西藏自治区县级卫生服务中心护士工作体验的质性研究

目的 了解西藏自治区县级卫生服务中心护士在临床护理工作中的真实感受, 旨在为西藏自治区县级卫生服务中心提升护理服务能力和加快人才队伍建设提供参考。方法 2017年9月—10月,运用现象学研究法,对西藏自治区某县级卫生服务中心的10名护士进行深度访谈,将获取的资料进行分析、总结、归纳。结果 提炼出西藏自治区县级卫生服务中心护士工作体验的3个主题：临床护理工作感受、压力与应对、期望与支持。结论 西藏自治区县级卫生服务中心护士工作体验受到多种因素影响,需要多角度、多层面的支持。建议加快改善县级卫生服务中心基础医疗条件,改善护理工作环境;加强培训和人文关怀,加快护理人才队伍建设,提高护士护理服务能力。     

基于新时期大型公立医院功能定位的 护理人力资源配置的思考

大型公立医院在医疗卫生服务体系中具有引领和支撑的战略性地位,而护士队伍在应对区域性、国家性以及全球性的卫生挑战,实现全民健康覆盖的政治承诺中具有巨大的潜力与责任。本文在分析新时期大型公立医院功能定位的基础上,针对大型公立医院护理人力资源配置存在的人力总量不足,优质护理人才短缺,岗位设置与职业路径与新时期功能定位的不匹配以及缺乏科学的护理人力资源配置标准与方法等问题和挑战,提出大型公立医院护理人才队伍建设的思考与建议。     

基于新时期大型公立医院功能定位的护理人力资源配置思考

大型公立医院在医疗卫生服务体系中具有引领和支撑的战略性地位,而护士队伍在应对区域性、国家性以及全球性的卫生挑战,实现全民健康覆盖的政治承诺中具有巨大的潜力与责任。文章在分析新时期大型公立医院功能定位的基础上,针对护理人力资源配置存在的人力总量不足、优质护理人才短缺、岗位设置及职业路径与新时期功能定位不匹配,以及缺乏科学的护理人力资源配置标准与方法等问题和挑战,提出大型公立医院护理人才队伍建设的思考与建议。     

实施阶梯式全程排班 稳定护理人才队伍

目的:探讨阶梯式全程排班管理对稳定护理人才作用的效果。方法:采用阶梯式全程排班,结合满足病人需要的弹性排班,调整班次,实行按职称上岗,因人施用,发挥主观能动性,发挥年龄优势,稳定护理人才队伍。结果:改变排班模式后,减轻了轮班、夜班对老护士的心理压力,调动了护士的积极性,护士的价值得到了提升,护理人才队伍稳定,有效的保障了医疗护理安全,提高了病人对护理工作的满意度。结论:阶梯式全程排班方法提高了人力资源的管理水平,使护理人员的工作积极性得到了最大的发挥,起到了稳定护理人才队伍的作用。     

军队中小医院护理人力资源管理模式构建与成效

目的:探讨科学配置利用护理人力资源的多维护理管理体系.方法:针对目前护理人力资源管理面对的诸多矛盾,从完善现有护理队伍多元结构、分类分层次培训使用护理人才、依据患者需求明确岗位职责和内涵、培养具备科学管理能力的护理管理队伍、构建健康和谐护理工作环境保护护理人才等方面着手,构建多维护理管理模式.结果:护患满意度明显提升,护理人才队伍稳定,极大规避了人才浪费和人力不足,同时也保障了护理安全和质量.结论:护理管理层秉承科学管理理念、不断完善科学规范管理模式,立足实际,创新配置挖掘护理人力资源,充分发挥护理人力资源的最大效能,是提升护理质量和护理服务的根本保证.     

提升专科护士认证班科研能力的方法与效果

目的探讨提升专科护士认证班科研能力的方法与效果。方法对认证班的课程、师资进行设置并加入考评与课外辅导。结果初步取得了提升学员的动手写作能力，增强了对专科护理的认识，突显了专科的特色，提高了答辩通过率的成效。结论通过专科护士认证班的课程设置、师资配置、课外辅导等提升了学员的科研能力。     

对年轻护士的培训及效果评价

21世纪医疗市场的竞争归根结底是人才的竞争，因而，培养建设一支综合素质较高的护理人才队伍，对医疗护理事业的发展至关重要。为此，我院针对年轻护士的特点及存在的问题开展了强化培训。现将培训方法与效果评价报告如下。     

