E- Global Congress Hosted online from Dubai, U. A. E., E - Conference. Date: 30th March 2025 Website: https://eglobalcongress.com/index.php/egc ISSN (E): 2836-3612 10 | P a g e ORGANIZING PRACTICAL TRAINING FOR THE MANAGEMENT STRUCTURE OF HIGHER EDUCATION NURSES IN CLINICAL SETTINGS Mirdadaeva Dilfuza Tashkent Pediatrice Medical Institute, Uzbekistan Abstract A clinical practice guide will be developed using the analysis, design, development, implementation, and evaluation (ADDIE) model. The purpose of this study is to develop and evaluate the effectiveness of a clinical practice guide for nursing management using the ADDIE model for the TPMI BSN Nursing program. A posttest method with a nonequivalent control group will be used to evaluate the program in terms of teacher satisfaction and applicability in clinical settings. The result will contribute to enhancing the managerial role of senior nurses in inpatient settings. Along with the opinion of the head or senior nurses themselves on the need and / or possibility of expanding their work functions in the field of practical training of bachelor's and master's students of higher medical education, an important task is to identify the attitude of medical personnel to the very idea of changing nursing managers in the process of teaching practical skills and abilities of bachelors and masters in personnel management, improving health care services to the population. Keywords. Organization, practice, training, for the management structure of higher education nurses in clinical settings ОРГАНИЗАЦИЯ ПРАКТИЧЕСКОГО ОБУЧЕНИЯ ДЛЯ УПРАВЛЕНЧЕСКОЙ СТРУКТУРЫ МЕДИЦИНСКИХ СЕСТЕР ВЫСШЕГО ОБРАЗОВАНИЯ В КЛИНИЧЕСКИХ УСЛОВИЯХ Мирдадаева Дилфуза Давлатовна Ташкентский педиатрический медицинский институт, Узбекистан Аннотация Руководство по клинической практике будет разработано с использованием модели анализа, проектирования, разработки, внедрения и оценки (ADDIE). Целью данного исследования является разработка и https://eglobalcongress.com/index.php/egc E- Global Congress Hosted online from Dubai, U. A. E., E - Conference. Date: 30th March 2025 Website: https://eglobalcongress.com/index.php/egc ISSN (E): 2836-3612 11 | P a g e оценка эффективности клинического практического руководства по управлению сестринской деятельностью с использованием модели ADDIE для программы TPMI BSN сестринское дело. Для оценки программы будет использован посттестовый метод с неэквивалентной контрольной группой с точки зрения удовлетворенности преподавателей и применимости в клинических условиях. Результат будет способствовать повышению управленческой роли старших медицинских сестер в стационарных учреждениях. Наряду с мнением самих главных или старших медицинских сестер о необходимости и/или возможности расширения их трудовых функций в области практической подготовки бакалавров и магистров высшего медицинского образования важной задачей является выявление отношения медицинского персонала к самой идее смены сестринских руководителей в процессе обучения практическим навыкам и умениям бакалавров и магистров по управлению персоналом, совершенствованию медицинского обслуживания населения. Ключевые слова. Организация, практика, обучения, для управленческой структуры медицинских сестер высшего образования в клинических условиях Introduction With the development of medical science, the improvement of medical technologies, the role and importance of the nurse's activities in the health care system increases. The coherence of the work of medical institutions depends on her knowledge and professional training. A modern nurse should perfectly know the nursing process and actively participate in the promotion of nursing knowledge [1, 3, 4]. Since 1999, in our country, based on the experience of world medicine, a system of training nurses with higher education has been introduced. Departments of Higher Nursing were opened in all medical universities of the republic, which train bachelors in the areas of anesthesiology and resuscitation, obstetrics, surgery and management, and master's degree [2]. To date, more than three thousand nurses with higher education have been trained, most of whom work as chief, senior and leading nurses in medical and preventive institutions. In accordance with the qualification requirements, a "nursing manager" must possess management methods and be able to: https://eglobalcongress.com/index.php/egc E- Global Congress Hosted online from Dubai, U. A. E., E - Conference. Date: 30th March 2025 Website: https://eglobalcongress.com/index.php/egc ISSN (E): 2836-3612 12 | P a g e - use management functions of planning, organization, motivation, control and coordination in their administrative activities; - assess the level of professional training and qualifications of the institution's mid-level and junior medical personnel; - carry out current and long-term planning for advanced training of nurses; - carry out systematic work to improve the level of professional knowledge, skills and abilities of nursing personnel in accordance with the current level of development of nursing and medical technologies; - hold nursing conferences, seminars, practical classes; - develop mentoring, stimulate cognitive and professional motivation of students; - provide methodological guidance to nurses in teaching patients and families on issues of strengthening and maintaining health; - conduct certification of the institution's mid-level medical personnel; - implement social and psychological