Establishment of a clinical decision-making ability indicator system for pediatric nursing interns based on evidence-based practice

Chang Jie; Xiang Qiong; Zhou Xiaoyu; Zhang Min; Wei Juan; Guo Feng; Pan Rui

doi:10.3760/cma.j.cn116021-20250102-02116

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Establishment of a clinical decision-making ability indicator system for pediatric nursing interns based on evidence-based practice

Nursing Education Study | 更新时间：2025-10-29

- Establishment of a clinical decision-making ability indicator system for pediatric nursing interns based on evidence-based practice
- Chinese Journal of Medical Education Research Vol. 24, Issue 10, Pages: 1393-1399(2025)
- 作者机构：
  
  1.空军军医大学第一附属医院/西京医院儿科，西安 710032
  2.空军军医大学第一附属医院/西京医院骨科，西安 710032
- 作者简介：
  
  Xiang Qiong, Email: Xiangqiong963852@163.com
- 基金信息：
  
  Health Scientific Research Project of the Shaanxi Provincial Health Commission(2022JQ-04)
- DOI：10.3760/cma.j.cn116021-20250102-02116
  CLC： R-05
- Received：02 January 2025，
  
  Published：20 October 2025
- 稿件说明：
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常杰, 相琼, 周晓瑜, 等. 基于循证实践的儿科护理实习生临床决策能力指标体系的建立[J]. 中华医学教育探索杂志, 2025, 24(10): 1393-1399.

Chang Jie, Xiang Qiong, Zhou Xiaoyu, et al. Establishment of a clinical decision-making ability indicator system for pediatric nursing interns based on evidence-based practice[J]. Chinese journal of medical education research, 2025, 24(10): 1393-1399.
常杰, 相琼, 周晓瑜, 等. 基于循证实践的儿科护理实习生临床决策能力指标体系的建立[J]. 中华医学教育探索杂志, 2025, 24(10): 1393-1399. DOI： 10.3760/cma.j.cn116021-20250102-02116.

Chang Jie, Xiang Qiong, Zhou Xiaoyu, et al. Establishment of a clinical decision-making ability indicator system for pediatric nursing interns based on evidence-based practice[J]. Chinese journal of medical education research, 2025, 24(10): 1393-1399. DOI： 10.3760/cma.j.cn116021-20250102-02116.

摘要

目的

构建基于循证实践的儿科护理实习生临床决策能力指标体系，为临床教学与评价提供科学依据。

方法

采用文献分析、德尔菲专家咨询及实证研究相结合的方法。首先，系统检索中英文数据库（2018—2023年），依据PICO框架筛选文献，提取循证证据，初步形成包含4个一级指标、12个二级指标、39个三级指标的体系。随后，通过两轮德尔菲专家咨询（25名专家，工作年限19~27年）修订指标，专家权威系数（Cr）为0.898~0.907，肯德尔协调系数为0.351~0.420（

0.001）。最终采用层次分析法确定权重，并通过问卷调查验证信效度（样本量：预调查30人，正式调查58人）。

结果

构建的指标体系包含4个一级指标（权重）、13个二级指标和42个三级指标。一级指标权重分别为：知识整合能力（0.300）、循证实践能力（0.250）、临床判断能力（0.280）、伦理决策能力（0.170）。条目重要性评分均

4.0分（满分5分），变异系数

0.20。信效度检验显示，总量表Cronbach’s

系数为0.89，重测信度ICC=0.88；探索性因子分析累计方差解释率69.30%，验证性因子分析模型拟合良好（CFI=0.93，RMSEA=0.05）。

结论

该指标体系具有良好的科学性和实用性，可为儿科护理实习生临床决策能力的规范化培养与评价提供参考。未来需加强高级循证技能培训及长期应用效果追踪。

Abstract

Objective

To construct a clinical decision-making ability indicator system based on evidence-based practice for pediatric nursing interns

and to provide a scientific basis for clinical teaching and evaluation.

Methods

A method combining literature analysis

Delphi expert consultation

and empirical research was used. Firstly

a systematic search of Chinese and English databases (2018-2023) was conducted. Literature was screened based on the PICO framework and evidence-based data were extracted

resulting in a preliminary system consisting of 4 primary indicators

12 secondary indicators

and 39 tertiary indicators. Subsequently

the indicators were revised through two rounds of Delphi expert consultation (25 experts with 19-27 years of work experience). The expert authority coefficients (Cr) were 0.898-0.907 and the Kendall's concordance coefficients were 0.351-0.420 (

0.001). Finally

the analytic hierarchy process was used to determine the weights

and the reliability and validity were verified through a questionnaire survey (sample size: 30 participants in preliminary survey and 58 participants in formal survey).

Results

The constructed indicator system included 4 primary indicators (weights)

13 secondary indicators

and 42 tertiary indicators. The weights of the primary indicators were as follows: knowledge integration ability (0.300)

evidence-based practice ability (0.250)

clinical judgment ability (0.280)

and ethical decision-making ability (0.170). The importance scores of all items exceeded 4.0 points (out of 5 points)

and the coefficients of variation were less than 0.20. The reliability and validity tests showed that the Cronbach's

of the overall scale was 0.89

and the intraclass correlation coefficient was 0.88. The cumulative variance contribution rate of exploratory factor analysis was 69.30%. The confirmatory factor analysis demonstrated a good model fit with a comparative fit index of 0.93 and a root mean square error of approximation of 0.

