我国临床整体护理开展现状

The present situation of clinical holistic nursing in China

整体护理是我国十二五规划中明确全国推广的护理模式，自1995年开始，其在我国已有20余年发展历程。本文从护理服务模式、护理人力配置、护士培训和质量评价方面对开展现状进行综述。目前在十二五规划目标指引下我国临床服务模式已开始向责任制整体护理服务模式转变。但在实施过程中因为多种因素的影响，针对疾病和医嘱的护理思维仍然是多数护士开展临床护理的主要思维方式，护理程序等整体护理理念和方法还没有落到实处。护理人员的合理配置已被列入国家护理规划，经过几年的努力护理人员配置有所改善，但仍不能满足实际需要。因此，排班模式作为解决人员配置与实际需要之间矛盾的途径，也开始发生转变，APN排班以及一些数学模型开始运用于排班模式的改革中。护士能力水平被认为是影响整体护理落实的重要因素，因此护士培训也受到重视，但是培训的规范化仍是我国护士培训正在面临的问题。作为促进整体护理持续改进的重要方式和因素，我国的整体护理质量评价体系正在逐步完善，但是科学管理方法的运用还不能和临床实践相结合，成为制约护理质量提升的因素。因此探讨现状与理论之间的关系，如何进行现状的改革与规范，以及理论中国化的探索，是整体护理能真正在我国生根发芽、茁壮成长的必要措施。

Since from 1995, holistic nursing has over 20 years of development in China. And now as the nursing models spread to national wide, holistic nursing aim to the National Twelfth Five-year Plan. At the guidance of the National Twelfth Five-year Plan, the nursing model in China has been began to turn to holistic nursing model. But because of the influence from many factors from the implementation, the way of thinking about to carry out the nursing care using by most of the nurses in clinic is also from the illness and the medical orders. The holistic nursing philosophy and methods, for example the care program, have been not implemented well. Nurse staffing has been in the national plan. And after years of effort the situation has been improved. But it also can not fit the needs in clinic. So as the method to solve the contradiction between the staffing and the needs, the nursing schedule has began to change. The APN model and some mathematic model have been used to the innovation for the nursing schedule. The ability level of the nurses is known as the important fact on the implementation of holistic nursing. So the nurse training is in the attention. But the standardization for the training is the problem we face now. As the chief method and factor to the continual improvement for holistic nursing, quality evaluation system in our country has been improved gradually. But the scientific management methods have not well combine to the fact, and became a factor to restrict the improvement. So the necessary steps for the improvement of holistic nursing in China involve the investigation about the fact and the theory, the innovation and the standardization for the current situation, and the chinization of the theory.