临床23项护理操作规范性的评价研究

Standardization degree of 23 nursing skills in clinical settings

目的评价临床护士实际工作过程中23项常见护理操作的规范化程度。方法对北京市4所三级甲等医院40名护士的23项临床护理操作执行情况进行参与性观察,采用自设的临床常用护理操作技术操作流程记录评价表对其规范性进行评价。结果 23项护理操作在实际执行中规范化程度为66.30%±13.55%;无菌类操作的规范化程度高于非无菌类操作的规范化程度(P<0.01);实际操作中存在评估解释不足(34.78%±6.15%)、操作后健康指导欠缺(52.17%±6.15%)、三查七对落实欠佳(38.04%±2.17%)、抽药方法不够规范(100%)4个共性问题。结论临床实践中护理操作流程与医院的规范化操作流程存在差异,护理管理者应加强管理和培训,提高护理操作规范度,同时,也要根据学科发展修订临床护理操作规范。

Objective To evaluate the standardization degree of 23 frequentlyused nursing skills in clinical settings.Methods The participant observation was carried out among 40 nurses from four tertiary hospitals in Beijing to understand the standardization degree of 23 common nursing skills.Selfdesigned record and evaluation form were used to evaluate the standardization degree.Results The general standardization degree of 23 nursing skills was 66.30%±13.55%,according to the standardized operation procedures provided by hospitals.The standardization degree of aseptic operations was higher than that of nonaseptic operations(P<0.01).Four general problems were found during the evaluation including lack of assessment and explanation(34.78%±6.15%),lack of health education after the procedure(52.17%±6.15%),poor implementation of doublechecking(38.04%±2.17%)and nonstandard medication preparation(100%).Conclusion There are differences between actual nursing operation procedures in clinical settings and the standardized operation procedures provided by hospitals.Clinical nursing administrators should provide training to improve the standardization degree of nursing operations and revise nursing operation standardization regularly according to the development of nursing discipline.