05.

Conclusions

This indicator system has high scientificity and practicality

and can provide a reference for the standardized cultivation and evaluation of clinical decision-making ability of pediatric nursing interns. In the future

it is necessary to strengthen advanced evidence-based skills training and long-term application effectiveness tracking.

关键词

Keywords

references

Nørskov AK , Jakobsen JC , Afshari A , et al . Collaboration for evidence-based practice and research in anaesthesia (CEPRA): a consortium initiative for perioperative research [J ] . Acta Anaesthesiol Scand , 2023 , 67 ( 6 ): 804 - 810 . DOI: 10.1111/aas.14235 http://dx.doi.org/10.1111/aas.14235 .

Berrios-Siervo GM , Salinas CM , Bender HA , et al . Culturally informed neuropsychological evaluations in pediatric epilepsy: evidence-based practice considerations [J ] . Arch Clin Neuropsychol , 2023 , 38 ( 3 ): 395 - 407 . DOI: 10.1093/arclin/acac092 http://dx.doi.org/10.1093/arclin/acac092 .

黄宇星，刘宁，黄婷 . 基于核心能力构建适宜中低资源地区护理本科循证实践教学指标体系 [J ] . 护理学报， 2023 ， 30 （ 13 ）： 24 - 28 . DOI: 10.16460/j.issn1008-9969.2023.13.024 http://dx.doi.org/10.16460/j.issn1008-9969.2023.13.024 .

保晶，王莎莎，李月，等 . 基于指南构建的重症患者身体约束循证实践护理方案的应用及评价 [J ] . 中华现代护理杂志， 2023 ， 29 （ 22 ）： 2969 - 2973 . DOI: 10.3760/cma.j.cn115682-20230206-00375 http://dx.doi.org/10.3760/cma.j.cn115682-20230206-00375 .

李如琴，周进芳，路璐 . 医务人员伦理敏感性问题及对策研究: 以儿科医务人员为例 [J ] . 中国医学伦理学， 2022 ， 35 （ 6 ）： 649 - 653 .

罗维，罗佳，黄玉群，等 . 情景模拟联合清单式教学在烧伤科护理实习生临床决策能力培训中的应用效果 [J ] . 中华烧伤与创面修复杂志， 2024 ， 40 （ 9 ）： 876 - 884 . DOI: 10.3760/cma.j.cn501225-20240425-00152 http://dx.doi.org/10.3760/cma.j.cn501225-20240425-00152 .

Dannemiller L , Mueller M , Leitner A , et al . Physical therapy management of children with developmental coordination disorder: an evidence-based clinical practice guideline from the academy of pediatric physical therapy of the American physical therapy association [J ] . Pediatr Phys Ther , 2020 , 32 ( 4 ): 278 - 313 . DOI: 10.1097/PEP.0000000000000753 http://dx.doi.org/10.1097/PEP.0000000000000753 .

de Graeff N , Groot N , Brogan P , et al . European consensus-based recommendations for the diagnosis and treatment of rare paediatric vasculitides-the SHARE initiative [J ] . Rheumatology (Oxford) , 2020 , 59 ( 4 ): 919 . DOI: 10.1093/rheumatology/keaa057 http://dx.doi.org/10.1093/rheumatology/keaa057 .

Young LK , Mansfield B , Mandoza J . Nursing care of adult hematopoietic stem cell transplant patients and families in the intensive care unit: an evidence-based review [J ] . Crit Care Nurs Clin North Am , 2017 , 29 ( 3 ): 341 - 352 . DOI: 10.1016/j.cnc.2017.04.009 http://dx.doi.org/10.1016/j.cnc.2017.04.009 .

何兴月，杨辉，曹慧丽 . 脑卒中患者家庭护理循证实践方案的构建 [J ] . 护理学杂志， 2021 ， 36 （ 20 ）： 5 - 9， 14 . DOI: 10.3870/j.issn.1001-4152.2021.20.005 http://dx.doi.org/10.3870/j.issn.1001-4152.2021.20.005 .

Lempinen H , Pölkki T , Kyngäs H , et al . Feasibility and clinical utility of the Finnish version of the FLACC pain scale in PICU [J ] . J Pediatr Nurs , 2020 , 55 : 211 - 216 . DOI: 10.1016/j.pedn.2020.07.011 http://dx.doi.org/10.1016/j.pedn.2020.07.011 .

熊紫薇，史雯嘉，蔡晓菡，等 . 降低婴幼儿外周静脉血标本不合格率的循证实践 [J ] . 护理学杂志， 2025 ， 40 （ 7 ）： 44 - 49， 85 .

张云萍，马琼，丁晓霜，等 . 基于教学系统化设计模型的儿科护理虚实融合混合式实践教学改革 [J ] . 护理研究， 2025 ， 39 （ 5 ）： 738 - 744 . DOI: 10.12102/j.issn.1009-6493.2025.05.005 http://dx.doi.org/10.12102/j.issn.1009-6493.2025.05.005 .

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