regulation in the work collective, promote the creation of a businesslike, creative environment; Currently, the issue of relevance of educational preparation of practical training of nurses with higher education [2], the need to develop their professional competencies in practical training in management issues [3], is discussed in a number of literary sources. A number of scientific articles illustrate the results of already implemented changes in the functions of nurses in clinics [4], describe the potential effect of the practical implementation of a new model of a nurse in the capital's healthcare [5] and Russian regions [6-7]. Much attention is also paid to the image of nurses with higher education (and nursing in general): both in Russian studies [8] devoted to the image of a nurse in the eyes of patients, and in foreign studies touching on the importance of developing a true, not distorted image of the nursing profession [9-10], as well as the satisfaction of nurses with working conditions in the current situation [11]. Today, there is an increasing need to improve the status of nurses and expand their functions. The need to strengthen the role of clinics of higher medical education institutions in the integration of advanced scientific developments and technologies in practical health care is noted; improving the training of medical personnel in narrow specialties, optimizing the duration of training in the master's degree and clinical residency based on the complexity of mastering clinical skills; revision of the system of postgraduate education, advanced training and retraining of health care https://eglobalcongress.com/index.php/egc E- Global Congress Hosted online from Dubai, U. A. E., E - Conference. Date: 30th March 2025 Website: https://eglobalcongress.com/index.php/egc ISSN (E): 2836-3612 13 | P a g e specialists, the introduction of problem-oriented modular curricula, widespread use of distance learning mechanisms. The purpose of nursing education is to enable students to acquire practical skills based on theoretical knowledge and experience to select the desired nursing process in various clinical situations [1]. Clinical practice is especially useful for nursing students to gain general knowledge of nursing through educational processes and methods that can be integrated, applied and used in clinical situations. At the present stage, the World Health Organization considers nursing personnel as a real potential for meeting the growing patient demand for affordable health care. Important for health care. [3,4]. Teams of nurses from health care institutions that accept student interns into nursing management practice programs - formally offering practical nursing activities - are important for professional training, since the support and recognition of these professionals can help students cope with the difficulties of gradually assuming the role of a nurse. In this logic, it is important to have people with the characteristics of the organizational profile, especially in a university hospital that integrates teaching, research and health care, striving to achieve quality in the provision of health care and in the process of learning and teaching. Starting from the 2023-2024 academic year, the 4-year institute will be transferred to the Faculty of Nursing with the bachelor's degree system of TPMI. However, the curriculum is not fully prepared for the level of the world standard BSN program, and the knowledge and skills of students are insufficient. In particular, although nursing management tasks are one of the priority roles of leading nurses in the hospital, their potential is not sufficiently prepared. Training of nurses with higher education is carried out in the subject "Nursing Management". Training in this subject is based on a systematic approach to the development and implementation of policies in the field of training highly qualified managers in accordance with the state educational standards of the Republic of Uzbekistan. The mission of the subject "Nursing Management" is to provide the healthcare system with in-demand, competitive, harmoniously developed specialists who are able to ensure the development and implementation of management decisions to improve the efficiency of medical organizations that meet the needs of society and the industry. The decisive role in organizing the work of nurses in any medical and preventive institution belongs to the head of the nursing service - the chief nurse. One of the main tasks in the management activities of chief nurses is to ensure high quality of nursing https://eglobalcongress.com/index.php/egc E- Global Congress Hosted online from Dubai, U. A. E., E - Conference. Date: 30th March 2025 Website: https://eglobalcongress.com/index.php/egc ISSN (E): 2836-3612 14 | P a g e care. The quality of nursing care can be considered as a set of characteristics and medical and economic indicators confirming the compliance of the care provided with the existing needs and expectations of the patient, the current level of technology and medical science. Recently, one of the key areas of reforming the state health care system has been the preparation of changes in the practical training of bachelors of nursing. The processes of ongoing transformation of the medical education system in the Republic of Uzbekistan require the search for new effective solutions to both old and emerging problems in the field of practical training on issues of