目的 探讨“医联体”模式下脑卒中专科护士的在职培训路径及培训效果。方法 以宜昌市第一人民医院卒中中心32名专科护士为研究对象,运用网络授课及临床实践相结合的方式,实施脑卒中专科护士培训,在培训前后对专科护士进行理论考试和实践考核以评估他们的专科护理水平。结果 受训护士的理论考试合格比例由培训前的37.5%(12/32)提高到100.0%(32/32)(χ²＝29.09,P<0.05),患者就诊至静脉溶栓时间(door-to-needle times,DNT)合格比例由培训前的50.0%(6/12)提高到86.2%(25/29)(χ²＝4.23,P<0.05)。结论 在职培训提高了脑卒中护士的专科护理知识水平,提高了“医联体”单位患者静脉溶栓DNT合格比例,使更多的脑卒中患者从早期血管再通治疗中获益。

Objective To explore the implementation of on-the-job training pathway for stroke specialist nurses under the medical alliance model and to evaluate the effectiveness of training. Methods The subjects of the study were 32 professional nurses in primary stroke center of the first People's Hospital of Yichang. We used the combination of network teaching and clinical practice to train management group of specialist nurses. Before and after the training, evaluated the professional capacity level of specialist nurses by theory examination and practicing examination. Results The qualification rate of stroke nurses' professional knowledge was increased from 37.5% (12/32) up to 100.0% (32/32), (χ²＝29.09, P<0.01), the qualified rate of the door-to-needle times raised to 86.2%(χ²＝4.23, P<0.05). Conclusions Implementing the on-the-job training path extends the professional knowledge of stroke nurses. Improving the qualification rate of DNT of the patient in medical alliance units, so more stroke victims benefit from early vascular re-canalization .