Development of Nursing education Model based ethical judgment and clinical judgment

基于伦理判断和临床判断的护理教育模型的发展

• 批准号: 13307070
• 负责人: NOJIMA Sayumi
• 金额: $ 16.72万
• 依托单位: Kochi Women's University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (A)
• 财政年份: 2001
• 资助国家: 日本
• 起止时间: 2001 至 2003
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-13307070/
• 关键词: ethical judgment; clinical judgment; restraint; infection; 感染管理; 倫理原則; 感染症患者への倫理的配慮; 看護処理; 抑制・身体拘束; 看護倫理; 倫理判断; 看護教育

This study was conducted in order to elucidate the applications of ethical and clinical decisions among nurses with regard to restraint and infection, and related guidelines were created.Responses to a questionnaire survey on restraint were obtained from a total of 777 nurses. Nurses providing emotional care for restrained patients (n=392) felt "responsible for protecting the dignity of patients and ensuring their comfort", and tended to use "cognitive ability" and "effects on patients" as assessment indicators. Based on these results, the "Care guideline for ensuring the safety, comfort, and dignity of care recipients during physical restraint" was created, and then refined after obtaining evaluations. Responses to a questionnaire survey on infection were obtained from a total of 499 nurses. When implementing seclusion, nurses stated individual plans regarding issues such as "methods and standards of seclusion" and "explanations to the patient and family", but tended not to state individual plans for "stress coping techniques and their assessment".Nurses reported that in addition to other types of support, the following were constantly implemented during seclusion: "daily living assistance", "responses to limitations on daily living", "monitoring of signs of infection", and "emotional care for patients". Nurses responded that the conditions necessary for appropriate infection control included the following: "changes in the consciousness of doctors and other coworkers", "establishment of a system for collaborating and cooperating with doctors and other coworkers", "changes in the consciousness of nurses", "acquisition of specialized skills by nurses", and "development of a nursing education system". Based on these findings, the "Infection management guideline for ensuring the safety, comfort, and dignity of care recipients" was created.

本研究旨在阐明护士在约束和感染方面的伦理和临床决策的应用，并制定相关指南。对777名护士进行约束问卷调查。对受限患者进行情感护理的护士（n=392）认为“有责任保护患者的尊严，确保患者的舒适”，倾向于以“认知能力”和“对患者的影响”作为评估指标。在此基础上，制定了“确保受护人在身体约束期间的安全、舒适和尊严的护理指南”，并在获得评估后进行了细化。对499名护士进行感染问卷调查。在实施隔离时，护士会就“隔离的方法和标准”、“对患者和家属的解释”等问题陈述个人计划，而不会就“压力应对技术及其评估”等问题陈述个人计划。护士报告说，除了其他类型的支持外，在隔离期间还不断实施以下措施：“日常生活援助”、“应对日常生活限制”、“监测感染迹象”和“对患者的情感护理”。护士回应，适当控制感染的必要条件包括：“医生和其他同事意识的改变”、“建立与医生和其他同事协作和合作的制度”、“护士意识的改变”、“护士获得专业技能”和“护理教育体系的发展”。基于这些发现，制定了“确保接受照护者安全、舒适和尊严的感染管理指南”。