Construction Of The Standardized Training Program For New Nurses Rotating In Operating Rooms: Based On Miller’s Pyramid Competence Model

ObjectiveThis study aims to construct a standardized training program suitable for new nurses during operating room rotation based on Miller’s Pyramid Competency Model in order to promote their post competency during operating-room rotation,such as quickly familiarizing themselves with the operating room environment,mastering basic theoretical knowledge and common surgical coordination skills.This program must follow the Training Outline for New Nurses(Trial)issued by the General Office of the National Health and Family Planning Commission(2016)and the Operating Room Nursing Practice Guide(2020 edition).MethodsThis study is a mixed quantitative and qualitative study.It consists of two parts:The first part is the construction of standardized training program for newly recruited nurses during operating-room rotation based on Miller’s pyramid competency model.The second part is the preliminary application and evaluation of the training program.1.Construction of the standardized training program for newly recruited nurses during operating rooms based on Miller’s pyramid competency model.First of all,the research group adopted literature analysis method,studied a large number of relevant literatures at home and abroad and conducted inductive analysis to understand the status quo of standardized training for new nurses in the operating room at home and abroad,identified the existing problems in the current training in China,and established the Miller Pyramid competency model as the theoretical framework of this study.Guided by the Training Program for New Nurses(Trial)(2016)and The Operating Room Nursing Practice Guide(2020 edition),the training objectives and tasks of new nurses during operating room rotation were determined;Then,semi-structured interviews were used to collect experts’ opinions and suggestions on the training of operating room planning nurses.On this basis,the research group drew up the first draft of the operating room standardized training program for new nurses.Secondly,two rounds of expert consultation were carried out on the first draft of the training program strictly in accordance with Delphi expert consultation method.According to the calculation of the distribution and recovery of the two rounds of expert consultation questionnaire,the results showed that the positive coefficient of experts was 83.3%,the average authority coefficient of experts was 0.85,and the mean value of importance assigned to all indicators was 3.75～4.95.Kendal coordination coefficient is 0.32 and variation coefficient is 0.05～0.25.According to the opinions and suggestions of experts,the research group revised the initial draft and formed the implementation draft of the training program.2.Preliminary application and evaluation of the standardized training programme.A total of 78 newly recruited nurses who received standardized training in the operating room from July 2020 to June 2021 in a third-class A hospital in a city of Shanxi Province were selected as the research objects.They were divided into control group and experimental group by lotting method,each group of 39 persons.The control group was rotated in the operating room of Hospital A,use traditional training programs.The experimental group was rotated in the operating room of Hospital B,and the operating room training program based on Miller pyramid capability model was adopted.The training effect was evaluated by means of theoretical knowledge written examination,operation skill examination,questionnaire survey and semi-structured interview.Baseline measurements were taken for the two groups of trained nurses using general information survey and theory examination paper(one)before training;A week before training is given after 3 months,using the theory of examination papers(two),operation skills appraisal(aseptic technique to extract the operating room operation,the prone position and emergency cesarean section surgery),operating room nurses post competency assessment scale and doctors satisfaction questionnaire to collect data,using SPSS 21.0 statistical software input data and statistical analysis.The semi-structured interview adopted the snowball method and took information saturation as the standard.A total of 8 experimental nurses were interviewed.The results of the interview data were analyzed by colaizzi7-step analysis method to further understand the experience and opinions of the new nurses on the training.Results1.This study constructed a standardized training program for new nurses during operating room rotation based on Miller pyramid competency model.There are three parts including training objectives,training process and assessment methods.The training process includes training content,training hours and training methods.The training lasts for 3 months and adopts diversified training methods.The training content is divided into four levels based on The Miller Pyramid competency model:professional theoretical knowledge,knowledge application ability,operation performance and practical performance.2.The application effect of the training program.In this study,a total of 78 subjects were included and 2 were lost due to leave or resignation.The actual effective sample size was 76,including 38 subjects in the control group and 38 subjects in the experimental group.The quantitative results show that:Before the training,there was no difference in the general information of the two groups of newly recruited nurses,and there was no statistical difference in the scores of the theoretical knowledge test(one volume)(P>0.05).Comparison of scores between the two groups of new nurses after training:(1)After training,the scores of the theory test(Volume two)of the two groups were compared:the theoretical test scores of new nurses in the experimental group were higher than those in the control group,the difference was statistically significant(P<0.001).(2)After training,the results of operation skill assessment of new nurses in the two groups were compared:the score of the prone position of the experimental group(87.99±2.87)was higher than that of the control group(80.54±3.20).Emergency cesarean operation coordination score(87.40±4.15)was higher than the control group(76.62±4.84).The total score of aseptic technique operation in operating room(386.50±2.62)was higher than that in control group(369.32±3.29),with statistical significance(P<0.001).Aseptic techniques in the operating room included four items,among which,there was statistically significant difference between the scores of the two groups of nurses in surgical hand disinfection and transfer of surgical instruments(P<0.001),while there was no difference between the scores of the two groups in wearing aseptic surgical clothes,wearing aseptic gloves and laying aseptic instrument table(P>0.05).(3)After training,the two groups of newly recruited nurses in the operating room post competency evaluation scale scores were compared.The total score of the test group(192.24±7.96)was higher than that of the control group(173.11±8.38),and the scores of all dimensions were also higher than that of the control group,with statistical significance(P<0.001).(4)After training,the two groups of new nurses in the doctor satisfaction questionnaire score comparison,the experimental group nurses satisfaction score(83.37±5.77)was higher than the control group(75.00±5.32),doctors were more satisfied with the experimental group nurses work performance,the difference was statistically significant(P<0.001).The qualitative results showed that:After the training,the semi-structured interview collected the experience and opinions of the experimental group nurses on the standardized training,and refined 3 themes and 8 sub-themes.Topic 1:The operating room post competence has been improved,including the improvement of professional knowledge and skills,the improvement of communication ability,and the improvement of operation cooperation ability;Theme 2:Harvest and growth,including the improvement of psychological quality,the improvement of the sense of responsibility,the change of mentality;Topic 3:Suggestions on standardized training in operating room:Hope to increase some elective contents and the time and frequency of simulation exercises.Conclusion1.Based on the Miller Pyramid Competency Model,this study constructed a set of standardized training programs for new nurses in the operating room,and the construction process of the programs was scientific and standardized.2.The application effect of the training program is good,which can enable the new nurses to better master the theoretical knowledge,improve the professional and technical level,and become competent for their roles as soon as possible,providing theoretical and practical basis for improving the quality of standardized training in the operating room.