医联体内基层医疗机构护理服务供需差异调查

Investigation of supply and demand differences of nursing services in primary medical institutions of regional medical consortium

目的了解医联体内基层医疗机构护理服务现状,为完善基层护理服务项目及基层护理培训提供参考依据。方法采用自行设计的问卷,于2019年5月—6月分别对镇江市医联体内46个基层医疗机构(13个社区卫生服务中心、33个乡镇卫生院)的360位护理人员的一般资料、实际开展的常见慢性病护理服务内容、是否接受过常见慢性病护理服务培训,以及对护理服务内容重要性的认识进行问卷调查,对基层医疗机构就诊的220位患者进行护理服务内容需求度的调查。结果基层医疗机构的护理人员普遍存在年龄小、职称低、学历低的情况。基层医疗机构就诊患者对常见慢性病管理的需求普遍较高,但开展率却并未达到100%,有的项目开展率低于60%。基层医疗机构护理人员对常见慢性病管理的重要性认识较高,在“脑卒中管理”、“糖尿病管理”、“高血压管理”方面差异有统计学意义(P<0.05),但培训率远低于开展率,社区卫生服务中心在常见慢性病管理的培训和开展方面优于乡镇卫生院。结论医联体内基层医疗机构护理服务的开展不能满足患者需求,医联体内基层医疗机构护理服务的培训不能满足基层护理人员的需求,社区卫生服务中心和乡镇卫生院在常见慢性病管理的培训和开展方面有差异。

Objective To understand the current status of nursing services at the primary medical institutions in the regional medical consortium,and provide reference for improving primary nursing service items and primary nursing training.Methods Using self-designed questionnaires,we investigated 360 nurses about general information,development of common chronic disease care services,whether they have received training on common chronic disease care services,awareness of the importance of nursing service in 46 primary medical institutions(13 community health service centers,33 township health centers)in Zhenjiang regional medical consortium.A survey of the demand of nursing service content was conducted on 220 patients treated by primary medical institutions from May to June 2019.Results Nurses in primary medical institutions are generally young,have low professional titles,and have low education background.The needs of patients in primary medical institutions for the management of common chronic diseases are generally high,but the implementation rate has not reached 100%,some projects implementation rate are even below 60%.Nurses in primary medical institutions have a high awareness of the importance of common chronic disease management,and there are statistically significant differences in"stroke management","diabetes management"and"hypertension management"(P<0.05),but the training rate is much lower than implementation rate,community health service centers are superior to township health centers in training and implementation of common chronic disease management.Conclusion The development of nursing services in primary medical institutions of regional medical consortium can not meet the needs of patients,and the training of nursing services in primary medical institutions of regional medical consortium can not meet the needs of primary care workers.There are differences in the training and development of common chronic disease management between community health service centers and township hospitals.