我国31个省份三级医院专科护士培养及管理的现状调查

The current situation of the cultivation and development of specialty nurses in tertiary hospitals in China

目的调查我国31个省份三级医院专科护士的培养及管理现状,为规范三级医院专科护士的培养及使用提供参考。方法采用方便抽样法,于2018年8月—9月抽取31个省、自治区、直辖市的792所三级综合或专科医院的护理部专科护士负责人作为调查对象,自行设计调查问卷,并以电子问卷的形式进行调查。结果三级医院拥有的专科护士数量达到45.5(18.0,100.0)名,涉及的专科护士种类多样;专科护士学历以本科为主、中级职称最多,省级护理学会培养的专科护士最多;专科护士在临床发挥的角色主要体现在专科护理(97.3%)、护理管理(81.2%)、护理教学(77.5%)、护理科研(61.9%)等方面;目前针对专科护士管理的相关制度有岗位管理制度(92.0%)、考核制度(69.8%)、晋升制度(49.4%)、薪酬制度(38.0%);管理者对专科护士在临床发挥的作用较为满意,认为影响专科护士发挥临床作用的因素:支持政策不够(80.9%)、临床工作负荷过重(79.3%)、角色定位不清(67.9%)、岗位职责不明(57.6%)。管理者认为目前专科护士培养仍存在无再认证(63.6%)、质量参差不齐(58.0%)、缺乏统一认证机构(54.5%)等问题。结论专科护士整体素质较高,在临床专科护理中发挥了重要角色,管理者应进一步完善专科护士的晋升制度、薪酬制度,以提高专科护士工作的积极性和主动性,同时,应给予专科护士更多支持,包括政策支持、明确岗位职责等;培训机构应同质化专科护士的培养质量,促进专科护理发展。

Objective To investigate the status of training and development of specialty nurses in tertiary hospitals in China,and to provide suggestions for further standardization of the training and use of specialty nurses.Methods Using a convenient sampling method,from August to September 2018,792 tertiary general or specialized hospitals from 31 provinces,autonomous regions and municipalities directly under the central government were selected as the survey objects.The survey was done by using a self-designed questionnaire through the questionnaire star(an online questionnaire platform).Results The number of specialty nurses in all tertiary hospitals reached 45.5(18.0,100.0)persons,involving a variety of specialty nurses.The education background is mainly undergraduate;most of the specialty nurses have intermediate titles;the provincial nursing society trains the most specialty nurses.The role of specialty nurses in clinical practice is mainly reflected in specialized nursing(97.3%),nursing management(81.2%),nursing teaching(77.5%),nursing research(61.9%)and so on.At present,there are post management system(92.0%),examination system(69.8%),promotion system(49.4%)and salary system(38.0%).Managers are sati-sfied with the clinical roles of specialist nurses,and it is believed that the following factors can affect the clinical roles of specialty nurses:insufficient supportive policy(80.9%),excessive clinical workload(79.3%),unclear role orientation(67.9%)and unclear job responsibilities(57.6%).Managers believe that there are still problems of non-certification(63.6%),uneven quality(58.0%)and lack of uniform certification(54.5%)in the training of specialist nurses.Conclusion This study provides a basis for nursing managers to further standardize the training and use of specialized nurses.The overall quality of specialty nurses is high and plays an important role in clinical specialized nursing.Managers should further improve the promotion system and salary system of specialty nurses in order to improve their enthusiasm and initiative in their work.At the same time,managers should give more support to specialty nurses,including policy support and clear job responsibilities.Continuing education and training institutions should homogenize the quality of specialized nurses and promote the development of specialized nursing.