单荣芳　王丽华

摘要：目的  探討以胜任力为导向的案例导入式教学在护士血气分析技能培训中的应用效果。方法  选择我院2018年参加医院危重症专科护士培训的40名临床护士设为对照组，将2019年参加医院危重症专科护士培训的40名临床护士设为观察组，对照组采用常规方法进行血气分析技能培训，观察组采用以工作胜任力为导向的案例教学法进行培训。结果  观察组护士操作总得分及前、中、后得分均高于对照组，差异有统计学意义（P<0.05）;观察组操作前部位选择、病情评估、患者评估正确率均高于对照组，差异有统计学意义（P<0.05）;观察组应急处理意识、有效按压和标本处理合格率高于对照组（P<0.05）;观察组并发症观察和血气标本解读正确率高于对照组（P<0.05）。结论  以胜任力为导向的案例导入教学能够提高护士血气分析操作技能，实现了理论与实践相结合，护理人员综合能力的同步提升。

关键词：胜任力;案例导入;血气分析技能

中图分类号：R4;G642                              文献标识码：A                                 DOI：10.3969/j.issn.1006-1959.2020.14.061

文章编号：1006-1959（2020）14-0183-03

The Effect of Competency-oriented Case Teaching Method

on Nurses' Artery Blood Gas Skills

SHAN Rong-fang，WANG Li-hua

（Nursing Department，the Second Affiliated Hospital of Nantong University，Nantong 226001，Jiangsu，China）

Abstract：Objective  To explore the application effect of competency-oriented case-introduction teaching in the training of nurses' artery blood gas skills.Methods  The 40 clinical nurses who participated in the training of hospital critical care nurses in our hospital in 2018 were selected as the control group， and the 40 clinical nurses who participated in the training of hospital critical care nurses in 2019 were set as the observation group. The control group used conventional methods for artery blood gas skill training， and the observation group adopts case teaching method oriented to work competence.Results  The total operation scores of nurses in the observation group and the scores before， during and after the operation were higher than those in the control group， the difference was statistically significant （P<0.05）.The observation group pre-operation site selection， condition assessment， and patient assessment accuracy rate were higher than the control group， the difference was statistically significant （P<0.05）; the observation group emergency treatment awareness， effective compression and specimen processing qualification rate were higher than the control group （P<0.05）; the correct rate of observation of complications and interpretation of blood gas samples in the observation group was higher than that in the control group （P<0.05）.Conclusion  Competency-oriented case introduction teaching can improve nurses' artery blood gas skills， realize the combination of theory and practice， and improve the comprehensive ability of nursing staff.

Key words：Competency;Case introduction;Artery blood gas skills

血气分析（artery blood gas，ABG）是危重患者重要的监测手段，在急诊室、呼吸内科、心胸血管外科和监护室常规开展[1]。研究发现[2，3]，临床血气分析检验结果误差较多，而正确采集动脉血是控制结果质量的重要因素之一。2017年护理学会颁布《动脉血气分析临床操作实践标准》[4]，内容丰富、知识面广、专业性强，普通病房患者采集血气标本时情况相对紧急，护理人员接触此项操作机会较少，想要获此技能并熟练应用，解决患者临床问题，有效培训已成为临床教学的难点。案例导入法教学通过模拟不同临床情景提高护士理论知识的应用能力，以胜任力为导向的教学着重于培养护士适应临床变化，顺利进行护理活动的可迁移的能力。我院自2018年成立医院危重症护理专业学组，对普通病房专科护士进行急危重症护理技能的培训，在动脉血气分析技能教学中采用以胜任力为导向的案例导入法教学，现将应用情况报道如下。……