护理工作环境与低年资护士护理临床决策意识的相关性研究

Correlation study of nursing work environment and clinical decision making perception among junior nurses

目的调查护理工作环境与低年资护士的护理临床决策意识现状，并分析护理工作环境与护理临床决策意识的相关性。方法采用横断面调查方法，以符合纳入条件的633名低年资护士为研究对象，采用一般资料问卷、护理工作环境量表、护理临床决策意识量表进行问卷调查。结果护理工作环境均分为（2．99±0．37）分，各维度得分由高到低依次为：医护合作（3．12±0．47）分、护理管理者能力及领导方式（3．06±0．47）分、护士参与医院事务（2．91±0．48）分、高质量护理服务基础（2．78±0．48）分、充足的人力物力（2．75±0．52）分；护理临床决策意识均分为（143．36±14．01）分，各维度得分由高到低依次为：评价结果（37．31±4．53）分、确定解决问题目标（36．16±4．39）分、再次寻找相关信息（35．04±3．76）分、收集信息（30．98±3．80）分；护理工作环境和护理临床决策意识总分和各维度呈正相关（r=0．08～0．28，P〈0．01）。结论护理工作环境得分处于中等水平，护理工作环境对低年资护士护理临床决策意识有影响，因此，护理管理者应营造积极向上的护理工作氛围并根据低年资护士需求给予针对性的支持，有利于提高其护理临床决策意识。

Objective To investigate the status quo of junior nurses＇ nursing work environment and clinical decision making perception, and to analyze the influence of nursing work environment on clinical decision making perception. Methods The general data questionnaire, nursing work environment scale and clinical decision making perception scale was used to investigate 633 Junior nurses in hospitals. Results The overall mean score of nursing work environment was （2.99±0.57） points, the dimensions score from high to low were： medical cooperation （3.12±0.47） points, nursing management and leadership style （3.06±0.47） points, nurse participation in hospital affairs （2.91±0.48） points, high quality nursing service （2.78±0.48） points, sufficient manpower and material resources （2.75±0.52） points,; clinical decision--making perception of Junior nurses was （143.36±14.01） points, the dimensions score from high to low were： the decision-- evaluative feedback （37.31±4.53） points, determine the goal of solving the problem （36.16± 4.39） points, find the information again （35.04±3.76） points, gather information ability （30.98±3.80） points. The Total score of nursing work environment were positively correlated with the clinical decision making perception of junior nurses（r = 0.08-0.28, P 〈 0.01）. Conclusions Junior nurse＇s nursing work environment remains to be improved, nursing work environment has a good effect on clinical decision making perception, therefore, nursing managers should create a positive working atmosphere. It is beneficial to improve the awareness of nursing clinical decision-making by giving specific support to the needs of junior nurses.