昆明地区聘用制合同护士现状调查与分析

近年来,昆明地区省s市级医院以聘用制合同护士的方式补充护理人员不足,聘用制合同护士已成为护理队伍中不可缺少的重要组成部分。人数不断增多,但各项护理管理制度和措施又相对滞后,使聘用制合同护士存在很大的流     

审视聘用制护士管理现状思考未来医院护理队伍建设

随着医院聘用制护士队伍的不断壮大,聘用制护士的管理成为医院护理管理的重点和难点,也是制约医院护理工作的重要因素。为此,就如何加强聘用制护理队伍的建设做一探讨,以此引起领导层的重视并期望和广大护理管理者为进一步完善聘用护士的管理而共同努力。     

聘用制护士管理的实践与探索

随着国家劳动人事制度改革和军队卫生事业的发展，将有较多的聘用制护士进入军队医院工作，加强聘用制护士管理是军队医院亟待解决的新问题。经过多年的实践和探索，我们采取 了有效的措施，较好地提高了聘用制护士的整体素质，走上规范化管理的路子，收到了良好的社会效益和经济效益。     

军医大学附属医院低年资聘用制护士的留职意愿调查

目的：了解低年资聘用制护士留职意愿现状,并探讨其影响因素。方法采用一般资料问卷、留职意愿调查问卷,对驻沪某医院703名低年资聘用制护士进行问卷调查,对相关数据进行单因素分析及多元线性回归分析。结果低年资聘用制护士留职意愿平均得分为（3．17±0．67）分,不同年收入满意度、工作压力、周工作时数及对单位职称晋升支持、提供继续教育机会、积极办理居住证在意度不同的聘用制护士,留职意愿差异有统计学意义;其中年收入满意度、对继续教育在意度、工作压力是留职意愿的主要预测因素。结论低年资聘用制护士留职意愿处于中等水平,医院管理部门应根据影响因素,制订针对性措施,提高低年资聘用制护士的留职意愿,稳定护理队伍。     

聘用制护士压力源的影响因素分析

目的探讨聘用制护士压力源的影响因素,并提出相应的干预对策。方法选取我院78名正式在编护士及聘用制护士为研究对象,采用问卷调查法,调查两组护士的一般资料,工作满意度和工作压力源的情况。结果聘用制护士的工作满意度总体处于中等偏低水平,为3.12±0.61分。聘任制护士在专业及社会地位、工作量、工作环境和资源方面压力源方面的得分显著高于在编护士(P0.05)。结论聘用制护士的工作满意度较低,管理者应重视对聘用制护士压力应对能力的培养,并采取必要的措施满足聘用制护士的需求,提高其工作满意度。     

聘用制护士离职意愿相关因素分析

目的为了稳定医院护理工作人员,提高临床护理质量,分析探讨当前聘用制护士离职的原因以及建议与对策.方法随机选取2012年在该院工作的护理工作人员400例,其中编制护士和聘用护士各200例,通过填写问卷和谈话方式对其展开调查,调查内容包括工作时间、工作压力情况、福利待遇满意度、个人专业发展机会、今后打算等等,并将调查情况进行详细记录.结果聘用制护士工作时间、福利待遇明显低于编制护士,而工作压力却明显高于编制护士,对于今后的打算,聘用护士思考会很多,其职业规划很全面,而编制护士相对考虑得要少一些,职业规范也很局限.另外,聘用制护士个人专业发展机会明显低于对照组.结论聘用护士离职意愿相关因素主要有三方面,①由于是聘用制所以工作时间短,不像编制护士期限长;②在福利待遇方面明显低于编制护士,这对他们来说很受打击;③合同续签前他们就会考虑去留问题.为了稳定护理工作人员,提高临床护理质量,我们应在这方面加强改革.     

加强聘用制护士管理 提高护理工作质量

目前,医院为缓解护士短缺的矛盾,相继在社会上公开招聘合同护士已较为普遍。我院是安徽省最大规模的综合性医院,为解决病人就医难、住院难、手术难的矛盾,经省卫生厅批准,于1995年底在人员编制不变的情况下,自筹资金,扩大了300张病床,创建了安徽医大附院分院。分院护士大部分为聘用制护士,因此,加强对聘用制护士的管理,贯彻实施标准化程序,促进护理质量的全面提高具有重要的现实意义。以下从实践的角度谈谈我们的做法和体会。1 择优录用,严格把关 在社会上公开招聘,首先要进行严格审查和业务考核,     

