Construction and application of training program for in-hospital stroke recognition and treatment process among non-neurological nurses in tertiary hospitals
三级医院非神经科护士院内卒中识别和救治流程培训方案的构建及应用

摘要

目的 构建三级医院非神经科护士院内卒中识别和救治流程培训方案，并探究其应用效果，以提升非神经科护士对卒中的识别能力和规范救治流程的执行能力，缩短卒中患者的救治时间，改善患者预后。方法 选取2024年10月-2025年6月赣州市人民医院200名非神经科护士作为研究对象，采用随机数字表法分为对照组和观察组，分批次进行。对照组采用常规培训模式，包括参加医院组织的卒中相关知识讲座、阅读卒中救治手册等。观察组采用构建的系统化培训方案，具体如下：培训内容涵盖卒中的流行病学特点、临床表现、快速识别方法（如FAST原则）、院内救治流程（包括呼救、转运、交接等环节）、模拟演练等；培训方式采用线上理论学习（20学时）结合线下实操培训（15学时），其中线下培训包含案例分析、情景模拟、技能操作考核等；培训周期为4周，每2周进行1次，培训结束后进行理论和实操考核。结果 观察组护士的卒中识别准确率为92.00%（92/100），显著高于对照组的75.00%（75/100），差异有统计学意义（χ²=9.091，P=0.003）；观察组救治流程规范率为88.00%（88/100），明显高于对照组的68.00%（68/100），差异具有统计学意义（χ²=8.538，P=0.004）；观察组所护理的卒中患者DNT为（38.5±5.2）min，显著短于对照组的（56.3±6.8）min，差异有统计学意义（t=19.231，P=0.000）。结论 构建的三级医院非神经科护士院内卒中识别和救治流程培训方案应用效果显著，能有效提高非神经科护士的卒中识别准确率和救治流程规范率，缩短卒中患者的DNT，值得在临床推广应用。

Abstract

Objective To construct a training program for stroke identification and treatment procedures among non-neurological nurses in tertiary hospitals, and to explore its application effect, so as to improve the ability of non-neurological nurses in stroke identification and standardized implementation of treatment procedures, shorten the treatment time for stroke patients, and improve patient prognosis.
Methods A total of 200 non-neurological nurses from Ganzhou People's Hospital from October 2024 to June 2025 were selected as research subjects and randomly divided into a control group and an observation group using a random number table method, with training conducted in batches. The control group adopted a conventional training mode, including attending hospital-organized lectures on stroke-related knowledge and reading stroke treatment manuals. The observation group adopted the constructed systematic training program, which specifically included: training content covering epidemiological characteristics of stroke, clinical manifestations, rapid identification methods (such as the FAST principle), in-hospital treatment procedures (including calling for help, transportation, handover, etc.), and simulation drills; the training method combined online theoretical learning (20 class hours) with offline practical training (15 class hours), where offline training included case analysis, scenario simulation, and skill operation assessment; the training cycle was 4 weeks, with training conducted once every 2 weeks, and theoretical and practical assessments were carried out after the training.
Results The accuracy rate of stroke identification among nurses in the observation group was 92.00% (92/100), which was significantly higher than that in the control group (75.00%, 75/100), with a statistically significant difference (χ²=9.091, P=0.003); the standardization rate of treatment procedures in the observation group was 88.00% (88/100), which was significantly higher than that in the control group (68.00%, 68/100), with a statistically significant difference (χ²=8.538, P=0.004); the door-to-needle time (DNT) of stroke patients cared for by the observation group was (38.5±5.2) minutes, which was significantly shorter than that of the control group [(56.3±6.8) minutes], with a statistically significant difference (t=19.231, P=0.000).
Conclusion   The constructed training program for in-hospital stroke identification and treatment procedures among non-neurological nurses in tertiary hospitals has a significant application effect. It can effectively improve the accuracy rate of stroke identification and the standardization rate of treatment procedures among non-neurological nurses, and shorten the DNT of stroke patients, which is worthy of clinical promotion and application.