护理质量管理体系问题诊断与改进框架探索

Exploration of problem diagnosis and improvement framework of nursing quality management system

目的将全面质量管理体系ISO9001标准与医院管理评价标准相结合，探索临床护理质量管理中问题的诊断与改进方法，建立科学、实用、适用于临床护理质量管理体系诊断与改进框架，为护理管理部门做出科学的改进决策提供依据。方法对ISO9001标准与北京地区医院管理考核评价标准（护理部分）进行比较分析，采用特尔斐法对标准进行筛选和论证，将ISO9001标准和护理考核评价标准集合成框架，应用于临床护理质量管理与改进过程。结果建立了护理质量管理体系诊断与改进框架，分析、诊断出护理质量管理中存在的主要问题及改进目标。结论应用护理质量管理体系诊断与改进框架，能够科学判断护理质量管理改进重点，促进护理质量管理与医院管理发展方向保持一致。

Objective To combine the overall quality management system （ISO9001 standard） and standard of evaluation of hospital management, to explore the method of problem diagnosis and improvement of clinical nursing quality management, establish a scientific, practical, suitable for its diagnosis and improvement framework and provide the evidence for scientific strategic decision for nursing administration. Methods The standard of ISO9001 and Beijing hospital management evaluation standard （care） were compared and analyzed using Delphi method. The standard of ISO9001 standard and evaluation standards of nursing were integrated into framework, which were applied into clinical nursing quality management and process of improvement. Results Problem diagnosis and improvement framework were established, the main problems and improvement objectives were analyzed and diagnosed. Conclusions Application of nursing diagnosis and improvement framework of nursing quality management system is helpful to determine the key points of improvement of nursing quality management and promote the consistency between nursing quality management and the development of hospital management direction.