Nursing emergency management practice of COVID-19 in a traditional Chinese medicine hospital

Nursing work is an integral part of hospital work.Under the challenge of the COVID-19 epidemic,it is particularly important to establish a timely and efficient nursing management system.The nursing department of our hospital used the theory and method of feedforward control to formulate the emergency plan for epidemic prevention and control and to conduct drills.The plan includes the establishment of the emergency management system for epidemic nursing and key prevention and control positions,rational allocation of human resources,and strengthening personnel training,so as to ensure the efficient operation of nursing epidemic prevention and control work and provide a reference for nursing management mode during the epidemic.

Strategic management in the establishment of a magnet hospital: A nursing staff perspective

Magnet hospital certification has a reputation for being one solution to nurse recruitment and retention. It is a matter of priority for hospitals to identify and enhance the basic organizational social structures which promote the development and maintenance of magnetism. A total of 436 valid self-administered questionnaires were collected from nurses. Paired sample t-tests, importance-performance gap analysis andANO-VAwere applied. The aims of this study were to investigate the key factors in and the gaps between nurses’ perceptions and hospital performance in areas contributing to magnetism. The results showed that Salary structure, welfare, and manpower deployment were the key forces of magnetism influencing nursing practice. Public and private hospitals showed significant differences in manpower deployment and nurse-patient relationships. Nurses who rotated shifts were more dissatisfied with their hospital scheduling system. Therefore, personnel policies and program are the primary forces in the development of a magnet hospital. Considering the demand for flexible scheduling of nurses, providing a supportive work environment, and keeping pace with today’s changing health care environment could achieve better outcomes for nurses, patients, and hospitals. These findings provide a reference to help set priorities for the implementation and development of effective strategies with limited resources. Public hospitals should take the lead in promoting magnet hospitals and set up reasonable salary systems, nursing workforce standards, and administrative support in order to attract and effectively retain nurses.

Emergency management of nursing human resources and supplies to respond to coronavirus disease 2019 epidemic

Objective:To introduce the emergency management of nursing human resources and supplies of a large general hospital when facing the outbreak of coronavirus disease 2019(COVID-19).Method:The Nursing Department of the hospital fully executed its functional authority to establish a three-level echelon of sustainable support,allocate human recourses dynamically,organize pre-service training,supervise the key working steps,formulate positive incentive methods,and deploy medical supplies scientifically.Result:By taking these strategies,the hospital effectively improved the coping capacity of the nursing team and played a positive role in the prevention and treatment of COVID-19.Conclusion:The emergency management of nursing human resources and material resources for COVID-19 of the hospital is successful.But several deficiencies were identified as well,which indicated that the hospital needs to establish an efficient emergency management system,and pay attention to the practice of nursing emergency plans to enhance coping capacities in public health emergencies.

Value Based Purchasing and Nursing Case Management

The implementation of value based purchasing will bring major changes to the delivery of health care in the United States. This effort is being led by the Medicare Access and CHIP Reauthorization Act (MACRA). Medicaid and private insurance plans are developing similar programs. These programs reflect a change in pay or incentives in the direction of primary and ambulatory care at the community level. This study described the use of nursing case management as a tool for monitoring and coordinating the impact of value based programs at the community level. It suggested that, under these programs, nursing case management can contribute to reduction of hospital admissions/discharges, emergency department visits, and hospital readmissions. This can be accomplished through monitoring of utilization levels for these indicators. These are major objectives of MACRA and related programs. The study also suggested that nursing case management can contribute to the development of new programs, such as Complex Care, as a means of reaching these objectives. The study included estimates of the costs and benefits of using case management to reduce hospital admissions for low severity of illness patients at the community level. It suggested that the service can provide important opportunities for health planning and development in this area.

Application of refined management in prevention and control of the coronavirus disease 2019 epidemic in non-isolated areas of a general hospital

Objective:This article summarizes the experience in the prevention and control of coronavirus disease 2019(COVID-19)epidemic in non-isolated areas in a general hospital.Methods:Based on refined management theory,we professionally developed the standards for prevention and control of COVID-19 in non-isolated areas,systematically implemented various prevention and control measures,performed gridding audits,effectively communicated among teams and between medical staff and patients assisted by information techniques,and reported results for quality improvement.Results:There was no hospital-acquired COVID-19 infections among staff in the hospital.The rates of mask-wearing,epidemiological history screening,and the medical supplies disinfection were all 100%in the hospital.The accuracy rate of mask-wearing of patients and their families was 73.79%and the compliance rate of their hand hygiene was 40.78%.Conclusion:Refined management strategies for the prevention and control of COVID-19 infection in non-isolated areas of the general hospital are effective.The accuracy rate of mask-wearing and hand hygiene compliance of patients and their families need to be further improved.