governance in nursing and modernization of the provision of medical services to the population. One of the important tasks in this area is the improvement of labor relations in medical organizations, which implies the systematization of the best practical approaches, as well as scientific support in the form of typology of the most successful models of practical training and adaptation of managers of mid-level medical personnel to constantly changing working conditions. Thus, issues of expanding professional functions and, accordingly, the role and status of nurses have been repeatedly considered in scientific publications in recent years. The works of scientists are mainly devoted to the expectations and concerns of the medical community from the planned innovation [1]. The need for urgent adaptation to new conditions of activity in the extreme conditions of the pandemic only proved that the role of the nurse should be enhanced, including through scientific justification of the redistribution of functions between the nurse and the doctor. The main criteria for the quality of nursing care are: accessibility - the ability to receive the necessary medical care and care regardless of economic, social and other barriers; continuity and succession - the patient receiving the necessary medical care without delays and interruptions; safety - minimizing the risk of possible complications, side effects of treatment; effectiveness - the effectiveness of nursing interventions that improve the health of the patient. In order for all of the listed components to be implemented in practice, nursing service managers need to pay special attention to the level of professional training of nursing personnel, the correct performance of manipulations in appropriate conditions, as well as the style of communication with patients. To successfully complete these tasks, it is not enough for a manager to have knowledge in the area of his narrow professional competence. The most important criterion for the value of a nurse as a manager is; its managerial competence, leadership qualities, communication https://eglobalcongress.com/index.php/egc E- Global Congress Hosted online from Dubai, U. A. E., E - Conference. Date: 30th March 2025 Website: https://eglobalcongress.com/index.php/egc ISSN (E): 2836-3612 15 | P a g e skills, optimism, vision of the future and the desire to know tomorrow what you do not know today become its key. Currently, the priority task for healthcare is to improve the quality of medical care, this issue is especially acute in the primary health care sector. Reforming the nursing service in the Republic of Uzbekistan, first of all, aims to improve the quality of nursing care to the population. An unconditional reserve for improving the quality of medical services to the population is the correct organization of the work of mid-level medical specialists: rational placement of personnel, redistribution of functions between mid-level and junior medical personnel, work planning, reduction of non-production costs of working time, etc. The main role in solving these problems is assigned to the heads of nursing services. The main goal of the head nurse of a clinical hospital is: improving the quality of patient care through more efficient use of available resources, as well as by introducing standards of practical activities of a nurse in the treatment process, improving the professional level of nursing personnel to improve the quality of medical care provided. In her activities, the senior nurse is guided by the current legislation, orders and instructions of the Ministry of Health of the Republic of Uzbekistan, the relevant territorial and local health authorities, internal orders and regulations of the medical institution, as well as this Regulation. The appointment and dismissal of the senior nurse is carried out by the head of the department in accordance with the current legislation of the Republic of Uzbekistan. The main functions of the senior nurse are: Assistance in organizing and conducting all activities on medical and preventive activities of the institution, jointly with the head; Organization of accounting, storage and correct use of drugs, contraceptives and vaccines, ensuring timely applications for the purchase of drugs, contraceptives, vaccines, medical products; Keeping records of medical equipment and medical inventory and monitoring the correct use by medical personnel; Organization of the effective work of mid-level and junior medical personnel; Carrying out activities to improve the level of knowledge and skills of mid-level and junior medical personnel (training, briefing, individual work, interview); Control over the high-quality and timely completion of accounting documentation by medical personnel and the preparation of reporting documentation; Assistance to the head of the department in the preparation of medical and statistical reports; Participation in the implementation of events to prevent diseases, improve medical literacy and promote a healthy lifestyle; Performing the functions of a https://eglobalcongress.com/index.php/egc E- Global Congress Hosted online from Dubai, U. A. E., E - Conference. Date: 30th March 2025 Website: https://eglobalcongress.com/index.php/egc ISSN (E): 2836-3612 16 | P a g e paramedic or general practitioner nurse, if necessary, within the framework of their job responsibilities; Participation in the annual audit of the activities of mid- level