重症监护室护士繁忙认知及场景的质性研究

The cognition of busyness and main busy scenes in intensive care unit nursing care:a qualitative study

目的探究重症监护室(intensive care unit,ICU)护士对繁忙的认知,并总结繁忙的主要发生场景,为缓解忙碌感、提高护士护理质量提供策略或建议。方法 2020年9月—2021年1月采用目的性抽样法对上海市东方医院的3个ICU科室的护士进行面对面半结构式深度访谈,运用Colaizzi资料分析的方法对访谈资料进行分析和主题提炼。结果共访谈护士10名,其中普通护士8名、护士长2名,均为女性。护士对繁忙的认知涵盖工作量爆炸式增长、时间压力大和多方信息涌入3个维度,繁忙主要场景提炼出服务患者多、患者病情重、抢救或患者不稳定、服务衔接4个主题。结论根据护士繁忙认知的3个维度,结合繁忙的主要场景,护理管理人员可以有针对性地提出相应解决办法,留住或吸引更多护士在ICU工作,并为患者提供更优质的服务。

Objective To explore the nurses’ cognition of busyness in intensive care unit(ICU), summarize the main busy scenes, and provide strategies for solving problems of busyness. Methods Nurses in three ICU departments of Shanghai Oriental Hospital were selected by purpose sampling method from September 2020 to January2021. Face-to-face semi-structured in-depth interviews were conducted with nurses. The interview data were analyzed and thematically refined using the method of Colaizzi data analysis. Results A total of 10 nurses were interviewed, including8 general nurses and 2 head nurses, all of whom were women. The cognition of busyness covered three elements:explosively increased workload, time pressure, and overwhelming information from multiple sources. Busy scenes included four themes: large amount of patients, critical conditions of patients, unstable conditions of patients, and frequent service transfer among different medical divisions. Conclusions According to the three elements of nurses’ cognition of busyness and scenes of it, nursing managers can put forward corresponding solutions. This can retain or attract more nurses to work in ICU and provide better services for patients.