团体沙盘游戏对护士长管理模式的影响体会

Influence experience of group sandtray play on head nurse management mode

目的 探析护理工作中应用团体沙盘游戏对护士长管理模式的影响.方法 选择2011年4月～2012年1月杭州市余杭区第五人民医院临床一线在职护士及护士长89名为研究对象,并按科室分为10个小组,每组8～10名,每个科室进行为期3个月的团体沙盘游戏,2次/月,每组共计6次.应用中文版M氏职业倦怠量表测评护士职业倦怠情况,并和实施团体沙盘游戏前进行对比,分析护士长经过团体沙盘游戏后,在护理管理模式上发生的变化,调查护理满意度、不良事件发生情况.结果 团体沙盘游戏干预后护士MBI各项评分如情绪衰竭、去人格化、个人成就感评分[（14.23±7.92）、（3.46±3.32）、（33.56±9.32）]明显优于干预前[（26.76±6.35）、（7.78±4.29）、（23.97±9.25）分],差异均有高度统计学意义（t=10.971、7.078、6.491,均P＜0.01）;以干预前为基线,护士对护士长满意度提高,从原来的90分提高到了95分;护理不良事件发生率降低40％,护士给药错误发生率降低50％,差异有统计学意义（P＜0.05）.结论 护士长在日常护理管理过程中合理应用团体沙盘游戏,能有效地促进发挥护士个体主观能动性、同事协作精神、换位思考、给予成员情感关注与支持、增强自我沟通能力、护理人力分层管理等方面有了很大变化,使护理团队凝聚力、护理质量、护士对护士长满意度提高,全年护理不良事件及差错发生率减少.

Objective To explore and analyze the influence of group sandplay applied in the head nurse management mode.Methods 89 on-duty nurses and head nurses of clinical of the front line in Fifth People＇s Hospital of Yuhang District in Hangzhou City from April 2011 to January 2012 were selected as study objects.They were divided into 10 groups according to departments set in the hospital,with 8-10 nurses in each group,the group sandplay with three months of duration was conducted in each department and 2 times per month,therc were a total of 6 times of group sandplay in each group,Chinese version of M＇s job burnout scale was applied to assess the job burnout of nurses,and it was compared to that before the implementation of the group standplay,the changes of the management mode of head nurses after the implementation of the group sandplay were analyzed,and the nursing satisfaction and the occurrence of adverse events were investigated.Results Scores of nurses＇ MBI after the group sandplay intervention,such as emotional exhaustion,de-personalization and personal accomplishment [（14.23±7.92）,（3.46±3.32）,（33.56±9.32） scores] were obviously better than those before the group sandplay intervention [（26.76±6.35）,（7.78±4.29）,（23.97±9.25） scores],the differences were high statistically significant （t =10.971,7.078,6.491,all P ＜ 0.01）.The status before the group sandplay intervention served as the baseline,the satisfaction of the nurse on the head nurse,and increasing was improved from original 90 scores to 95 scores; the incidence of nursing adverse events reduced by 40％,and the error rate of nurse dosing reduced by 50％,the difference was statistically significant （P ＜ 0.05）.Conclusion The reasonable application of the group sandplay made by the head nurse in the process of routine nursing management can effectively promote individual subjective initiative of nurses,team spirit of colleagues and perspective-taking,give members with emotional concern and support,and strengthen their ability to communicate,making the nursing human layered management change significantly,has the nursing team filled of cohesion,and nursing quality and nurses to improve the head nurse＇s satisfaction,the annual incidence of nursing adverse events and errors has reduced.