夜班护理加强班工作情况的调查分析

目的:调查护理夜班加强班工作情况,以期改进工作,保证夜班护理质量。方法:应用自行设计“夜班护理加强班工作情况专项检查表”和“夜班护理加强班评价调查表”对全院40个科室(44个护理单元)夜班护理加强班工作情况进行调查。结果:夜班护理加强班的设置对病房的夜间护理质量能起到较好的作用,同时通过夜班加强班制度能间接地培养骨干护士的管理能力和业务能力,但夜班加强班制度尚需进一步完善。     

护士专职夜班岗位的设置与管理

目的:探讨护士专职夜班岗位设置与管理的实践效果及体会。方法:于2012年6月起在中南大学湘雅二医院胸外科、心脏大血管外科和骨科4个病区试点护士专职夜班岗位,比较实施前后患者对护理服务满意度、护士对工作满意度、夜班护理质量的变化。结果:实施护士专职夜班岗位后患者对护理服务满意度、护士工作满意度均明显提升(P<0.05),夜班护理质量提升。结论:建立在岗位管理基础上的护士夜班岗位管理,能够提高护理管理效能和护理服务满意度,促进责任制整体护理的深入开展。     

二级医院夜班护士睡眠质量现状与影响因素的调查分析

目的了解二级医院夜班护士的睡眠质量及影响因素,为制订管理对策提供依据。方法采用匹兹堡睡眠质量昔表对淮安市8所二级医院581名夜班护士进行调查。结果夜班护士匹兹堡睡眠质量得分高于国内正常成人（P〈0．01）;44．92％的夜班护士存在睡眠障碍;夜班护士睡眠质昔的影响因素为科室和有无二线班（P〈0．O1或P〈0．05）。结论准安市二级医院夜班护士睡眠问题比较突出,应引起社会、有关管理层及护士自身的重视,建议从社会、医院、护士自身方面采取相应的对策。     

深化护理夜班制度改革的实践与效果

目的规范护理夜班管理,为护理人员岗位绩效薪酬制度改革奠定基础。方法调整各护理单元护理人员结构,明确各护理单元在常规情况下夜班岗位数的设置,明确各级、各类护理人员每月应完成的基本夜班数要求,实施护理夜班岗位绩效奖励制度。结果护理人员特别是高年资护理人员承担夜班工作的积极性增加,聘用护士离职率降低。结论规范夜班管理及建立夜班岗位绩效奖励制度是护理夜班安排更加合理化、人性化的重要途径。     

床边综合能力考核模式在新护士夜班准入中的实践

目的:探讨两种考核模式对夜班准入新护士的影响,帮助临床寻求更好的评价模式。方法:将我院2007年7月至2011年6月采用床边综合能力考核模式前后的夜班准入护士资料进行回顾性整理分析,比较两组之间自我评价、导师评价、护士长评价、医生评价、不良事件发生率。结果:采用床边综合能力考核方式的新护士自我评价、导师评价、护士长评价、医生评价均较高,不良事件发生率较低(P<0.01)。结论:床边综合能力考核是一种能真正评价新护士实际工作能力的模式。在新护士的夜班准入系统中,应推广使用这种更为科学、有效的方法。     

Working with stories in nursing research: procedures used in narrative analysis

This paper describes the procedures undertaken in a qualitative study that used nurses' stories to examine the influence of Gestalt therapy training on the professional practice of psychiatric nurses. The paper places narrative research methodologies within a nursing context before introducing narrative inquiry, specifically narrative analysis methodology. Procedures used in the study are subsequently described in sufficient detail to serve as a guide for novice researchers interested in undertaking a narrative analysis study. An exemplar of a storied outcome is provided to evidence the product of the narrative analysis research process. The paper concludes with reflections on the importance of articulating the process of narrative analysis as a means of developing interest and competence in narrative research, and using nurses' stories as a means of exploring, understanding, and communicating nursing practice.     

