应用Orem理论合理利用护理人力资源

目的了解护理人力资源在病人的生活照料方面的配置,探索生活照料方面人力资源的合理利用途径.方法对281名的住院病人及260名护士进行问卷调查.结果病人能自理时、能部分自理以及完全不能自理3种情况下病人与护士对病人是否需要生活照料的认识均有差异(P＜0.001).结论根据Orem理论和现有护理人员的层次,合理利用低层次护理人员,才能满足患者生活照料的护理需求.     

护士与自理病人对生活照料需求态度的调查分析

目的:比较护士与自理病人对生活照料需求的认识情况。方法:对300名能自理的住院病人及260名护士进行问卷调查。结果:当病人能自理时,他们需获得生活照料的占33.6%,而护士为54.5%,两者比较,经统计学分析,χ2=23.46,P=0.00,差异有统计学意义。结论:能自理的病人对护士向他们提供生活照料的要求不高,他们更倾向于让护士教授自己更多的自我护理技能。护士应更新护理理念,适应病人心理变化,把对病人提供生活照料转为协助他们自理,以真正地满足病人的需求。     

Orem自理模式在儿科护理人力资源分层管理中的应用

目的探索Orem自理模式在儿科护理人力资源分层管理的可行性和经验。方法通过Orem自理模式在儿科的应用分析患儿的自理需求,评估患儿的自理缺陷以选择相应的护理体系,按系统有层次的配置护理人力并建立各职能层次人员的目标管理制度。结果Orem自理模式的应用对提高患儿生活质量及建立健全人格非常重要;可以增加护患之间的沟通及提高患儿及家属对护理工作的满意度,强调了护理的专业自主性,但也对护士提出了更高的要求。结论应用Orem自理模式于儿科护理人力资源,能给患儿提供更合适的护理帮助并能分层次合理使用护理人员,充分发挥了各级护理人员的工作积极性。     

弹性排班与护理人力资源的合理利用

目的评价弹性排班在护理人力资源中的应用价值.方法随机抽取医院临床科室中实行护理弹性排班前后的病人、护理人员、医院管理人员共3组人员对护理工作的满意度调查、对比.结果实施弹性排班前、后,病人、护理人员、医院管理人员对护理工作的满意度有显著性差异(p＜0.05).结论弹性排班能体现护理人力资源的合理利用.     

Orem自理模式在儿科护理人力资源分层管理中的应用

目的 探索Orem自理模式在儿科护理人力资源分层管理的可行性和经验。方法 通过Orem自理模式在儿科的应用分析患儿的自理需求，评估患儿的自理缺陷以选择相应的护理体系，按系统有层次的配置护理人力并建立各职能层次人员的目标管理制度。结果 Orem自理模式的应用对提高患儿生活质量及建立健全人格非常重要；可以增加护患之间的沟通及提高患儿及家属对护理工作的满意度，强调了护理的专业自主性，但也对护士提出了更高的要求。结论 应用Orem自理模式于儿科护理人力资源，能给患儿提供更合适的护理帮助并能分层次合理使用护理人员，充分发挥了各级护理人员的工作积极性。     

ICU助理护士的培养与管理体会

ICU作为一个特殊的医疗环境,集中了现代化的监护和急救设备,收治的病人病情重,生活不能自理,护理操作项目繁多,监护记录细致,对护理人员素质要求较高.由于历史的原因,我国医院护理人员普遍缺编,对病人基础护理的落实难以到位.为了推动ICU护理学科的发展,加强ICU的建设,缓解护理人力资源的紧张状况,并使各层次的护理人员充分发挥职能优势,我院ICU从2002年开始设置了助理护士岗位,作为护士助手协助护士进行病情观察并为病人提供生活护理等.     

护理干预对老年痴呆病人及居家照料者的影响

[目的]探讨提高老年痴呆(AD)病人及居家照料者生活质量的有效措施。[方法]干预人员采用定期或应急的上门服务、电话指导、知识讲座、联谊会等方式,对病人及其照料者提供以咨询、诊断、治疗、护理、照料为一体为期2年的护理干预,比较干预前后AD病人的生活质量及居家照料者的焦虑或抑郁程度。[结果]指导后病人的安全问题、与照料者冲突的发生率低于指导前(P<0.05),生活自理人数明显增加(P<0.05);居家照料者的精神压力减小。[结论]针对老年AD病人及居家照料者实施护理干预,有效地提高了照料者及AD病人的生活质量,减小了照料者的精神压力。     

