分层责任包干制在优质服务示范病房中使用的有效性研究

Validation study on the application of the hierarchical responsibility contract system in the quality nursing model ward

目的验证护士分层责任包干制护理模式在优质服务示范病房中使用的有效性,改变护理模式,最大程度地满足病人的护理需求,提高护理人力的使用效率和患者的满意度。方法全院实行护士分层级管理,设立专科护士(N4)-责任组长(N3)-高级责任护士(N2)-初级责任护士(N1)-助理护士(N0)五层分层级管理模式,做好护士分层级培训与考核,职责明确,实行责任包干制,改革护士排班模式,实施层级的工作权限与绩效考核。比较实施前后护理工作质量、患者满意度、直接护理时间、护士的职业价值观等改善情况。结果实施护士分层级管理模式后,基础护理合格率、健康教育落实率、护士对患者病情掌握率、护理差错缺陷发生率等各项护理工作质量较实施前显著提高(P<0.01),患者的满意度明显提高(P<0.01),护士对患者的直接护理时间明显增加(P<0.01),护士的职业价值观得到明显提高(P<0.05)。结论实施护士分层责任包干制护理管理模式,可以有效提升护理质量、病人满意度、直接护理时间及护士的职业价值观,提高了护理人力的使用效率。

Abstract Objective To verify the efficiency of the hierarchical responsibility contract system in the quality nurs- ing model ward, change the nursing model to satisfy patient＇s nursing as much as possible, and rise the efficiency and satisfaction. Method Nurse classification management system was carried out, and the five hierarchical manage- ment model, including nurse specialist, responsibility leader, senior responsibility nurse, prior responsibility nurse, anxiliary nurse, was set up in whole hospital The responsibility contract system, nursing hierarchical training and examination, hierarchical working authority and performance appraisal was guaranteed to work relatively smoothly. The improved degree of nursing quality, patients＇ satisfactions, direct nursing time, nurses＇ occupational values was measured and compared. Result After the application of the hierarchical responsibility contract system, accept- ance rate of basic nursing, implementation rate of health education, learn rate of patients＇ condition, and nursing defect were improved significantly（P〈0.01）. The satisfaction degree of patients was improved significantly（P〈 0.01 ） ; direct nursing time was increased significantly（P〈0.01）. Nurses＇ occupational values was improved signifi- cantly（P〈0.05）. Conclusion The application of the hierarchical responsibility contract system can improve nursing quality, patients＇ satisfaction, direct nursing time and nurses＇ occupational values effectively, then improve the effi- ciency of nursing human resources.