提升手術室護生實習成效之改善專案

A Project to Improve the Learning Outcomes ofClinical Practicum for Nursing Students in the Operation Room

為創造良好的護生實習環境與提升其臨床實習成效，完善之實習計劃與策略是需要的。但因手術室是一特殊單位，護生實習時常會因技術不熟悉、準備度不足及無固定之臨床指導老師等而影響其實習成效，甚至可能導致異常事件之發生，故本專案旨在提升手術室護生實習成效，並降低異常事件之發生。經重新修訂護生四週實習課程內容、製作實習指引手冊、修訂實習目標及設置獎勵制度後，結果使護生之（1）實習平均分數由過去的78分提升至88分；（2）異常事件發生件數下降：如針扎事件件數由2件降為0件，無菌器械、醫材被污染件數由58件降至25件，醫材誤拆件數由15件降為7件；（3）實習整體滿意度由原先70%提升至90%，達專案目的。本專案之實施不但使護生在手術室實習之成效提升，也讓手術室護理人員對護生之實習目標有更進一步之了解，並能適時加入護生的學習指導。In order to create a better learning environment and to improve the effectiveness of clinical practicum for nursing students, a comprehensive clinical plan and strategy is needed. However, due to the complexity of operation room, many factors may affect the effectiveness of practicum, such as nursing students’ lack of familiarity with surgical skills, inadequate preparation, and no fixed clinical educator. As a result, medical errors may occur. Therefore, the aim of this project was to improve the effectiveness of practicum and to reduce medical errors. After revising the four-week learning lessons, completing a clinical guideline, revising practicum goals, and establishing a reward policy, the results were as follows. The average learning scores were improved from 78 points to 88 points for each student. Medical errors were reduced, including reduction in number of accidental needle stabbings from 2 to zero, a reduction in the number of contamination of sterile appliances and materials from 58 to 25 items, and a reduction in the number of disinfected packages accidentally opened from 15 to 7 packages. Overall satisfaction was increased from 70% to 90%. The aim of this project was achieved. The results of this project cannot only improve the effectiveness of practicum for nursing students at an operation room, but also improve the understanding of learning objectives by nurses. Nurses, thus, can be appropriately involved in students’ education.