湖南：以加强护理人力资源配置为突破口

开展医院管理年活动以来，湖。南省卫生厅针对临床一线护士配备严重不足、临时聘用制护士比例大、同工不同酬及聘用5～7年规定期限辞退、聘用制护士离职率高等，导致护士队伍不稳定、工作负荷过重、心理压力过大等现状，加大整改力度，以解决护理人力资源配备和改菩护士待遇问题为突破口，保证临床一线护士人力，保护护理和病人安全。     

聘用制护士组织承诺与留职意愿的相关性研究

目的：了解军医大学聘用制护士组织承诺与留职意愿的现状及两者相关性。方法采用一般资料问卷、组织承诺量表、留职意愿调查问卷,对驻沪某军医大学附属医院1392名聘用制护士进行问卷调查。结果聘用制护士留职意愿和组织承诺的平均得分分别为（3．14±0．69）分、（2．96±0．58）分;感情承诺、经济承诺、理想承诺、机会承诺、年收入满意度、工作压力、职称（P ＜0．05）是留职意愿的主要预测因素。结论军医大学附属医院人力资源管理部门应采取综合措施提高聘用制护士的组织承诺水平,以提高其留职意愿,稳定护理队伍。     

医院实行全员合同聘用制的实践与成效

实行全员合同聘用制是医院人事制度改革的趋势之一,对调动职工工作积极性、优化人员结构、争取好的社会和经济效益起着积极的作用.通过对近年来医院实行全员合同聘用制的有益探索和做法的阐述,对医院实行以全员合同聘用制为主的人事制度改革有着一定的借鉴意义.     

西藏特殊环境对护理人员队伍建设的影响及对策研究

该文通过对西藏护理人员队伍建设的现状和自然环境、经济发展、文化习俗等影响因素的分析,提出了建立符合西藏实际的护理人员引进制度与用人制度、建立护士培训机制、健全护士管理制度等对策建议,以解决西藏护理人员短缺问题,满足临床服务需求。     

依托医院信息平台开展护理人员绩效考核的做法及体会

完善绩效考核制度是公立医院改革试点的一项重要内容。依托医院信息平台,研发《护理人员管理信息系统》,能够客观、公正地评价护理人员的工作绩效,从而实现护理质量的持续改进。     

Nurse-nurse manager conflict: how do nurse managers manage it?

This study was conducted to determine the conflict management styles used by nurse managers when in conflict with nurses and to ascertain the differences between sociodemographic characteristics and the style used. The study was conducted on 71 nurse managers working in 3 different hospitals in Antalya (Turkey). A personal information form and Rahim Organizational Conflict Inventory II were used for data collection. The most commonly used style by nurse managers when in conflict was integrating, and the least commonly used was avoiding. There was no difference between the style used and the nurses' educational status, marital status, and years of employment. The obliging style was used the most by those 45 years and older and those with 20 years or more of management experience, whereas the avoiding style was used by nurse managers with 6 to 10 years of management experience. This study suggests that nurse managers who are older and have management experience need to be encouraged to use effective conflict management and that there is a need for further research of the subject of factors that affect conflict management style.     

应用Delphi法构建ICU专科护士核心能力评价指标体系

目的：依据我国ICU的现况,构建一套客观、科学的ICU专科护士核心能力评价指标体系。方法：采用Delphi对17名专家进行两轮问卷咨询。结果：建立由5个一级指标、16个二级指标、50个三级指标组成ICU专科护士核心能力评价指标体系,并计算出专家咨询的权威系数为0．85,判断系数0．82,熟悉系数0．88;一、二级指标的协调系数分别为0．342、0．586。结论：ICU专科护士核心能力评价各级指标的条目可信度高,对ICU专科护士的临床任用、考核提供借鉴。     

The effects of California minimum nurse staffing laws on nurse labor and patient mortality in skilled nursing facilities

This article investigates how a change in minimum nurse staffing regulation for California skilled nursing facilities (SNFs) affects nurse employment and how induced changes in nurse staffing affect patient mortality. In 2000, legislation increased the minimum nurse staffing standard and altered the calculation of nurse staffing, which created incentives to shift employment to lower skilled nurse labor. SNFs constrained by the new regulation increase absolute and relative hours worked by the lowest skilled type of nurse. Using this regulation change to instrument for measured nurse staffing levels, it is determined that increases in nurse staffing reduce on‐site SNF patient mortality. Copyright © 2010 John Wiley & Sons, Ltd.     

