不同职级临床护理人员从事工作项目及其比重的调查

Investigation of the Contents and Their Proportions in the Work Undertaken by the Clinical Paramedics with Different Positions and Grades

目的调查不同护理项目及其比重在不同年资、学历、职称护理人员中的分布。方法采用文献检索和专家会议法自行设计临床护理人员工作项目及其比重情况调查表,随机抽取3所三级甲等综合性医院450名临床护理人员实施问卷调查。结果调查表的内部一致性信度Cronbach’sα系数为0.783,因子分析累计贡献率为60.91%;不同年资、学历、职称护理人员均从事所有护理项目,其中以大专学历、护士职称所占比例最高;中专及大专学历、护士职称均侧重执行治疗、等级护理和生活照护,本科学历、护师以上职称侧重危重病患者护理、健康教育、临床教学,不同学历、不同职称护理人员所从事的护理项目有统计学差异(P均<0.01);工作项目比重从大到小依次为等级护理、执行治疗、生活照护、健康教育、危重病患者护理、病区管理、临床教学、临床科研。结论护理人力资源不足和服务利用低效率现象并存,提示护理管理者应加大对临床护理研究工作的组织与管理,重视临床型科研人才的持续培养,推进护理科研水平的不断提高;并根据不同岗位的专业技术要求配备相应能力的护理人员,实现人力资源的优化管理。

Objective To investigate the distribution of the contents and their proportions in the work undertaken by the paramedics with different positions, education and professional titles. Methods By means of literature review and expert conference, we designed a questionnaire to investigate the items and their proportions in the work undertaken by the paramedics, and 450 nurses in 3 Grade A general hospitals were randomly investigated. Results The Cronbach＇s α factor of the questionnaire was 0. 783, with the total contribution rate of the factor analysis of 60. 905. The paramedics With different working experience, education and titles were engaged in all the nursing items, and the nurses with technical secondary school and junior college education accounted for the highest proportion. The nurses with technical secondary school and junior college education focused more on therapy administration, grading nursing and daily nursing, while those with a bachelor＇s degree or primary nurse focused more frequently in critical nursing, health education and clinical teaching. Significant differences were found in the items of working among the paramedics with different education and technical titles（ P 〈0.01）. The proportion of the items in the work were, in the order from the largest to the smallest, grading nursing, therapy administration, daily nursing, health education, critical nursing, ward management, clinical teaching and clinical research. Conclusion Lack of human resources in the nursing staff coexists with inefficient service utilization, suggesting the need of reinforcement of clinical nursing research and management to promote the development of nursing. Continued training of clinically oriented nursing staff with high research ability is crucial for improving the clinical nursing research and optimizing the management of the human resource.