Management of work place bullying in hospital:A review of the use of cognitive rehearsal as an alternative management strategy

Lateral violence is not uncommon in workplaces.Unfortunately,nursing,a profession that builds its practice on compassion and code of ethics while caring for their patients is not spared from this phenomenon of lateral violence.Studies have reported cases of lateral violence among nurses to occur frequently worldwide.The impact of lateral violence has serious repercussions not only on the health of bullied victims but also on the structure and financial spending of the organisation.More importantly,the potential latent impacts on the patients'safety and health is of great concern.This literature review suggests that the contributing factors towards lateral violence are mainly due to characteristics of perpetrators,victims'reaction to bullying and organisation's characteristic.To mitigate the impact of lateral violence among young and inexperienced nurses,a cognitive rehearsal scripted response is proposed to prevent harassment and bullying incidents from becoming a feature at the workplace for nurses.

Time Management of the Clinical Nurses at Public Hospital in Bangladesh

Nursing is a very intense and focused career, so picking the right time and its proper management can help to relieve personal stress, manage tasks properly and achieve patients and organizational outcome. Objective: This study aimed to explore perceived time management skill of the clinical nurses. Methods: This was a descriptive correlational study design using simple random sampling. A total of 77 clinical nurses working in Mugda Medical College Hospital, Dhaka, Bangladesh were selected as study participants. The data were collected through structure questionnaire which consisted of demographic questionnaire and five dimensions of Time Management Skill Questionnaire (TMSQ). Results: The overall mean score of time management skill was 2.63 (SD = 0.28) reflecting a medium level of nurses perceived time management skill. The results also revealed that nurses age (r = 0.39, p = 0.000), monthly income (r = 0.294, p = 0.017) and service experience (r = 0.248, p = 0.030) were statistically significant correlated with nurses’ perceived time management skill. Conclusion: The outcome of this research would add to develop a strategy for nurse administrators to take an initiative for how nurses could improve the time management and utilize their limited time effectively. It specifies that proper time management can influence to provide quality care and achieving organizational goal.

Conflict management and perceived team cohesion of nurses in university hospitals

Objective Team cohesion is an essential component in a multidisciplinary team and can inspire the team to perform creative and complex works.This descriptive correlational study aimed to determine the styles of conflict management,levels of team cohesion,and the relationship between each style of conflict management and perceived team cohesion among nurses at affiliated hospitals of Dali University.Methods The sample consisted of 336 nurses from two university hospitals in Yunnan province,selected using the proportionate sampling method.Research instruments included demographic data form,Dutch Test for Conflict Handling(DUTCH)and Group Cohesion Scale.The Cronbach’s alpha coefficient for the five subscales of DUTCH were the following:forcing(0.83),yielding(0.81),avoiding(0.88),problem-solving(0.85),and compromising(0.84).The Cronbach’s alpha coefficient of Group Cohesion Scale was 0.83.Data were analyzed using descriptive statistics and Spearman’s rank-order correlations.Results The results of this study revealed that nurses were most likely to use avoiding conflict management style to deal with conflict situations,followed in rank order by problem-solving,compromising,forcing and yielding conflict management style.Nurses perceived team cohesion at a moderate level(x=4.43,SD=2.01).Additionally,conflict management associated with team cohesion.Conclusion The study findings revealed that avoiding was the conflict management style most frequently utilized by nurses,and nurses perceived team cohesion was at a moderate level.It is required to identify various strategies to improve team cohesion in multidisciplinary teams and develop a support system for nurses.

