天津市6所二级医院护士执业环境现状及对离职意愿的影响

The present situation on nursery practical environment of 6 secondary class hospital of Tianjin and the effects on turnover intention

目的:分析天津市二级医院临床护士工作执业环境、离职意愿状况及其相互关系,为护理管理者采取针对性的改善措施提供依据和方向。方法:采用护士执业环境测评量表(PES-NWI)和离职意愿量表,对天津市6所二级医院分层随机抽样法抽取的414名临床护士进行一般情况、护士执业环境及离职意愿的调查。结果:414名二级医院临床护士执业环境测评得分为(79.81±14.90)分,不同工作科室的护士执业环境测评得分有统计学差异(P<0.05),且护士执业环境测评6个维度水平由高至低依次为优质护理服务的基础,医护合作,护理管理者的能力、领导力及支持,人力和物力配备,薪酬待遇和社会地位,护士参与医院事务;离职意愿总分为(2.26±0.71)分,指标值为56.65%;不同医院类别、就业状况、职称、职务、工作年限、工作科室的护士离职意愿得分比较有统计学差异(P<0.05);护士执业环境测评6个维度和离职意愿均成负相关(P<0.01),其中薪酬待遇和社会地位是影响离职意愿的重要因素。结论:天津市6所二级医院临床护士的离职意愿在中等水平,但处于不稳定状态且对工作环境的认知状况不容乐观,医院应采取有效措施积极改善临床护士的执业环境,提高护理人员的待遇,建立护士参与医院事务的民主机制,以提高护士工作的积极性和主动性,进一步降低离职意愿,促进护理事业的持续稳定健康发展。

Objective： To analyze the status of the nursery present practical environment and turnover intention, to find out the internal relation between them in order to provide the basic evidence and the direction for adopting suitable measures.Methods： 414 nurses from 6 hospitals were investigated the internal relation between the present practical environment and turnover intention by the practice environment scale of the nursing work index （PES-NWI） and WISC-R. Results： The score of the evaluation for the investigation of practical environment was （79.81±14.90）. There was statistics difference between different department （P〈0.05）. The 6 dimensions of nursery practical environment arranging from high to low, quality service basis, co-operation between doctor and nurse, the ability of nursing management, leadership and supporting, the allocate for manpower and resources power, compensation package and social status, the participate of nurse in the hospital affairs. The score of turnover intention was （2.26±0.71）, the index value was 56.65%. There were statistics difference in turnover intention among the different hospital class, employment situation, professional title, position title, work experiences, practical department（P〈0.05）. It reveals that it was negative correlation between the evaluation in 6 dimensions of nursery practical environment and the turnover intention（P〈0.01）. The most important factor was compensation package and social status. Conclusion： The level of turnover intention for the 6 secondary class hospital was still in medium scope, but in an unstable state and the nurse recognize the condition of practical situation not optimistic. It is indeed necessary to improve the practical environment for the clinical nurse. It is also important to raise the remuneration of nurse. To build up democratic system to let the nurse to participant into the hospital affair so that to improve their initiative and proactive. We must incessant to lower the willing of nursing separation, to expedite our nurse profession to be developed persistently steadily and healthily.