周明芳, 等. 患者安全胜任力护理人员自评量表的编制及信效度评价[J]. 第三军医大学学报, 2016, 38(7):776-780.
	Bian W, Wu Y, Zhou MF, et al. Development and evaluation of a rating scale of patient safety competency for nurses[J]. J Third Mil Med Univ, 2016, 38(7):776-780.
[10]	曾丽华, 陈娴, 朱珠, 等. 江苏省高年资护士共情疲劳的潜在类别分析[J]. 护理学杂志, 2024, 39(2):64-68.
	Zeng LH, Chen X, Zhu Z, et al. Analysis of potential catego-ries of compassion fatigue among senior nurses in Jiangsu province[J]. J Nurs Sci, 2024, 39(2):64-68.
[11]	张小红, 刘英, 郭美英, 等. 基于目标教学理论急诊科护士死亡教育培训内容的构建[J]. 中华护理教育, 2020, 17(10):914-918.
	Zhang XH, Liu Y, Guo MY, et al. Construction of curriculum system of death education for nurses in emergency department based on Bloom's goal teaching theory[J]. Chin J Nurs Educ, 2020, 17(10):914-918.
[12]	刘璐, 王为红, 孙世文, 等. 终止畸形胎儿妊娠孕产妇哀伤辅导方案的构建及应用[J]. 中华护理杂志, 2022, 57(24):2964-2971. doi: 10.3761/j.issn.0254-1769.2022.24.003
	Liu L, Wang WH, Sun SW, et al. Construction and application of a grief counseling programme for women undergoing pregnancy termination due to fetal anomaly[J]. Chin J Nurs, 2022, 57(24):2964-2971. doi: 10.3761/j.issn.0254-1769.2022.24.003
[13]	张秀梅, 袁先翠, 李京京, 等. 基于Benner理论的能级进阶分层培训对基层医院护士综合能力及岗位胜任力的影响[J]. 护理研究, 2021, 35(23):4278-4281.
	Zhang XM, Yuan XC, Li JJ, et al. Effect of advanced level training based on Benner's theory on the comprehensive ability and post competence of nurses in primary hospitals[J]. Chin Nurs Res, 2021, 35(23):4278-4281.
[14]	汪颖越, 喻姣花. 情景模拟教学在护生患者安全教育的应用进展[J]. 护理学杂志, 2022, 37(24):85-88.
	Wang YY, Yu JH. Application of simulation teaching in education on patient safety for nursing students:a review[J]. J Nurs Sci, 2022, 37(24):85-88.
[15]	周鹭. 以患者安全胜任力为导向的高职护理专业学生阶梯式教学策略的构建及初步应用[D]. 重庆: 重庆医科大学, 2024.
	Zhou L. Development and preliminary application of a step-by-step teaching strategy oriented by patient safety compe-tency for nursing students in vocational colleges[D]. Chong-qing: Chongqing Medical University, 2024.
[16]	丁晓华, 张雪芬, 马雪文, 等. 基于成人学习理论指导的临床护士分层培训效果评价[J]. 西北民族大学学报(自然科学版), 2025, 46(2):40-44,94.
	Ding XH, Zhang XF, Ma XW, et al. Methods and effects of hierarchical training of clinical nurses based on adult-learning theory[J]. J Northwest Minzu Univ Nat Sci Ed, 2025, 46(2):40-44,94.