丹麦Hvidovre Hospital临床护理管理学习见闻

2015年4—6月，笔者前往丹麦哥本哈根大学HvidovreHospital进行了为期2个月的研修。在此期间，通过实践观察及沟通交流，发现该院与我院在临床护理管理中存在的差异。现将对该院临床护理管理的学习见闻报告如下。

The challenges that head nurses confront on financial management today:A qualitative study

Aim: To explore challenges that Chinese head nurses confront on financial management from the perspective of different levels of nursing and non-nursing managers and to provide contemporary nurse managers with suitable supports.Methods: Eighteen nursing leaders in different levels were divided into two groups: Junior Leadership Group (head nurses) and Senior Leadership Group (nurse coordinator, nurse executive, and vice-president of the hospital). All the subjects were invited to participate in a semi-structured interview. The interviews were audio-taped and transcribed, and data were analyzed using a comparative content approach. Results: The four following challenges that head nurses confront on financial management practice were identified from the research findings: 1) lack of intrinsic motivation;2) insufficient training and edu-cation on financial management and nursing economics;3) desires for cross-uniting communication and cooperation;4) insufficient reference managerial tool. Conclusions: The confusion confronted by head nurses in Changsha include three aspects: managerial roles, managerial training, and managerial tools. Cooperative management model, evidence-based management training, and data-driven tools will contribute to improving the financial management capacity of nurse managers.

Impact of Healthcare Management and Control on Service Delivery, a Case of Oklahoma Healthcare Facilities

Background: Healthcare management and control have been essential to any economy and a concern for most nations. Health care being in the service industry gives another challenge as they are inseparable from the service providers. As a result, a significant focus should be made on the management and control of healthcare. A study is necessary to establish how such practices influence service delivery within the healthcare industry. Objective: To show the influence of health care management and control on the service delivery in the health sector and to establish the impact of health care management system on the delivery of health services, find out the extent to which health leadership has influenced service delivery in the health industry and to establish the existence of healthcare control practices in the health industry and their impact on service delivery. Methods: The general information questionnaire, interviews patient’s satisfaction scale, and the hospital performance index were investigated by interviewing 42 healthcare workers working in Oklahoma hospitals. The study utilized a combination of data collection instruments, questionnaires, and interviews for primary data collection and a cross-sectional survey for secondary data from healthcare records within the healthcare facilities. The research adopted a descriptive statistics methodology for data analysis. The study tested the validity of data collected and reset test for omitted variables and simple correlation analysis. Results: effective healthcare management yields reasonable patient satisfaction and ignites motivation among healthcare workers. Additionally, quality service delivery is a function of proper healthcare management systems. Although it is impossible to measure effective management through observation, the testimonies and satisfaction levels among the nurses and the patients communicate accurately.

综合性医院病区分类管理评价指标体系构建

目的:构建综合性医院临床病区分类管理指标体系,为科学评价岗位价值奠定基础、对护理岗位管理提供理论依据。方法:对综合医院病区分类管理主要构成要素进行分析,根据专科属性结合各临床病区的工作量、护理难度等因素选择客观、可测量的指标,采用德尔菲专家咨询法构建临床病区分类管理指标体系。结果:2轮函询分别向15名专家发出函询表,回收率均为100%。2轮专家函询有12名专家提出修改意见,专家权威程度为0.89。最终形成包括护理工作量、护理工作难度、护理职业风险和工作压力负荷4个一级指标、11个二级指标、33个三级指标的评价体系。结论:构建的综合医院病区分类管理指标可为临床病区分类及临床护理管理实践提供理论基础。

精细化护理管理模式在控制医院感染中的效果

目的探讨将精细化护理管理模式运用于医院感染控制中的效果。方法选取吉林省前卫医院医院感染率较高的重点科室(重症医学科、普通外科、心内科、综合内科)的住院患者及护理人员作为研究对象,其中2023年1月至3月为干预前阶段设为对照组(住院患者1850例,护理人员74人),4月至6月实施精细化护理管理模式为干预后阶段设为观察组(住院患者1880例,护理人员74人),分析比较实施精细化护理前后医院感染监测指标、医院感染知识掌握及院感措施落实情况。结果观察组的院内感染发生率低于对照组,住院患者治疗前病原学送检率高于对照组,差异有统计学意义(P<0.05);两组的多重耐药菌检出率比较,差异无统计学意义(P>0.05);观察组护士的感控知识知晓率、环境清洁消毒合格率、消毒物品管理合格率、无菌物品的管理合格率高于对照组,差异有统计学意义(P<0.05);两组的医疗废物管理情况比较,差异无统计学意义(P>0.05)。结论在医院感染管理中实施有针对性的精细化护理管理模式,能够显著提高护理质量,有效控制医院感染。

