新疆四所三级甲等医院专科护士岗位设置及护理实践现状的调查分析

Investigation and analysis on the post setting and advanced nursing practice status of specialist nurses in four tertiary grade A hospitals in Xinjiang

目的 :调查新疆专科护士的岗位设置及护理实践现状,为专科护士的培养和使用提供依据。方法 :采用典型抽样法对新疆乌鲁木齐市、石河子市4所三级甲等医院的护理部及780名专科护士进行问卷调查。结果 :4所医院共设置10个专科护士岗位和3个专科门诊,其选拔条件的学历要求大专及以上。高级护理实践内容排前三的维度是应变性(3.27±0.82)分、护理实践(3.26±0.78)分和临床判断(3.11±0.69)分;不同学历的专科护士除护理实践和系统思考外,对高级护理实践情况得分差异均有统计学意义(P<0.05),不同职称、工作年限的专科护士在临床判断和协作维度得分差异有统计学意义(P<0.05),不同职称的专科护士在临床探究得分差异有统计学意义(P<0.05)。结论 :新疆部分医院设置了专科护士岗位,但是缺乏专科护士岗位设置标准,高级护理实践内容中直接的临床实践能力较好,但临床探究及循证护理实践能力薄弱;不同的学历、职称、工作年限之间,专科护士的高级护理实践存在差异,且在一定程度上制约了高级护理实践内容的开展。

Objective： To investigate the job setting of specialty nurses and the status ot advanced nursing practice m Xinjiang, and provide basis for the training and use of specialist nurses. Methods： Nursing departments and 780 specialty nurses from 4 of the tertiary grade A hospitals in Urumqi and Shihezi in Xinjiang were investigated by questionnaires. Results： There were 10 specialty nurse positions and 3 specialist outpatient clinics in the four hospitals. The educational qualifications for these positions were junior college or above. The top three dimensions of advanced nursing practice were the contingency （3.27±0.82）, the clinical nursing （3.26±0.78）, and the clinical judgment （3.11±0.69）. The specialty nurses with different educational levels had different advanced nursing practice except the clinical nursing and systematic thinking dimension （P〈0.05）. There was a statistically significant difference in the clinical judgment and collaboration dimension between the nurses with different professional titles and working years （P〈0.05）. The specialty nurses with different job titles scored different points in the clinical inquiry dimension （P〈0.05）. Conclusion： Specialty nurse positions had been set up in various hospitals in Xinjiang, but there was lack of standard for setting these positions. The directly clinical practice ability in advanced nursing practice was rather good, but the clinical inquiry and evidence-based nursing practice ability were weak. There were differences in the advanced nursing practice among specialty nurses with different educational levels, professional titles, and working years. All of these conditions may restrict the development of advanced nursing practice.