天津市三级综合医院临床科室岗位风险测定的初步研究

A preliminary study on risk evaluation of nursing posts in clinical departments of tertiary general hospital of Tianjin

目的:探讨天津市三级综合医院临床护理岗位风险测评方法,并进行初步测定。方法:2017年7-8月,采用目的抽样的方法,从天津市抽取21名专家进行问卷函询,确定岗位风险要素权重;2017年8-9月,采取整群随机抽样的方法,从天津市抽取4所三级综合医院共计1 000名护士,针对33个科室护理岗位风险问卷调查和测定。结果:岗位评估要素权重方面:疑难危重患者多且专业程度复杂、接触有毒有害物质/感染传染病、面临病情变化快需随时抢救患者、工作量大超时工作四个风险因素权重系数分别为0.30、0.25、0.25、0.20;护理管理者、临床护士权重系数为0.60、0.40。岗位风险值最高的前三位科室分别为重症医学科、急诊和NICU(新生儿重症监护室),风险值最低的三个科室为内分泌科、疼痛科和眼科。结论 :护理岗位风险评定是开展护理岗位管理、完善护理绩效考核制度的重要环节。护士岗位风险的评定要素贴近临床实际,符合政策导向,构成合理,评定结果可信。

Objective： To explore the risk evaluation method of nursing posts in tertiary general hospital of Tianjin, and tomake a preliminary study. Methods： From July to August 2017, purposive sampling method was used to invite 21 experts to do the questionnaire inquiry, and to determine the weight of post risk factors. From August to September 2017, a total of 1000 nurses from 4 tertiary general hospitals in Tianjin were recruited using the cluster random sampling method, to investigate and evaluate the risk of nursing post in 33 clinical departments. Results： For factor weights of post assessment, risk weight coefficients of care for critically ill patients, exposure to toxic and hazardous substances, care for patients whose condition changes quickly, care for patients needing rescue at any time were respectively 0.30, 0.25, 0.25, 0.20. Weight coefficients of nursing managers and clinical nurses were respectively 0.60 and 0.40. The top 3 departments with the highest post risk were ICU, emergency department and neonatal intensive care unit （NICU）. The 3 departments with lowest risk were department of endocrinology, department of pain and department of ophthalmology. Conclusion： Evaluation of nursing post risk is an important part of carrying out nursing post management and perfecting the system of nursing performance assessment. This risk evaluation of nursing posts is close to the clinical practice, which conforms to the policy orientation. And the results are reasonable and credible.