护理干预对老年痴呆病人及居家照料者的影响

[目的]探讨提高老年痴呆（AD）病人及居家照料者生活质量的有效措施。[方法]干预人员采用定期或应急的上门服务、电话指导、知识讲座、联谊会等方式，对病人及其照料者提供以咨询、诊断、治疗、护理、照料为一体为期2年的护理干预，比较干预前后AD病人的生活质量及居家照料者的焦虑或抑郁程度。[结果]指导后病人的安全问题、与照料者冲突的发生率低于指导前（P〈0．05），生活自理人数明显增加（P〈0．05）；居家照料者的精神压力减小。[结论]针对老年AD病人及居家照料者实施护理干预，有效地提高了照料者及AD病人的生活质量，减小了照料者的精神压力。     

护理本质的探讨

护理学本质的探讨首先应该从"护理"概念的分析开始,笔者通过对护理者、护理对象以及护理实践范畴深入考察,并对其相互关系的综合分析与概括后认为:护理源于母亲和亲属对孩子、老人和病人照料职能的缺失或不足.护理人员的角色源于承担家庭照料责任的母亲和亲属角色.护理实践专指护理人员的照料活动,护理的本质也即照料需要的本质.因依赖性需要而发生在人与人之间的帮助与被帮助的现象即称为照料,依赖性是需要依赖他人的帮助才能满足其基本的生存需要.照料的目的是维护处在依赖期的人的基本生存.护理的定义可概括为:护理人员对处在依赖状态的人的照料.     

新疆建设兵团护理人力资源现状分析及对策

目的 探讨新疆生产建设兵团护理人力资源现状,强化管理人员对人力资源的合理配置、使用和管理,保证服务质量,以适应护理事业可持续发展的需求.方法 调查、统计兵团各级医院2005年护理人员的编制、年龄、学历及职称结构等方面的现状.结果 护理人员缺编,平均医护比为1:1.20;护理人员年龄层次较理想,呈现两头小、中间大的现象;高学历、高职称护理人员偏少.结论 合理调整护理人力资源增量,科学利用存量,结合地域特点加强护理人员双语培训.     

Demands for religious care in the Taiwanese health system

In order to care ethically nurses need to care holistically; holistic care includes religious/spiritual care. This research attempted to answer the question: Do nurses have the resources to offer religious care? This article discusses only one aspect--the provision of religious care within the Taiwanese health care system. It is assumed that, if hospitals do not provide enough religious services, nurses working in these hospitals cannot be fully ethical beings or cannot respect patients' religious needs. The relevant literature was reviewed, followed by a survey study on the provision of religious facilities and services. Aspects considered are: the religions influences in and on Taiwanese society; the religious needs of patients and their families; strategies that patients use to enable them to cope with their health care problems; professional motives for attuning to patients' religious needs; and hospital provision for meeting the religious and spiritual needs of patients. A survey of nursing executives showed differences between religious service provision in hospitals with and without a hospice ward. The practical implications for hospital management and nursing practice are discussed.     

助理护士岗位设置对提高基础护理质量的作用

目的探讨助理护士岗位设置对基础护理质量的影响。方法采用问卷调查形式,对助理护士岗位设置前后的基础护理合格率、危重病人护理合格率、病人对基础护理质量的满意度进行对比。结果助理护士岗位设置后基础护理质量、危重病人护理质量、病人对基础护理质量的满意度明显提高,差异具有统计学意义(P<0.01或P<0.05)。结论助理护士岗位设置能有效地提高基础护理质量,培养护士的专业内涵,提高护士的整体素质,并达到合理利用人力资源的效果。     

护士岗位管理在护理管理中的应用

目的：探索护士岗位管理在护理垂直管理中的应用。方法结合人力资源现状及科室床位数,借助医院信息系统梳理出临床护理工作量,设定不同岗位、层级护士配置比例,采用竞聘上岗,根据个人能力确定适合岗位。结果实施后护理质量、患者满意度、护士满意度均高于实施前,差异有统计学意义( P<0.05)。结论通过实施岗位管理,为科学设置护理岗位、加强护士岗位培训、合理配置护士数量、完善绩效考核分配制度等起到了积极的作用,使得各护理单元护理工作负荷与护理人力配置相均衡,从而优化人力资源管理,提升护理管理水平,不断深化优质护理服务。     

How do intensive care nurses assess patients’ pain?

