Abstract:

Objective To construct,implement and evaluate the effectiveness of the refined nursing training programme for ultra-low birth weight infants. Methods A refined care training programme for ultra-low birth weight infants was constructed,including individualized development support,airway cluster care,nutritional feeding,establishment and management of vascular access,family participatory care,and selection and training of nursing staff in the neonatal intensive care unit. In March 2019,we implemented the training of refined care training programme for ultra-low birth weight infants,and applied the Korotkoff evaluation model to assess the training effects. Results After the training,97.0% of the nursing students were satisfied with the refined care content;94.1% of the nursing students were satisfied with the teaching methods; 91.2% of the nursing students were satisfied with the teaching environment;100% of the nursing students thought that their nursing attitudes had been changed after the training,and they believed that they had enhanced the nursing confidence of ultra-low birth weight infants. The theoretical assessment score of nursing students before the training was（59.7±13.6） points,and it was（88.4±6.2） points after the training with statistically significant differences（t=-14.763,P<0.001）. There were statistically significant differences in the development support such as smell,hearing and touch,pain control,arteriovenous catheterization,visual puncture,maintenance of peripheral central venous catheterization and manual reduction,in-situ tube replacement,umbilical arteriovenous maintenance,parental support model and kangaroo-style nursing technique before and after the training（P<0.05）. Conclusion The refined care training programme for ultra-low birth weight infants can effectively improve the nursing ability of nursing staff for ultra-low birth weight infants.

Key words: Refined Care, Ultra Low Birth Weight Infant, Neonatal Intensive Care Unit, Neonatal Nursing

摘要：

目的 构建、实施并评价超低出生体重儿精细化照护培训方案的有效性。方法 构建超低出生体重儿精细化照护培训方案,包括课前预习、个体化发育支持护理评估程序、气道集束化照护技术、营养喂养技术、血管通路的建立和管理技术、家庭参与式照护技术。2019年3月对新生儿重症监护病房护士按超低出生体重儿精细化照护培训方案进行培训,应用柯氏评价模式评估培训效果。结果 培训后97.0%的护士对精细化照护内容满意,94.1%的护士对教学形式满意,91.2%的护士对教学环境满意;100%的护士认为培训后改变了护理态度,增加了为超低出生体重儿提供更好护理的信心;培训前护士理论考核成绩为（59.7±13.6）分,培训后为（88.4±6.2）分,差异具有统计学意义（t=-14.763,P<0.001）;培训前后嗅觉、听觉、触觉等多感官的发育支持,疼痛管理,动脉、静脉置管规范,可视化穿刺,经外周中心静脉置管和维护、手法复位、原位换管,脐动脉、静脉维护,父母支持模式、袋鼠式护理得分差异具有统计学意义（均P<0.05）。结论 构建的超低出生体重儿精细化照护培训方案可有效提高护理人员对超低出生体重儿的护理能力。

关键词: 精细化照护, 超低出生体重儿, 新生儿重症监护病房, 新生儿护理