手术室护士实施分级管理的实践

Effects of hierarchical management on optimization of basic clinical service and improvement of professional competence of operation room nurses

目的：探讨手术室实施护士分级管理在提高基础临床服务能力和专业能力中的作用。方法：对我院手术室护士进行分级管理，明确各级护士的责任，培训及能力要求，晋升条件，工作标准和绩效系数，对实施前后的临床基础理论、护理实践、培训和继续医学教育完成情况以及临床服务能力进行考核和评估。结果：护士的临床基础理论和专业技能考核达标率大幅度提高，尤其是临床基础理论，由原来的61．9％提高到现在的100％（x2=9．882，P=0．002），专业技能也由原来的71．4％提高到现在的100％（x2=7．000，P=0．008）；护士参加院内相应层级的培训更加积极，继续医学教育项目超额完成，分级后合格率达到100％。结论：护士分级管理有助于提高手术室护士的专业素质水平。

[ Objective]To investigate the effect of hierarchical management on improving the capacity of clinical service and profession of operating room nurse. [Method] Steps were including nurses grading, stating of responsibilities for different grade nurses, requirements of training and competency, conditions for promotion, working standards and performance coefficient. Capabilities of nursing theory, practice, and service were evaluated before and after implementation. [ Result] Compliance rates of basic theory and clinical skills were significantly increased from 61.9% to 100% （X2 = 9.882, P = 0.002）, and 71.4% to 100% （X2 = 7.000, P = 0.008）, respectively; More participation of appropriate level of trainings and continuing medical education programs were observed with -pass rate of 100% after grading. [ Conclusion] Hierarchical management of nurses contributed to improving basic care and professional quality in operating room.