連續性腎臟替代治療自學手冊介入護理人員學習成效之研究

Critical Care Nurse Learning of Continuous Renal Replacement Therapy: The Efficacy of a Self-Learning Manual

背景：現今重症醫療儀器日新月異，突破傳統限制、挽救病人生命，但卻也由於設計複雜，護理人員不易學習，繼而影響臨床成效；因此運用符合實務所需之自學教材輔助在職教育訓練，可有效提升急重症護理人員的專業技能與醫療品質。
目的：本研究以連續性腎臟替代治療（Continuous Renal Replacement Therapy, CRRT）為主題，設計一本適合隨身攜帶、自我學習的手冊，將其介入於加護護理人員，以探討CRRT操作技能之學習成效。 方法：本研究採準實驗性前後測研究設計，以立意取樣，選取台北市某醫學中心加護單位護理人員共66人進行施測。於「CRRT自學手冊」介入之前後，以「CRRT技術自評表」收集相關資料。研究資料以SPSS 17.0 Window套裝軟體進行各項統計分析。
結果：本研究結果顯示：一、CRRT自學手冊介入後，實驗組的技術自評平均得分為91.06分，標準差為9.49分；對照組的平均得分為79.75分，標準差為11.65分，兩組達顯著差異。二、CRRT自學手冊介入前，實驗組在CRRT技術自評得分為80.71 ± 11.82分，介入後的得分為91.06 ± 9.49分，平均進步10.35 ± 10.35分，實驗組的CRRT技術自評前後測得分有顯著差異。
結論：實務應用 依本研究結果建議未來安排護理人員繼續教育時，可運用自學手冊輔助教學，以提高學習成效，並提升學習滿意度。

Background: Many nurses have difficulty learning to use the complex, non-traditional, and regularly-updated critical care equipment. Failure to use such equipment properly can seriously compromise treatment and endanger patient health and lives. New self-learning materials for novice nurses are necessary to provide essential and effective guidance as a part of formal nursing training. Such materials can enhance the capabilities of critical care nurses and, thus, improve the general quality of critical care.
Objectives: The purpose of this research was to develop a continuous renal replacement therapy (CRRT)-themed self-learning manual that would provide easily absorbed and understood knowledge in an easy-to-carry format for ICU nursing staff. This study also investigated CCRT skill learning efficacy.
Methods: This study adopted a quasi-experimental design with pretests and posttests. Purposive sampling generated a sample of 66 critical care nurses currently working at one hospital in Taipei City. Participants submitted a completed self-assessment survey that rated their command of continuous renal replacement therapy before and after the self-learning manual intervention. Survey data were analyzed using SPSS Version 17.0 for Windows.
Findings: The two major findings derived from the study included: (1) The mean response score from the self-assessment survey filled out after the intervention was 91.06 and 79.75 (SD = 9.49 and 11.65), respectively, for experimental and control groups. Such demonstrated significant difference. (2) The mean posttest score after the intervention for the experimental group was 91.06 ± 9.49. This represents a significant increase of 10.35 ± 10.35 over their mean pretest score (80.71 ± 11.82). The experimental group showed other significant differences in terms of the CRRT self-assessment survey posttest.
Conclusions / Implications for Practice: Self-learning manuals may be introduced in nursing education as useful aids and catalysts to achieve more effective and satisfying learning experiences.