Investigation And Analysis On The Advanced Nursing Practice Status Of Specialist Nurses In Four Tertiary Grade A Hospitals In Xinjiang

Objective: To understand the current status of advanced nursing practice of specialist nurses,explore its influencing factors,and analyze existing problems;to understand the training-use-management status of nurses by nurses in four tertiary hospitals in Xinjiang,with a view to further improving the training of specialist nurses,Use and management provide a reference basis.Methods: From March 2018 to May 2019,four top three hospitals in Urumqi and Shihezi were selected by typical sampling method.The "General Nurses General Information Survey Form" and "Special Nurses Advanced Nursing Practice Contents Survey Form" were used to investigate the advanced nursing practice of 897 specialist nurses.The current situation of training,use and management of specialized nurses in Xinjiang top three hospitals was investigated.During the same period,the semi-structured interview method was used to conduct in-depth interviews with the head of nursing department(4),head nurses and head nurses(8),and specialist nurses(28).Quantitative data were analyzed by SPSS 20.0 for statistical description,t test,one-way analysis of variance,and multiple stepwise regression analysis;qualitative data were collated and analyzed by content analysis.Results: 1.The field of specialized nurses: a total of 20 types of work were involved,of which 317(35.3%)were in ICU;155 were in emergency and emergency(17.3%);and 117 were in operating room(13.0%).2.The work development status of specialist nurses: 94.4% think that the hospital attaches importance to and above;79.4% can play the role function;63.0% increase in work pressure,and 89.2% can answer relevant specialized knowledge.In the daily work of specialist nurses,the most involved in clinical routine nursing care,accounting for 81.4%;the least involved in organizing and preparing related specialist education activities inside and outside the hospital,accounting for 8.1%.3.Current status of advanced nursing practice for specialist nurses: The total score of the self-assessment scale for advanced nursing practice contents for specialist nurses is(3.03 ± 0.63)points;the highest average score for the dimensionality items(3.24 ± 0.81)points;the average points for clinical inquiry dimensions The lowest(2.75 ± 0.87)points.Education background,title,years of specialist work,years of specialist qualifications,grades of specialist certificates,total frequency of continuing education,average monthly income,managers,hospital attention,role functions,and specialty nursing clinics are the main influencing factors of ANP.4.Training,use and management status of the four top three hospitals: The specialized nurse training bases approved by the four top three hospitals are at the autonomous region level or the regiment level;SN selection conditions require a college degree or above,and the frequency of continuing education is 1-2 Times / year;carry out specialized nursing group activities;set up specialized nursing posts;there are different degrees of treatment preference;a total of 3 types of specialist outpatient clinics have been carried out.5.Interview results: In-depth interviews extracted 14 subject groups related to advanced nursing practice in three categories.(1)Director of Nursing Department: The number of specialist nurses is increasing,and the use situation needs to be further improved;some hospitals have set up specialist nursing posts,but it remains to be clear;attach importance to the training quality of specialist nurses and carry out advanced nursing practice activities;There are difficulties and challenges in assessing performance.(2)Interviews with head nurses and head nurses: generally improved practical ability;relatively heavy work tasks;difficulties and challenges in management and scientific research.(3)Interviews with specialist nurses: mainly engaged in direct nursing practice activities;education and guidance are specialist,strategic and beneficial;participation in management is mainly head nurses and head nurses;continuous expansion in the field of consultation;An important coordinating role;while the hospital began to attach importance to scientific research,specialist nurses gradually realized its importance;obstacles faced in the clinic.Conclusions: 1.The field of specialty work of specialist nurses basically meets the national requirements,but it needs to be further expanded.2.The work of specialized nurses has begun to reflect the content of advanced nursing practice;and has the ability of advanced nursing practice,but its clinical inquiry ability is still relatively weak.3.Education,title,years of specialist work,years of specialist qualifications,grades of specialist certificates,total frequency of continuing education,average monthly income,managers,hospital attention,role functions,and specialty nursing clinics are SN's advanced nursing practices Influencing factors.4.The hospital began to attach importance to the quality of training for specialist nurses;however,the post setting of specialist nurses needs to be further clarified,which is a common difficulty and challenge faced by hospital management and specialist nurses.