聘请院外护理专家实施以问题为本的示范查房及效果评价

The practice and effects of problem-based ward round by extramural nursing experts

目的探讨院外护理专家以问题为本(Problem Based Managing,PBM)现场查房的实践模式及其在临床护理管理实践中的积极作用,加强临床护理管理质量的持续改进。方法采用客观、开放的态度,聘请院外护理专家来院进行PBM现场查房,建立类似企业电信系统"零缺陷"管理的护理质量"旁路控制"科学评价机制,客观真实地反映医院临床护理工作中存在的问题和隐患,并运用根因分析查找系统原因,进行及时改良,数月或1年后请专家再来医院"回头看",对问题的整改情况进行持续评价。结果通过聘请院外护理专家来院进行以问题为本的现场示范查房,能帮助各科室护理管理者更好地及早发现问题、排查隐患,学习问题解决的方法和经验,从而培养年轻管理者发现问题、解决问题、对问题进行分级归类的能力,使以问题为本的管理理念落到实处。结论聘请院外专家来院进行以问题为本的现场示范查房,能够提高护理管理者发现问题、解决问题、防范问题发生的能力,在一定程度上保证了临床护理质量的可持续改进。

Objective To explore the effects of problem-based ward round by extramural nursing experts in nursing management,and enhance the continuous quality improvement of nursing management. Methods The extramural nursing experts were invited to provide problem-based ward rounds and establish a bypass supervising system to identify the problems and risk factors in clinical nursing objectively. Based on the principle of Root Cause Analysis ,the root causes were analyzed and modified in time. Then,the extramural nursing experts were invited to reevaluate the problems and its coping strategies several months or one year later. Results This practice could help the nursing managers to detect problems and risk factors earlier, learn how to solve problems,and thereby to enable the young nursing managers to identify,sort and solve these problems. Conclusion Inviting extramural experts to provide problem-based ward rounds can enhance the nursing managers＇ abilities to identify,solve and prevent problems, and thereby to ensure the continuous improvement of clinical nursing quality.