| Objectives:The purpose of this project is to construct the content of anesthesia nursing risk management training courses that suitable for anesthesia nurses in China.Then,to carry out the preliminary application and evaluation of the teaching practice,so as to provide relevant research results,theoretical support and practical basis for Chinese anesthesia nursing education.Method:This in project,the research process has been divided into four stages including analysis,design and development,implementation and evaluation.All studies were conducted with a combination of qualitative and quantitative analysis.The whole project can be divided into two main parts.Part I : the construction of the training course content of anesthesia nursing risk management.(1)Taking the ADDIE teaching model as the theoretical guidance,the content framework of the initial item pool is constructed through literature research,expert consultation,and research group discussions;(2)Based on the content of the initial entry pool,conduct semi-structured interviews with 6 experts in the relevant fields,such as clinical anesthesia medicine,clinical anesthesia nursing,nursing teaching and nursing management.Analysis the data by using the method of the content analysis.(3)Forming a course content item pool based on themes screened and extracted from interviews,literature review and drawing on the expression form of relevant scale items.(4)To have two rounds of consultations with 26 experts from different provinces or cities,such as Beijing,Shanghai,Zhejiang,Henan,Hebei,Hubei,Liaoning,Sichuan,Shandong,Chongqing,Fujian,Jiangxi and Yunnan,and work in different fields including clinical anesthesia nursing,medical treatment,anesthesia nursing management,nursing education,nursing research,and statistics.Screen and optimize the entry pool according to the consultation results,and build an anesthesia nursing risk management training course content.Part II: Preliminary application and evaluation of anesthesia nursing risk management training courses.On the basis of the content of the anesthesia nursing risk management training course constructed by the expert consultation,the ADDIE model is used as the guide to improve the specific teaching content of the course.40 nurses engaged in clinical anesthesia nursing work in 5 hospitals with anesthesia nursing positions in Yunnan Province who met the admission and discharge standards were selected as the research objects,and the practice teaching and effect evaluation were carried out from March 2022 to May 2022.The quasi-experimental research method was used to compare the subjects ‘before’ and ‘after’: questionnaires were conducted before and after the course training.The questionnaires included general information,anesthesia nurses’ perception of anesthesia risk questionnaire,and anesthesia nurses’ job competency self-evaluation questionnaire.and a post-training satisfaction survey.Results:The the first part of the research results:(1)In the theoretical guidance of the ADDIE teaching model and literature research,the "highly recommended" and "recommended" content related to "anesthesia nursing risk" were extracted,and the preliminary item pool of 41 items of the course content was determined.(2)30 topics in the training course content item pool,7 topics in the training method item pool and 4 topics in the effect evaluation item pool were identified by analysis the data and content of qualitative research expert pre-interview and semi-structured interview.(3)After two rounds of Delphi expert consultation,the effective recovery rates of the questionnaires were 73.08% and 84.62%,respectively,the productivity of experts’ opinions were 73.68% and 36.36%.The expert authority coefficients were 0.902 and 0.894,and the Kendall coordination coefficients were were 0.347-0.497 and 0.371-0.372(p<0.001),and the entry coefficients of variation were 0.00-0.30 and 0.00-0.18 respectively.After the modified,deleted and merged according to expert opinions,and finally 29 items of training course content,6 items of training method and 4 items of effect evaluation method were formed.(4)Under the guidance of ADDIE teaching model theory,combined with qualitative research,semi-structured interviews were formed,including "cultivation of anesthesia nursing risk control ability","establishment of anesthesia nursing safety and quality system","peri-anesthesia nursing risk quality control","Anesthesiology hospital infection risk prevention and control" 4 modules,23 courses,27 hours,theoretical knowledge lectures and simulation exercises and other teaching methods to complete the course content construction of anesthesia nursing risk management training.The second part of the research results:(1)The training course was completed in9 weeks as planned,and the attendance rate of the trainees was ≥96.25%.40 questionnaires were distributed before and after the training,40 questionnaires were effectively returned,and the effective recovery rate of the questionnaires was 100%.(2)After the training,the trainees’ scores in each item of anesthesia-related knowledge and anesthesia risk factor cognition were improved or kept at the same level,and there was a statistically significant difference in the improvement of "knowledge of the commonly used anesthesia strategies during surgery"(p<0.05).Comparative analysis was carried out from the dimension level in each dimension of anesthesia risk factor cognition,in which there were significant statistical differences in cognitive improvement in the three dimensions of "anesthesia factor","equipment factor" and "environmental factor"(p<0.05).There were significant differences in cognition improvement in 11 aspects including "comprehensiveness of monitoring items during anesthesia","means to establish an effective airway",and "emergency plan"(p<0.05).(3)After receiving anesthesia nursing risk management training,the research subjects’ scores in each dimension and specific items of self-assessment of anesthesia nurses’ post competency have improved.Among them,the self-evaluation scores of 22 secondary items,such as “can take corresponding preventive measures for the potential complications of patients,prevent them before they occur” have significant statistical differences(p<0.05),and the remaining 13 secondary items have no significant difference.There were significant differences in cognitive improvement among the four dimensions of "risk control","basic knowledge","preoperative knowledge" and "operational skills" in the first-level items(p<0.05),in which the score of “risk control” was significantly higher than that before training,3.82±0.83 and 4.29±0.76,respectively,and the difference was statistically significant(p<0.05);the two dimensions of “career development” and “individual characteristics” There was no statistically significant difference in cognitive improvement(p>0.05).(4)The course satisfaction assessment was conducted for the trainees who received anesthesia nursing risk management training.More than 95% of the trainees felt very satisfied or satisfied with the quality of teachers’ teaching and course setting.(5)The final theoretical assessment was conducted for the trainees who received the anesthesia nursing risk management training.62.5% of the students passed the theoretical assessment,37.5% of the students achieved excellent results in the theoretical assessment,and no students failed the theoretical assessment.Conclusion:Under the guidance of the theory of ADDIE teaching model,this study constructs the content of anesthesia nursing risk management training courses suitable for anesthesia nursing staff in my country.After preliminary teaching application practice and evaluation of teaching effect,it is verified that the content of this course can effectively improve anesthesia nursing staff’s cognition of anesthesia risk factors and post-competence nursing risk management ability,and provide a reference for the on-the-job education and training of anesthesia nursing in our country. |
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