护理人员对《护理分级》的认知现状调查

Investigation on nurses'cognition of the Nursing Classification

目的:调查护理人员对国家卫生行业标准《护理分级》的认知及落实情况,为《护理分级》标准的进一步修订提供依据。方法:通过方便抽样法,对全国31个省份的143941名护理人员进行问卷调查,调查内容包括对标准的认知及落实情况、对标准的意见和建议。结果:99.71%及以上的护理人员认为《护理分级》标准各项内容明确、清晰;99.48%的护理人员认为目前护理分级评定方法适用于临床;99.18%的护理人员认为Barthel指数评定量表适用于临床;护理管理者与临床一线护士之间对标准的认知存在差异(P<0.05)。护理分级的评定以医护人员共同确定为主(51.25%),护理分级的医嘱开立以医生为主(94.57%)。目前存在医护人员对标准内涵理解不够、标准对部分专科护理分级存在局限性、标准中患者病情判断依据相对主观、医护合作不够等问题。结论:《护理分级》标准清晰、明确,在我国适用性较好,但仍需要加强医护人员培训并推进医护合作,同时探索更为客观的分级方法和专科分级依据,不断完善护理分级标准。

Objective:To investigate the cognition of the Nursing Classification among nurses nationally and to know the problems during implementation of the Nursing Classification.Methods:A questionnaire survey was conducted among nurses in 31 provinces(municipalities and autonomous regions)across the country.A total of 143941 nurses were included by convenience sampling.Data were analyzed regarding nurses'understanding of the Nursing Classification,and their opinions and suggestions for the Nursing Classification.Results:More than 99.71%of nurses believed that contents of the Nursing Classification were clear.99.48%of the nurses believed that the current Nursing Classification was suitable for clinical practice.99.18%of the nurses believed that Barthel index rating scale was applicable.The cognition of the Nursing Classification between nursing managers and nurses was different(P<0.05).The assessment of patient classification was mainly determined by doctors and nurses(51.25%).Doctors were the main person to make the prescription regarding the classification(94.57%).The problems were as follows:insufficient understanding of the Nursing Classification,limitation of the Nursing Classification in some particular clinical settings,subjective judgement of patients'condition,and insufficient cooperation between physicians and nurses.Conclusion:The Nursing Classification is clear and definite,and it has good applicability in China.However,it is still necessary to strengthen training of medical staff and promote medical cooperation.At the same time,more objective grading methods and professional grading basis should be explored further.Nursing classification standards should be constantly improved.