| ObjectiveUse Green model to construct systemic questionnaire to evaluate occupational exposure and protection status of student nurses during internship and to discuss the existing problems and the occupational protection education needs; using Green mode to plan and implement pointed health protection education intervention for nurse students before and during the clinical practice according to the survey results.Methods1. Using the method of descriptive research. Convenience sampling from2011grade nursing students of Ningbo College of Health Sciencesas as the research object, they are Students in class11(3+2)1(50students) and class11(3+2)2(49students), a total of99students. Use Green mode to frame the "student nurses occupational exposure and protection during internship" questonnaire. Describe occupational exposure status of nursing students during the internship in technical secondary school, occupational protection knowledge, attitude and behavior status, in order to analyse the existing main problems and occupational protection education requirements and compare the two groups before intervention of nursing students have significant differences.2. Using the method of quasi-experimental study.After the baseline survey using the questionnaire above, to perform a controlled educational intervention for some nursing students of Ningbo College of Health Sciences. Students in class11(3+2)1were at experimental group (n=50) who got systemic occupational protection education one month before the clinical practice and further occupational protection guidance from the researcher of the study during the first7months’practice, while students in class11(3+2)2were at control group (n=49) who learned the teaching material themselves. By comparing the two groups of nursing students before intervention,4months and7months after intervention of protection knowledge, attitude and behavior questionnaire score, knowledge exam score and behavior evaluation scores, occupational exposure questionnaire scores and sharp injury occurence to evaluate the efficacy of the intervention.Results1. Occupational exposure and protection status of student nurses.1) According to the number of students counted about the harmful occupational hazard factors happen during the clinical practice, the results found:the ten occupational hazard factors that rated high are the disinfectant (100%), antibiotic (100%), the night shift (100%), anesthesia waste gas (97.0%), antitumor drugs(94.9%), working pressure (93.9%), blood and body fluid (90.9%), sharp instrument injury (90.9%), hand have no protection while broking ann cutting bottle (88.9%), and radiation (87.9%). In the clinical practice the student nurses felt the eight professional hazard factors threnghting health most ranked as follow. They are infection transmission of blood disease (79.8%), contact sharp instrument (76.8%), bacteria infection (67.7%), the night shift (60.6%), working intensity (58.6%), contact the antitumor drugs (58,6), the patient/family pressure (41.4%), and their co-workers (13.1%).2) The results of the survey found that the student nurses’ scoring average of knowledge part of occupational protection was77.5%, and the lowest points was only eight, the scores of chemical and physical occupational hazard factor were much lower; that in occupational protection manner score average was higher, about90.4%, and the scores of physical and psycho-social occupational hazard factor were much lower, the scoring averages were89.2%and87.6%; that in act compliance of occupational protection the scoring average was only76.3%, and the scoring average of physical occupational hazard factor was the lowest, was only67.03%.3) In the aspect of occupation protection education status and needs, the survey shows70.7%of students had not take part in the training of occupational protection and99.0%of the students thought it is necessary and willing to participate in the training of occupational protection.4) Before the intervention, two groups of students’ general information, the present situation of occupational exposure, the occupational protection knowledge, attitude and practice, the current situation of occupational protection education, and education needs have no statistically significant difference (P>0,05).2. Implementation and evaluation of occupational protection strengthening education.1) Analysis of variance of repeated measures showed that the difference of knowledge questionnaire score between experimental group and control group was statistically significant (P<0.01). Nursing students’ score of knowledge questionnaire has a tendency to change over time (P<0.001). The two factors (time and group) had interaction with each other (P<0.001). Multivariate analysis of variance showed that after4months and7months intervention experimental group nursing students’ mean scores of knowledge questionnaire were higher than the control group, the difference was statistically significant (P<0.01). T test results show that after4months and7months intervention knowledge exam scores of experimental group are higher than the control group, the difference was statistically significant (respectively, P<0.01and P <0.05).2) Analysis of variance of repeated measures showed that the difference of attitude questionnaire score between experimental group and control group was statistically significant (P<0.001). Nursing students’ score of attitude questionnaire has a tendency to change over time (P<0.001). The two factors (time and group) had no interaction with each other (P>0.05). Multivariate analysis of variance showed that after4months and7months intervention mean scores of attitude questionnaire of experimental group nursing students’ were higher than the control group, the difference was statistically significant (respectively, P<0.01and P<0.05).3) Analysis of variance of repeated measures showed that the difference of behavior questionnaire score between experimental group and control group was statistically significant (P<0.05). Nursing students’ score of behavior questionnaire has a tendency to change over time (P<0.001). The two factors (time and group) had no interaction with each other (P>0.05). Multivariate analysis of variance showed that after4months and7months intervention mean scores of behavior questionnaire of experimental group nursing students’ were higher than the control group, the difference was statistically significant (respectively, P<0.01and P<0.05). T test results show that after4months and7months intervention behavior evaluation scores of experimental group were higher than the control group, the difference was statistically significant (P<0.05).4) Analysis of variance of repeated measures showed that the difference of professional exposure questionnaire score between experimental group and control group was statistically significant (P<0.05). The score has a tendency to change over time (P<0.001). The two factors (time and group) had no interaction with each other (P>0.05). Multivariate analysis of variance showed that after4months and7months intervention mean scores of professional exposure questionnaire of experimental group nursing students’ were higher than the control group, the difference was statistically significant (respectively, P<0.05and P<0.01).5) Kruskal Wallis analysis results show that the occurrence of sharp instrument injury of experimental group were both less than control group during the first3and6months, the difference was statistically significant (P<0.05). Results of chi-square test showed that during6months internship the students number of needle stick injuries of experimental group was less than control group, the difference was statistically significant (P<0.05).Conclusion1. The structure, clauses and subclauses of the "student nurses occupational exposure and protection during internship" questionnaire are reasonable, the reliability and validity are good, and the questionnaire can be used to evaluate occupational exposures and protection status of student nurses during the clinical practice.2. Higher vocational student nurses’ lack occupational protection knowledge with different degree, the attitude is positive, but occupational protection compliance is bad. Among them the lack of knowledge are mainly embodied in the chemical and physical professional harmful factors, the shortcomings of the occupational protection attitude are mainly embodied in the physical and psychosocial harmful factors, and they keep some consistent.Behavior problems mainly manifests in the physical occupational hazard factors.3. Using Green mode to implement occupational protection strengthening education can increase nursing students’ occupational protection knowledge, attitude level and promote occupational protection behavior. |
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