县级医院骨干护士培训的实践与思考

加强县级医院骨干护士培训，可以有效改善护士队伍的人才结构，促进护理观念、知识和技能的更新，改变基层医院护理发展滞后的现状，为人民群众提供更加优质、高效的护理服务。我院从2011年开始承担县级医院骨干护士培训项目，共培养了262名县级医院骨干护士，为其提供了良好的学习平台，全面提升了学员综合素质，带动了县级医院护理服务水平的提高，为进一步加强湖南省县级医院护理能力及人才建设，起到了很好的指导、推动和示范作用。     

能级进阶护士分层培训在妇产科的应用研究

[目的]评估能级进阶护士分层培训在妇产科的应用效果。[方法]比较能级进阶护士分层培训与传统护士培训的认可度、效果和病人满意度。[结果]护士对能级进阶分层培训认可程度较高,专科理论知识、专科操作技能、护理工作质量、护理科研能力和病人满意度及护理安全明显优于传统培训模式。[结论]能级进阶模式的护士分层培训护士认可程度高,病人满意度及安全有保障,护士能力提升快,还能有效地帮助护理管理者建设人才梯队。     

现代急诊护理文化建设初探

目的 研究现代急诊护理文化建设，发展急诊护理。方法 制定急诊护士职业道德、服务要求、工作标准，实施急救绿色通道服务系列措施，按国际急救服务体系(EMSS)和模拟急救法培训急诊专科护士。结果 确立现代急诊护理理念，建立急救绿色通道、创建急诊护理服务品牌，培养一支急诊专科护士人才队伍。结论 急诊护理文化建设，提高了现代急诊护理质量与水平。     

我国护理人员配置现状及研究进展

针对国内护理人员配置现状及研究进展进行综述，为制定科学合理、人性化的配置方式提供理论依据。目前，国内护理人员普遍配置不足，结构配置不合理，对护理人员配置的相关研究比较少。提出科学合理的配置护理人员、提高其素质是护理人员管理的重要内容。各级医院应根据实际护理工作量，合理配置，科学管理，改变目前护理人员缺编现状，确保临床护理安全。     

我市城区社区护理人力资源现状调查

目的分析我市城区社区护理人力资源现状,为合理配置社区护理人力资源提出建议。方法通过问卷调查、文献研究等方法调查我市城区社区护理人员数量、质量与结构。结果护理人员年龄、学历、职称、从事社区护理工作年限普遍偏低,从业范围较窄。结论护理人员素质偏低,严重影响了社区护理职能和护理质量,提高护理人员的整体素质和调整护理队伍结构是我市城区社区卫生服务全面发展的当务之急。     

Utilization of nursing teams in the collection of blood

The practice of nursing is group oriented. This was recognized in the past, but has only recently gained full acknowledgment by nursing managment. The concept of team assignment for the nursing staff was implemented in the blood program several years ago. The problems of the professional nurse in blood banking are not the same as in an acute or an extended care facility. Team assignments can improve both the delivery of care and the efficiency of the operation in the blood program. This paper describes many of the problems incurred under the system of conventional staffing and will show how these problems can be either eliminated or modified through the use of team assignment. Two centers experienced with permanent team assignments report these conclusions.     

护理人力资源配置的现状及进展

护理人力资源的开发和利用对于护理学科的发展具有决定性的作用,分析我国护理人力资源配备的现状和造成护理人员紧缺的原因,以及由于护理人力资源配备不足带来的负面影响,以寻求缓解护理人力资源不足的举措和合理配备方法,旨在引起对护理人力资源配置的重视,使我国的护理人力资源配置更加科学、合理。     

The nursing shortage: dynamics and solutions. A supportive clinical practice model

In a large VA teaching hospital, the primary nursing care delivery model is established with an all-RN staff. Several new initiatives and incentives have been implemented to maintain nurse satisfaction during this period of nurse shortage, but the primary nurse's relationship with her or his patient is the most satisfying and rewarding opportunity in this setting. The professional profile of the nurse staff reflects high academic preparation, certification in clinical area of practice, and involvement in nursing organizations. Primary nursing is successful because of the availability of support services, which enable the nurse to remain with the patient on the nursing unit. The primary nursing care delivery model and staffing were evaluated and revised to include licensed vocational (practical) nurses as associate nurses. Nurses on staff affirm their authority and autonomy to make and carry out clinical decisions about the nursing care of their primary patients. Physicians recognize nurses as the co-primary care provider in a clinical practice atmosphere of mutual respect and collaboration. New opportunities for professional growth and self-actualization enrich the work environment.     

