運用客觀性結構式臨床技能測驗（OSCE）評量新進護理師管路照護技能與信心－胸腔引流護理為例

Evaluation of Confidence and Nursing Skills of New Nurses by Using the Objective Structured Clinical Examination Taking Chest Drainage Care as an Example

張綺芸(Chi-Yun Chang) ； 吳紹歆(Shaw-Shin Wu) ； 洪麗玲(Li-Ling Hung) ； 王素秋(Su-Chiu Wang) ； 黃惠美(Hui-Mei Huang)

《榮總護理》 39卷3期 (2022/09) Pp. 222-232

https://doi.org/10.6142/VGHN.202209_39(3).0001

摘要

傳統新進護理師管路照護訓練多藉由臨床教師講授方式為主，較少以真實案例情境練習，導致新進護理師缺乏實務操作經驗。本研究目的為運用客觀性結構式臨床技能測驗（OSCE）評價新進護理師管路照護技能與信心。研究設計為回溯性研究，研究對象為中部某醫學中心新進護理師共224位，經護理臨床教師指導胸腔引流護理及自我學習「外科引流管臨床護理照護」教學影片，接受OSCE評價技能及信心結果。研究工具包括「胸腔引流護理信心指數量表」及「胸腔引流護理OSCE評量表」，在OSCE活動前後，完成胸腔引流護理信心指數量表。結果發現外科單位新進護理師胸腔引流護理OSCE技能總分略高於內科單位、特殊單位及急重症單位，尤其在「胸管引流前準備」、「洗手」（p＜.05）。操作方面具顯著差異（p＜.05）。不同科別屬性新進護理師操作胸腔引流護理的信心指數，皆具統計差異。建議新進護理師執行專科技術前，除臨床教師指導及自學技術操作影片，再輔以OSCE評價，能了解個人技能及信心程度，期提升專科技術執行成效與照護品質。

關鍵字

客觀性結構式臨床技能測驗 ； 護理師 ； 胸腔引流護理

並列摘要

The conventional training pipeline for new nurses is based on clinical teachers' teaching methods and involves less practice in clinical settings, resulting in the lack of practical skills among new nurses. This study evaluated the nursing skills and confidence of new nurses after undergoing the objective structured clinical examination (OSCE). This retrospective study included 224 new nurses from a medical center in the central part of Taiwan. The nurses were trained by clinical nursing teachers in thoracic drainage nursing and were provided a self-study teaching video of ＂Clinical Nursing Care of Surgical Drainage Tube＂ before undergoing OSCE. Their skills and confidence were evaluated using the ＂Chest Drainage Care Confidence Index＂ (CDCCI) and the ＂Chest Drainage Care OSCE Scale.＂The CDCCI was used before and after the nurses underwent OSCE. The results demonstrated that the total score of chest drainage nursing skills of new nurses in surgical units was slightly higher than those of new nurses in medical, special, acute care, and critical care units, especially the scores of ＂preparation before chest tube drainage＂ and ＂washing hands＂ (p＜ .05). A significant difference was also observed in the scores of ＂operation＂ (p＜ .05). Statistical differences were observed in the confidence index of new nurses performing chest drainage in different departments. Therefore, in addition to being trained by clinical teachers and training using self-learning technical operation videos, the skills and confidence of new nurses should be evaluated using OSCE before they practice their skills in clinical settings. This may improve nurses' performance and quality of care.

並列關鍵字

objective structured clinical examination ； nurse ； chest tube management

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