medical personnel and, together with the head of the department, in the development of measures to improve the quality of medical care provided to the population. Rights of the senior nurse: to make proposals to the head of the department and the family doctor on issues of work organization, provision of necessary medicines, instruments, medical products, as well as on issues of improving medical and preventive care to the population within the limits of their competence; Take part in meetings on issues of medical and preventive and organizational work in the assigned area; Give the necessary orders and instructions to the mid-level and junior medical personnel to ensure the sustainability and continuity of the provision of medical services to the assigned population; Improve their qualifications in nursing, management and medical statistics, improve their professional knowledge and skills through continuous self-education, participation in short-term training courses and seminars organized by health authorities; Undergo certification every 5 years to confirm the qualification category of nurses for compliance with the position held. The senior nurse is responsible for: the results of their work, the quality of service to the assigned population, as well as for actions or inactions related to the performance of their functional duties that entail damage to the activities of the institution or the health of patients; the safety and effective use of entrusted medical equipment, the use of medications to provide pre-hospital emergency medical care to patients strictly according to prescriptions and standards, the provision of pre-hospital emergency care; the reliability and timeliness of the completed documentation. Conclusion Thus, performing independent work makes it possible to improve the level of practical skills of nurses with higher education in management activities and conducting scientific research in the nursing specialty. Reflecting in the work the relevance of the topic, research methods, analyzing the obtained results, conducting their discussion, drawing conclusions, students largely solve most of the provisions of the State Standard (disease prevention, personnel management, conducting the pedagogical process, analyzing the activities of institutions, observing patient rights, conducting nursing research. https://eglobalcongress.com/index.php/egc E- Global Congress Hosted online from Dubai, U. A. E., E - Conference. Date: 30th March 2025 Website: https://eglobalcongress.com/index.php/egc ISSN (E): 2836-3612 17 | P a g e Literature 1. Alimov A.V. Development of primary health care in Uzbekistan: Achievements and problems. - Tashkent, 2013. - P.17-59. 2. Asadov D.A., Aripov T.Yu. // Organization and management of health care. - 2012. - No. 5. - P.39-44. 3. Sadraddinova N.O. Quality of nursing care in outpatient institutions: Materials of the scientific and practical. conf. mid-level medical workers. "Development of nursing in the Republic of Dagestan". - Makhachkala, 2006. - P.130-135. 4. Resolution of the President of the Republic of Uzbekistan dated March 29, 2017 No. 2857 "On measures to improve the organization of activities of primary health care institutions of the Republic of Uzbekistan". 5. Resolution of the Cabinet of Ministers of 13.09.2017 No. 718 "Regulations on the procedure for conducting a rating assessment of the effectiveness of the activities of central district (city) multidisciplinary polyclinics, city and rural family polyclinics, rural medical centers, as well as medical and nursing personnel." 6. Kamynina N.N., Nenakhova Yu.S., Yarasheva A.V., Aleksandrova O.A., Alikperova N.V. Expansion of the functions of nurses: expectations and concerns. Nurse. 2020; 22 (8): 3-7. https://doi.org/10.29296/ 25879979-2020- 08-01. Kamynina NN, NenakhovaYS, Yarasheva 7.AV, Aleksandrova OA, Alikperova NV. [Expanding Nursing Functions: Expectations and Fears]. Meditsinskaya sestra. 2020; 22 (8): 3—7. https://doi.org/ 10.29296/25879979-2020-08-01. Russian. 8. Aleksandrova OA, Yarasheva AV, Nenakhova YS. [Professional training of nurses for medical organizations in the capital: problems and solutions]. Problems of Social Hygiene, Public Health and History of Medicine. 2020; 28 (S): 680—686. https://doi.org/10.32687/0869-866X-2020-28-s1-680-686. 9. Stasyuk N.K., Chernova G.S., Anosova I.R., Boryabina I.E., Aksenova E.V. [On the way to nurse a universal]. Nurse. 2018; 8: 11–15. Available at: https://www.elibrary.ru/item.asp?id=36315146. Link active on: 15.05.2021. Stasyuk NK, Chernova GS, Anosova IR, Boryabina IE, Aksenova EV. [On the way to nurse a universal]. Nurse. 2018; 8: 11–15. Accessed 15.05.2021. https://www.elibrary.ru/item.asp?id=36315146. Russian. 10. Aleksandrova O. A., Nenakhova Yu. S., Makhrova O. N. Adaptation of doctors to the expanding role of nurses in the provision of medical care. https://eglobalcongress.com/index.php/egc E- Global Congress Hosted online from Dubai, U. A. E., E - Conference. Date: 30th March 2025 Website: https://eglobalcongress.com/index.php/egc ISSN (E): 2836-3612 18 | P a g e Problems of standardization in health care. 2021; 9-10: 62-69. doi: 10.26347/1607-2502202109- 10062-069public health and health care 11. Mirzabaeva S. A.// The role of head and senior nurses in the work of family clinics// Mirzabaeva S. A., Zhanibekov Zh. Zh., Dadabaeva N. A. Medicine "Young Scientist". No. 9 (68) pp. 60-68. 2014. https://eglobalcongress.com/index.php/egc