设立护理组长在护士层级管理中的实践与体会

目的探讨设立护理组长在临床护士层级管理工作中的实践。方法对外科病房8个病区试行设立护理组长工作岗位,实行护士长一护理组长一责任护士一助理护士层级管理模式,由护理组长或替班组长实现二级护理质控网,将护理质控前移,确保护理工作质量。结果实行护理组长后护理服务满意度97．3％,比实施前明显提高。结论护士层级管理体现以患者为中心的管理理念,充分发挥各层级护理人员的作用,有利于合理安排使用人力资源,更好实施层级管理,有利于护理人才的培养,推动护理专业发展。     

The relationship between nurse staffing and patient outcomes

OBJECTIVES: To examine the association between in-hospital mortality and four nurse staffing variables-the ratio of total nursing staff to patients, the proportion of RNs to total nursing staff, the mean years of RN experience, and the percentage of nurses with bachelor of science in nursing degrees. BACKGROUND: Studies suggest that nurse staffing changes affect patient and organizational outcomes, but the impact of nurse staffing on patient outcomes has not been studied sufficiently and the results of the previous studies are equivocal. Additionally, the studies of the relationship between nurse staffing and patient outcomes or the impact of nurse staffing on patient outcomes had not been previously examined in Thailand. METHODS: A retrospective, cross-sectional, observational research design was employed to study the research questions. Data of 2531 patients admitted to seven medical units and 10 surgical units of a 2300-bed university hospital in Thailand was used. All data of patients admitted to this hospital with four common groups of principal diagnoses (diseases of the heart, malignant neoplasms [cancer of all forms], hypertension and cerebrovascular diseases, and pneumonia and other diseases of the lung) was extracted from patient charts and discharge summaries in the calendar year 1999. Nurse staffing variables for each nursing unit in 1999 came from nursing service department databases. Multivariate logistic regression was used to determine the relationship between nurse staffing variables and in-hospital mortality. RESULTS: The findings of this study revealed that the ratio of total nurse staffing to patients was significantly related to in-hospital mortality in both partial and marginal analyses, controlling for patient characteristics. In addition, the ratio of total nursing staff to patients was found to be the best predictor of in-hospital mortality among the four nurse staffing variables, controlling for patient characteristics. The study did not find any significant relationship between in-hospital mortality and three nurse staffing variables (the proportion of RNs to total nursing staff, the mean years of RN experience, and the percentage of bachelor degree prepared nurses) probably due to the low variation of these variables across nursing units or because they may have correlated with other variables. CONCLUSIONS: The findings of this study add to our understanding of the importance of nurse staffing and its relationship to the patient outcome of hospital mortality. Further, the findings also provide information for hospital and nursing administrators to use when restructuring the clinical workforce, revising hospital policies, or making contractual decisions on behalf of nursing and public beneficiaries.     

各国护理人力资源配置政策比较研究的范围综述

目的 对国内外护理人力资源配置政策进行范围审查,为优化国内护理人力资源配置提供参考。 方法 系统检索各国政府网站、法令政策网站、国际组织网站,以及PubMed、Web of Science、中国知网、万方数据库中的相关研究。检索时限为建库至2021年9月。 结果 共纳入8个国家/地区的15篇政策文献。在配置参考指标上,中国与英国北爱尔兰均采用床护比,其他国家/地区采用护患比。在护理人员结构上主要包括注册护士和非注册护士两类,不同国家/地区的护理人员结构比例不同。3个国家/地区规定了急诊科护理人力资源配置,国内急诊科的配置按照床护比制订了通用标准,美国加州和澳大利亚维多利亚参考护患比,并根据工作区域或班次进一步细化了急诊科护理人力资源配置。5个国家/地区规定了重症监护室护理人力资源配置,配置参考依据不同,其中国内重症监护室的护患比最高。 结论 需进一步健全国内护理人力资源配置政策,丰富护理人员结构并充分发挥应用价值,继续完善急危重症科室的配置方案,推进护理人力资源配置政策的落实。     

护士职业道德建设中应加强人文关怀

护理工作贯穿于整个医疗过程中,护理质量和服务直接影响着医疗效果。本文基于人文关怀理论,分析影响护士职业认同感、归属感的原因,提出在护士职业道德建设中加强人文关怀,增强职业认同感和归属感,促进护士队伍的建设,提高护理质量。