The Research on Technicalization Scheme of Clinical Nursing Practice-From the construction of practice example accumulation system and hidden wisdom from nursing experiences

范例积累小组通过网络版日本护理实践范例积累中心(成立于2007年)，着手扩大可搜索的病历数据库。在成立时，该小组输入了170个病历，这些病历在2001年被投放到护理杂志上。2008年，该项目进行到2000年出版的125个案例已完成，并经提交人同意添加到数据库中。同时，开始对1999年的185例和2002年的142例进行分析。在日本护理艺术与科学学会第六次会议上，该小组参加了一次交流会，除了宣传该小组的主要活动外，还与一般与会者讨论了分析方法和开发临床智慧。在临床/教育环境中，使用了许多案例分析方法，因此实际上并没有一个固定的分析框架，一些…如上所述，更多的小组对框架分析本身感兴趣，案例历史的执行建立了分析成员的习惯和培训。此后，由于病历积累的速度正在加快，而通过Web贡献病历的人却寥寥无几，因此，建立一个供稿网络，使系统更易于使用成为一个讨论的主题。通过视频叙述IL的效果：(1)包扎技术，(2)重症监护病房母亲，(3)吞咽困难患者的方法是从熟练的护士的熟练技术中提取出来的。(1)的结果是：注意到特定的动作并赋予它们意义，反映经验智慧的动作，以及对一个人的技术成就的感觉和情绪。对于(2)，使用五种感官阅读患者轻微的反应，并表现出灵活性，不成为习惯的囚徒(3)：口腔护理，反映从吞咽困难患者的舌后等频繁聚集点清除痰的知识；这种评估基于吞咽机制；根据护士的讲话或工具与身体的联合指示进行口腔摄入。较少

The Example Accumulation Group, by means of the Web Edition Japanese Nursing Practice Example Accumulation Centers'(set up in 2007), set about to expand the searchable case history database. At the time of establishment, the group entered 170 case histories that had been contributed to nursing magazines in 2001. In 2008, the project proceeded to the point that 125 case histories published in 2000 were finished and were, with the consent of the authors, added to the database. At the same time, work began on the analysis of 185 cases from year 1999 and 142 from year 2002. At the 6th meeting of the Japanese Scciety of Nursing Art and Science, the group participated in an exchange session in which, besides publicizing the group's main activities, involved discussions with the general attendees concerning analysis methods and developing clinical wisdom. In clinical/educational settings, many methods of case analysis are used, so that there is not a fixed analysis framework In fact, some amo … More ng the group are interested in framework analysis itself As described above, the execution of the case histories establishes the analysis members' habits and training. Hereafter, because the tempo of case history accumulation is accelerating while only a few people are contributing case histories via the Web, the subject of building a contribution network to remake the system to be easier to use has become a topic of discussion. IL Through a video narrative the efficacy of methods for : (1) bandaging technique, (2) intensive care unit mom, and(3) swallowing for the patients with dysphagia were extracted from the skilled techniques of expert nurses. The results for(1) are : Noticing particular movements and attaching meaning to them , Actions reflecting wisdom from experience , and Feelings and emotions concerning one's technical achievements . For(2), reading slight patient reactions using the five senses and showing flexibility in not becoming a prisoner of habit For(3) : oral care reflecting knowledge of the clearing of sputum from frequent accumulation points such as the back of the patients tongue in the casa of those with dysphagia ; this assessment based on the swallowing mechanism ; enabling oral ingestion based on instructions through the nurse's speech or the uniting of tool and body. Less