运用工作分析法重新界定手术室护理岗位

Restructure Nursing Posts in Operating Room by Job Analysis Methods

目的在国内手术室护理管理模式的基础上,通过工作岗位分析,结合优质护理服务及责任制整体护理等理念,重新界定我国的手术室护理岗位,为岗位管理打下基础。方法以资料分析、工作日志及调查问卷法等工作分析法,多维度地对上海某三级甲等综合性医院手术室护理岗位有关工作内容、工作程序和工作的职责和权限、工作时间消耗的分布状况以及工作关系等信息进行分析,并在此基础上,导入优质护理服务及责任制整体护理等理念,重新界定手术室的护理岗位。结果手术室护理岗位共分为两大类7种岗位,外科患者在围术期共经历3个时期、5个阶段中,135项护理服务项目,并且在手术室内经历6次不同护理人员的病情交接。重新界定的手术室护理岗位,由原先两大系列7种岗位减少至5个手术室护理岗位和4个专科护理角色,包括手术巡回护士、手术室责任护师、手术专科护师(手术器械护士)、麻醉专科护师(麻醉诱导护理岗位、复苏室护理岗位)。结论手术室护理岗位的重新界定符合当代护理服务理念,其工作内容的调整不仅有利于手术室多元化专科的发展,而且有利于职业的国际化和护士的职业发展。

Objective To conduct a job analysis based on the current operating room nursing management mode in China and to restructure the operating room nursing posts by combining the concepts of high-quality nursing care and accountability-based holistic nursing services, in order to lay the foundation for position management. Methods We adopted job-analysis approaches, including data analysis, work-log record analysis and survey questionnaires,to conduct a multi-dimensional analysis of the operating room nursing post works （including activity contents,work procedures, work responsibilities and authorities, the distribution of work time consumption, the working relationship and so on） in a magnet hospital in Shanghai. Based on these analyses, we introduced the concepts of high-quality nursing care and accountability-based holistic nursing services to restructure the operating room nursing posts in China. Results The job analysis revealed that the operating room nursing posts could be divided into 2 categories containing 7 posts. During the perioperative period,the surgical patients experienced 3 periods,which could be divided into 5 stages consisting of 135 nursing service items. Furthermore,in the operating room, the patients were transferred between different nursing personnel 6 times. The restructured operating room nursing posts were reduced from the original 7 posts in 2 categories to 5 operating room nursing posts with 4 spe- cialist nursing roles,including a surgical circulating nurse,a duty nurse in the operating room,a surgery-specialized nurse （surgical instrument nurse） and an anesthesia specialist nurse （anesthesia induction nursing post and recovery room nursing post）. Conclusion The restructuring of operating room nursing posts is in accordance with the contemporary nursing service concept. This operation adjustment is beneficial not only for the development of multi-dimensional specialization of the operating room but also for the internationalization of the profession and the nurses; professional development.