Evaluation of the implementation effect of breastfeeding specialist nurse qualification certification in Guangdong Province based on advanced health assessment model
基于高级健康评估模型的广东省母乳喂养专科护士资格认证实施效果评估

摘要

目的 基于高级健康评估模型进行案例评审和考核，构建广东省母乳喂养专科护士资格认证体系，并评估其实施效果。方法 母乳喂养专科护士接受五个维度专科护士个案培训，在临床实践中采用此模式进行个案评估、开展个性化护理、完成个案收集和撰写，提交认证委员会进行审核，通过点评、修改、再审核确保个案质量，最后进行个案答辩。结果 该认证体系要求护士完成 90 例个案咨询、2 份典型个案报告、反思日记及个案答辩，最终 52 名护士的总成绩为 53.10～89.40 分。认证体系难度系数 0.698～0.903（偏易），区分度 0.060～0.297（部分环节区分度不足），但护士整体满意度达 98.0%。结论 高级健康评估模式可以让护士进行全方面的个案评估，提高临床思维能力、自主能力，可以用于专科护士的评价。后续继续加强培训，针对母乳喂养个案的高级健康评估的培训和应用。该体系实用高效，有助于提升护士的专业素养和实践能力，但其信度和区分度有待优化，需进一步完善。

Abstract

Objective To establish a breastfeeding specialist nurse certification system in Guangdong Province based on the advanced health assessment model through case review and evaluation, and to assess its implementation outcomes.
Methods Breastfeeding specialist nurses underwent case-based training in five dimensions. In clinical practice, they applied this model for case evaluation, provided personalized care, collected and documented cases, and submitted them to the certification committee for review. The review process involved feedback, revision, and reassessment to ensure case quality, culminating in a case defense.
Results Through this certification system, nurses' overall scores ranged from 53.10 to 89.40. The difficulty index of the system was 0.698–0.903, with a discrimination index of 0.060–0.297. Participants reported high satisfaction.
Conclusion   The advanced health assessment model enables comprehensive case evaluation, enhances clinical reasoning and autonomy, and serves as an effective assessment tool for specialist nurses. Further training should be enhanced to focus on the advanced health assessment of breastfeeding cases and its practical application. This system is practical and efficient, contributing to the improvement of nurses' professional competence and clinical skills.