床边护嘱在“优质护理示范岗”创建中的应用

Application of bedside nursing order in establishment of excellent nursing model post

目的探讨“优质护理示范岗”创建中实施床边护嘱的应用效果。方法采取分组负责制，设立责任组长，由责任组长下达护嘱，公示于患者床头，责任护士及助理护士按照护嘱要求执行落实，比较实施前（2009年11月至2010年9月）及实施后（2010年10月至2011年8月）护理措施与病情符合率、健康教育知晓人数、护理缺陷及患者满意度，并对护士的专科知识的应用能力进行考核。结果与实施前比较，实施床边护嘱后护理措施与病情的符合率、健康教育知晓人数（1501比1390，1511比1131）均较实施前明显改善，实施前后比较，差异有统计学意义（x2分别为21．849，133．150；P〈0．01）；实施床边护嘱后患者满意度由实施前的87．9％提高到实施后的93．3％，实施前后比较，差异有统计学意义（X2=25．036，P〈0．01）；执行护嘱制度前年轻护士掌握运用专科知识的能力考核成绩分别为：优秀34名，合格51名，不合格2名；实施护嘱制度后，能力考核成绩分别为优秀66名，合格28名，不合格1名，实施前后比较，差异有统计学意义（X2=16．951，P〈0．01）。结论建立床边护嘱制度令护理人力资源的使用更科学合理，并有利于护理服务和护理质量的提高。

Objective To explore the feasibility of implementing bedside nursing order in establishing excellent nursing model post. Methods Organization practices project taking charge by group, nursing order were assigned by responsible team leader. All orders was publicity at patients＇ bedside and were performed by responsible nurses and assistant nurses. The coincidence case in state of illness and nursing mesures, awareness in health education, nursing quality defective and patients＇ s satisfaction before and after implement were compared and the application ability in specialized knowledge were evaluated. Results The coincidence rate in state of illness and nursing mesures （1 501 vs 1 390）, awareness in health education （1 511 vs 1 131 ） after implementation of nursing order was significantly higher than before implementation, there was statistics difference （X2 = 21. 849,133. 150,respectively;P 〈 0.01 ）. The patients＇ s satisfaction showed a significant rise from 87.9% to 93. 3% after implementation of bedside nursing order（ X2 = 25. 036, P 〈 0. 01 ）. Before implementation in nursing bedside order, the score of application ability in specialized knowledge among nurse were excellence （12）, qualified nurses （51） and unqualified nurses （2） while the number was improved in excellence （66）, qualified nurses （ 28 ） and unqualified nurses （ 1 ） respectively after implementation. There was statistics difference between before and after implementation （ X2 = 16. 951, P 〈 0.01 ）. Conclusion The implementation of bedside nursing order optimizes the utilization of the nursing human resource and contributes to the improvement of the quality of nursing service.