分层次教学培训对护士医院感染防控知识掌握水平及管理质量的影响

目的探讨和分析分层次教学培训对护士医院感染防控知识掌握水平及管理质量的影响和改善效果。方法选择安徽医科大学第二附属医院402名护士作为研究对象,于2023年3月1日—7月31日开展分层次教学培训,采用回顾性分析,对是否担任过医院感染管控护士的护士知识掌握程度、培训前后护士医院感染防控知识掌握水平和医院感染管理质量进行比较与分析。结果担任过医院感染管控护士的护士医院感染防控知识掌握评分高于未担任过的护士,差异有统计学意义(P<0.05)。培训后,护士在医院感染管理规范、诊疗器械处理程序、医院感染概念、空气消毒方面的知识掌握评分高于培训前,差异有统计学意义(P<0.05);护士在操作技能、应急能力、理论知识以及消毒管理方面的医院感染管理质量评分高于培训前,差异有统计学意义(P<0.05)。结论分层次教学培训的实施,显著提升了护士的医院感染防控知识掌握水平,同时也改善了医院感染管理质量。

广东省二、三级医疗机构延续护理部门设立及运作现况调查

目的:了解广东省二、三级医疗机构延续护理部门的设立及运作情况,为医疗机构建设延续护理部门、开展延续护理提供参考和借鉴。方法:采用便利抽样法于2023年5月4日—19日选取广东省110所二、三级医疗机构的护理管理人员进行调查,调查其所在医疗机构延续护理部门的建立情况、运作情况、阻滞因素及相关建议。结果:110所医疗机构中有35所(31.82%)设立了延续护理部门,58所(52.73%)拟计划开展延续护理服务,17所(15.45%)暂无设立延续护理部门及开展延续护理的计划。已开展延续护理的35所医疗机构中,2010年前设立延续护理部门的有3所(8.57%),2010—2018年有9所(25.71%),2019年至今有23所(65.71%)。35所医疗机构延续护理运作情况良好,但在医疗收费、医院-社区联动及延续护理质量指标设置方面需进一步加强和完善。51所(46.36%)医疗机构认为设立延续护理部门开展延续护理服务无障碍,59所(53.64%)认为存在障碍,障碍因素主要包括人力资源短缺(79.66%)、经济效益受限(76.27%)、实施场地缺乏(54.24%)、不知如何开展(32.20%)、院领导不支持(23.73%)等。结论:因缺乏统一、规范的标准及指南,广东省二、三级医疗机构延续护理部门的设立及运作情况参差不齐且存在多方面争议、困惑及不足。建议从“相关政策制度、部门组织架构、信息共享与协调机制、服务收费与支付机制、延续护理质量评价指标、工作人员绩效”等方面完善延续护理部门的设立及运作,从而推进延续护理的发展,助力实施健康中国战略。

改良正念减压疗法在原发性肝癌切除术患者中的应用

目的探究改良正念减压疗法在原发性肝癌(primary liver cancer,PLC)切除术患者中的应用。方法选取2020年5月至2022年5月北京市和平里医院收治的160例PLC患者作为研究对象,按照随机数字表法分为对照组(n=80)和研究组(n=80)。对照组采用风险管理护理模式,研究组在对照组基础上联合改良正念减压疗法干预,比较两组患者干预前后癌症疲乏量表(cancer fatigue scale,CFS)评分、中文版压力知觉量表(Chinese perceived stress scale,CPSS)评分、心理弹性水平、疼痛程度、心理应激程度和满意度。结果研究组患者干预后躯体疲乏、情感疲乏、认知疲乏CPSS评分均显著低于对照组(均P<0.05),坚韧性、自强、乐观评分和疼痛改善程度均显著优于对照组(均P<0.05)。两组患者干预后焦虑自评量表(self-rating anxiety scale,SAS)和抑郁自评量表(self-rating depression scale,SDS)评分较干预前均显著降低(均P<0.05),且研究组患者干预后SAS和SDS评分均显著低于对照组(均P<0.05)。两组患者干预后CFS各项评分均较干预前显著降低(均P<0.05),且研究组降低幅度显著大于对照组(均P<0.05)。研究组患者的干预满意度显著高于对照组(P<0.05)。结论采取风险管理护理模式联合改良正念减压疗法干预PLC患者,能显著降低术后并发症发生率,缓解患者疼痛、疲乏感和心理应激反应,减轻患者的知觉压力并有效改善患者的心理弹性,提升生活质量。