Case management: managing the nurse case manager

Nurse executives and nurse managers have become proactive in response to the health care crisis by creating and implementing innovative health care delivery models such as nursing case management. Nursing case management utilizes a nurse as case manager and the unit-based system of managed care to achieve financial and clinical outcomes for target patient groups. Nurse managers can support the nursing case management model best by practicing good managerial skills, developing a participative style of leadership, and empowering the nurse case manager.     

Career management support for nurses

The downsizing of many areas of the NHS is now affecting nurse education as it moves into the Further/Higher Education sector. Many staff are terminating their employment relationship through early retirement. Describes a career management workshop run for such staff and makes reflections on careers, especially of the objective and subjective kind.     

A human resources decision support model: nurse deployment patterns in one Canadian system

Optimal deployment of current staff--as opposed to recruitment of new staff--has been recognized as an effective strategy for dealing with nurse human resource shortages in hospitals, especially during periods of overall nursing shortages. In this article we present a model for maximizing current nursing staff resources by incorporating three dimensions of staff deployment: workforce stability, employment mix, and average paid hours. Using centralized provincial payroll data from British Columbia, we analyzed a set of three indices that measure these factors to examine patterns of nurse deployment and their impact on total nurse human resource requirements. Furthermore, by constructing hypothetical scenarios and changing the parameters according to possible situations depicted by the model, it is possible to demonstrate the impact of alternate management strategies on nurse requirements. The results emphasize the need for dealing with staff deployment in a multidimensional manner that may vary by facility type; it is not the size of the full-time nursing component alone that should be the dominant consideration for all facilities. Innovative approaches to management are called for to maximize the deployment of a limited human resource pool.     

A rural-urban comparative study of nonphysician providers in community and migrant health centers.

This is a study of the employment of nonphysician providers--nurse practitioners, physician assistants, and certified nurse midwives--in both rural and urban Community and Migrant Health Centers and of factors associated with their employment, based on a 1991 national survey of 383 Centers. Results of the survey suggest that nonphysician providers, in particular nurse practitioners and certified nurse midwives, primarily serve as physician substitutes, and are more likely to be employed by Centers that are larger and have affiliations with nonphysician provider training programs. Rural or urban location is not significantly related to the employment of nonphysician providers after controlling for center size. The fact that rural centers employ fewer nonphysician providers than urban centers can primarily be accounted for by their relatively small size, rather than a lack of interest. These findings demonstrate that the use of nonphysician providers is an important way both to achieve cost containment and improve access to primary care for those residing in medically underserved areas.     

Nurse employment contracts in Chinese hospitals: impact of inequitable benefit structures on nurse and patient satisfaction

Purpose

Ongoing economic and health system reforms in China have transformed nurse employment in Chinese hospitals. Employment of ‘bianzhi’ nurses, a type of position with state-guaranteed lifetime employment that has been customary since 1949, is decreasing while there is an increase in the contract-based nurse employment with limited job security and reduced benefits. The consequences of inequities between the two types of nurses in terms of wages and job-related benefits are unknown. This study examined current rates of contract-based nurse employment and the effects of the new nurse contract employment strategy on nurse and patient outcomes in Chinese hospitals.

Methods

This cross-sectional study used geographically representative survey data collected from 2008 to 2010 from 181 hospitals in six provinces, two municipalities, and one autonomous region in China. Logistic regression models were used to estimate the association between contract-based nurse utilization, dissatisfaction among contract-based nurses, nurse intentions to leave their positions, and patient satisfaction, controlling for nurse, patient, and hospital characteristics.

Principal Results

Hospital-level utilization of contract-based nurses varies greatly from 0 to 91%, with an average of 51%. Contract-based nurses were significantly more dissatisfied with their remuneration and benefits than ‘bianzhi’ nurses who have more job security (P <0.01). Contract-based nurses who were dissatisfied with their salary and benefits were more likely to intend to leave their current positions (P <0.01). Hospitals with high levels of dissatisfaction with salary and benefits among contract-based nurses were rated lower and less likely to be recommended by patients (P?<?0.05).

Conclusions

Our results suggest a high utilization of contract-based nurses in Chinese hospitals, and that the inequities in benefits between contract-based nurses and ‘bianzhi’ nurses may adversely affect both nurse and patient satisfaction in hospitals. Our study provides empirical support for the ‘equal pay for equal work’ policy emphasized by the China Ministry of Health’s recent regulations, and calls for efforts in Chinese hospitals to eliminate the disparities between ‘bianzhi’ and contract-based nurses.