Explorations of disgust: A narrative inquiry into the experiences of nurses working in palliative care

While feelings of disgust and repulsion are experienced and accepted as part of care practices of nurses who work in palliative care, they are often silenced. Working alongside two palliative care nurses in a hospice setting, we engaged in a narrative inquiry to inquire into their experiences of disgust. The study took place in a palliative care setting in a large urban city in Germany. We understand care practices as actions that follow a logic of care. According to a logic of care, actions are situated within a social context, given by specific relationships including power, and individual needs. Various aspects of disgust are visible in the experiences of the participants and highlighted in the narrative threads of disgust and silence, disgust and protection, and disgust and boundaries. Embedded in the experience of disgust of nurses working in palliative care, we see that there are borderlands of care that challenge who we are and are becoming. Opening discussion about disgust in nursing makes visible the complexity of care.     

设立儿科夜班护理二线值班对缓解一线护士压力的效果分析

目的了解设立护理二线值班对一线夜班护士压力的缓解情况。方法采用自设问卷,对64名儿科夜班护士进行调查。结果夜班中设立护理二线值班对一线夜班护士来源于环境和个人自身素质的压力起到了明显的缓解作用;对来源于患儿及护理工作本身的压力缓解作用不明显。结论夜班中设立护理二线值班能够缓解一线夜班护士在工作环境和自身素质方面的压力,该制度有一定应用推广价值。     

联合病区夜班护理二线值班制度的实施方法及体会

目的探讨联合病区夜班护理二线值班制度实施的可行性和效果。方法实施联合病区护理二线值班,将全院病区以护理内容具有的相似性和普遍性分为6个小组,在普通护理联合值班制度的基础上对参与人员、值班方法、工作职责和待遇等问题进行修改和补充。结果二线值班的工作内容集中在指导危重抢救、协助困难操作、排除急救仪器故障、分担常规工作和解决医患矛盾等方面。结论联合病区夜班护理二线值班制度整合了护理人力,实现了资源共享;保证夜间护理质量,降低护理差错发生率;锻炼了中高层护理人员队伍。     

非夜班岗位护理人员调查与人力使用对策

目的 优化护理队伍岗位设置,合理使用护理人力资源。方法 就非夜班部门护理人员的岗位调整问题向全院护理人员做调查;并采取相应对策,如职称晋升、职务聘任、奖金分配等机制来引导护理人员向临床一线夜班部门流动。结果 这一措施的实施,有效提高了护士的积极性和工作质量,满足了护理人员自身发展和医院发展的需要,从2000年开始至2003年10月已有26人顺利轮到夜班岗位。结论 调整非夜班岗位人员的结构,改变了护士老了就只能在门诊的观念;培养护士一专多能:使部分护理人员因怀孕、哺乳免夜班期间的工作得到合理的安排;克服了因无夜班影响晋升与聘用的困难;克服人力使用上的不合理性;护士流动与调整走上了制度化管理的轨道。     

A critical narrative analysis of shared decision-making in acute inpatient mental health care

Shared decision-making (SDM) is a high priority in healthcare policy and is complementary to the recovery philosophy in mental health care. This agenda has been operationalised within the Values-Based Practice (VBP) framework, which offers a theoretical and practical model to promote democratic interprofessional approaches to decision-making. However, these are limited by a lack of recognition of the implications of power implicit within the mental health system. This study considers issues of power within the context of decision-making and examines to what extent decisions about patients’ care on acute in-patient wards are perceived to be shared. Focus groups were conducted with 46 mental health professionals, service users, and carers. The data were analysed using the framework of critical narrative analysis (CNA). The findings of the study suggested each group constructed different identity positions, which placed them as inside or outside of the decision-making process. This reflected their view of themselves as best placed to influence a decision on behalf of the service user. In conclusion, the discourse of VBP and SDM needs to take account of how differentials of power and the positioning of speakers affect the context in which decisions take place.     

供给特定营养素提高夜班护士工作质量的研究

目的 改善频繁夜班对护士身心健康的影响,进一步稳定护理队伍,全面提高护理质量.方法 随机选择临床科室夜班护士60例,分为实验组、对照组各30例,实验组在夜班同定时间段内提供咖啡,对照组夜班期间则不供给;根据康奈尔医学指数(CMI)和特质应对方式问卷,结合本项目需要设计调查表进行问卷调查,并测定肾上腺皮质醇及血糖浓度.结果 实验组兴奋性增强,积极性增高,有消除困倦作用而不影响下班后睡眠,肾上腺皮质醇浓度和血糖浓度上升明显,与对照组比较差异均有统计学意义.结论 通过供给特定营养素,能人为干预、消除夜班护士困倦疲劳状态,降低护理事故发生率,提高护理质量.