三级甲等医院护士坐诊社区卫生服务中心的慢性病管理实践

目的:评价三级甲等医院护士坐诊社区卫生服务中心的慢性病管理实践效果,为促进优质护理资源下沉提供借鉴和参考。方法:合肥市某三级甲等医院选拔护士到医联体单位的4个社区服务中心,实施“1+1+1+N”管理团队的慢性病管理服务模式并开设专科护理门诊,对高血压、糖尿病、脑卒中3类慢性病患者进行规范管理。以开设专科护理门诊后第1次建档的513例患者为研究对象,比较实施前后患者的血压、血糖控制情况,生活质量,自我管理行为,自我效能和患者满意度。结果:三级甲等医院护士坐诊社区卫生服务中心后,患者的血压、血糖控制率,生活质量,自我管理行为,自我效能和满意度优于坐诊前,差异均有统计学意义(P<0.05)。结论:三级甲等医院护士坐诊社区服务中心的慢性病管理实践能够提高慢性病患者的管理质量,提高其生活质量和自我效能。

护理主导多部门协作管理提升血培养标本质量的效果研究

目的 :评价护理主导的多部门协作管理模式对血培养标本质量提升的效果,为护理临床实践和质量改进提供参考。方法 :成立护理主导多部门协作管理团队,开展质量改进,比较措施实施前后血培养标本送检率、合格率、污染率,以及护士血培养知识、态度、行为的变化。结果 :2023年5月—6月血培养标本送检率、送检方式为双瓶双侧的比例分别为19.1%、61.3%,高于2022年同期的4.7%、35.6%,差异有统计学意义(P<0.05);2023年5月—6月和2022年同期污染率分别为2.9%和3.8%,呈下降趋势;2023年护士血培养相关知识、态度、行为得分分别为(12.69±2.81)、(5.89±0.44)、(36.73±3.40)分,高于2018年的(7.89±2.79)、(5.82±0.52)、(30.81±4.35)分,差异有统计学意义(P<0.05)。结论 :护理主导多部门协作管理模式下的质量改进策略,提高了血培养标本送检率和合格率,降低了血培养标本污染率,提高了护士血培养的知识、态度、行为水平,体现了护士在院感防控工作中的价值。

我国三级医院急诊病人激增应对方式调查

目的:了解我国三级医院急诊病人激增应对方式。方法:于2023年1月—3月选取我国54所三级医院急诊科作为研究对象,其中,东部地区26所(48.1%),中部地区10所(18.5%),西部地区18所(33.3%)。采用自行编制的中国不同地区医院急诊病人激增应对方式调查问卷进行调查。结果:三级医院急诊病人激增后日均急诊量增幅达87.5%,急诊日均候诊时间整体延长(Z=-5.560,P<0.001),东部地区三级医院急诊病人激增后72 h出抢救室病人比例较激增前下降(P<0.05)。面对急诊病人激增,各三级医院采取的应对措施包括增加急诊床位数和出诊医生诊位、增设专门收治新型冠状病毒感染病人的病房、增加重点设备投入、调配医护人员支援急诊等。东部地区三级医院急诊候诊时间变化率与医患比变化率(r=-0.418,P=0.034)、护患比变化率(r=-0.469,P=0.016)、互联网诊疗变化率(r=-0.684,P=0.020)均呈负相关,东部地区三级医院抢救室滞留时间变化率与护患比变化率呈负相关(r=-0.422,P=0.032),中西部地区三级医院抢救室滞留时间变化率与留观室床位变化率呈正相关(r=0.405,P=0.036)。结论:急诊科应不断优化人力、床位、仪器设备等医疗资源配置,探索急危重症病人“互联网+”新模式,进一步提升重大传染病的应对能力。

5A护理模式在日间全髋、全膝关节置换手术患者院前管理中的应用

目的:评价5A护理模式在日间全髋、全膝关节置换手术患者的应用效果,为优化日间手术患者院前管理提供参考。方法:采用便利抽样法选取2023年6月—11月在浙江省某综合三级甲等医院行日间全髋、全膝关节置换术的296例患者为研究对象,按照入院时间分为对照组和观察组。对照组采用日间常规院前管理流程,观察组在此基础上增设5A护理模式,开展院前管理。比较2组患者术前焦虑、当日手术取消率、退住院率、术前检查缺项率、满意度。结果:观察组患者术前焦虑情况改善优于对照组(P<0.05)。2组患者当日手术取消率、退住院率、术前检查缺项率比较,差异无统计学意义(P>0.05)。观察组患者满意度均值得分高于对照组,差异有统计学意义(P<0.05)。结论:应用5A护理模式进行院前管理,可缓解全髋、全膝关节置换手术患者术前焦虑状况,提高满意度。