Identification and evaluation of pain in critical care patients may be difficult because of communication problems. Moreover, at present there are very few nursing studies that examine the attitudes of critical care nurses towards the assessment of patients' pain. This study was designed to determine the approach of critical care nurses towards assessing patients' pain levels, and to evaluate the problems in nursing diagnosis of those having difficulty in articulating their pain symptoms. We used a questionnaire to assess nurses attitudes to patients' pain. The study sample consisted of 91 critical care nurses who were recruited between January and February 2002. The results suggest that patient pain was considered undesirable by 44% of nurses. About 70-3% of the nurses reported resorting to administering analgesics to relieve their patients' pain. Some 57.1 % of nurses stated that they would have investigated whether the patients had really been experiencing pain, prior to administering the prescribed analgesics to patients. Some 85.7% of the sample indicated that the patients themselves would make the most accurate evaluation of their pain. The data suggested that 39.6% of nurses did not know how to evaluate pain symptoms in critical care patients suffering from complicated problems, and that 37.4% evaluated pain by monitoring the patients' behaviours. The study demonstrated that most of the critical care nurses did not know how to evaluate pain in patients having communication problems. The paper concludes by suggesting that there is a clear need to address nursing education and training with regard to evaluation and management of patients' pain whilst in critical care environment.     

Death education in baccalaureate nursing programs

These findings reveal that an emphasis on death and dying in baccalaureate nursing schools has definitely increased over the past 20 years. Ninety-five percent of the schools reported here have some emphasis on death and dying. The majority of nursing students take the death and dying offerings. Overwhelmingly, the professional background of the instructor is nursing. While only 5 percent of the schools do not offer anything in death and dying, nearly half of these plan to offer something "within the next five years." If death and dying offerings influence students' attitudes, as is suggested in research cited above, baccalaureate nursing programs in the United States apparently have taken positive steps toward helping nurses cope with dying over the past 20 years. If nurses themselves cannot deal with death, caring for a dying patient may be difficult. With continued increased emphasis on death and dying in nursing curricula, both nurses, patients, and patients' families will hopefully benefit.     

Discrepancy between patients' perspectives,staff's documentation and reflections on basic nursing care

In recent years, Denmark has witnessed an increasing written and oral debate concerning the quality of basic nursing care. The present study is an attempt to characterize basic nursing care in a Danish hospital by collecting data on patient perceptions of their main somatic problems in seven pre-set categories. These data include documentation of patient problems in corresponding problem categories, and the staff's additional knowledge about patient problems. Triangulation of methods was used. Data were collected on 120 patients and from 22 nurses. The patients had 2.3 problems on average: pain (58%) and sleep (43%) were the problems cited most frequently. Only 31% of patients' experienced problems were documented in the nursing records. The nursing staff had more knowledge than was registered in the nursing records. However, one-third of the patients' problems was totally unknown to the nursing staff. From the patients' point of view, essential aspects of basic nursing care are overlooked in daily clinical practice. The findings show that the method employed is suitable for integration of the patients' perspective.     

Nursing needs of acutely ill older people

BACKGROUND: Investigating older acutely ill hospitalized patients' nursing needs and quality of care is paramount, given the growing pressure on nurses to provide increasingly intensive levels of care to a growing older population while at the same time working with reduced staffing levels. AIMS: The aims of this study were to determine: (1) important aspects of nursing care as perceived by older patients, their family member/carer who observed care during hospitalization, and nurses; (2) satisfaction levels of patients, family/carers and nurses on nursing care received; and (3) mismatches between nursing care priorities and satisfaction with nursing care. METHODS: Two hundred and thirty-two acutely ill patients aged over 65 years, 99 carers/family members and 90 nurses completed the Caregiving Activities Survey, which measures importance of and satisfaction with various aspects of nursing care. Qualitative data, which qualified responses to survey items, were also obtained from participants. RESULTS: Patients, carers and nurses perceived that carrying out doctors' orders was the most important aspect of nursing care, followed by physical care, psychosocial care and discharge planning. Nurses and carers rated physical care, psychosocial care and discharge planning more highly than patients. Physical care was rated highly by patients in terms of importance, but rated moderately in terms of satisfaction. Carers' and patients' ratings of satisfaction with physical care were lower than nurses' ratings of opportunities to provide it. The importance of discharge planning was rated highly by nurses but all groups were only moderately satisfied with this aspect of care. STUDY LIMITATIONS: The findings do not apply to acutely ill older patients with confusion, mental illness or more than early stage dementia. CONCLUSIONS: Patients, nurses and family/carers were generally in agreement about the relative importance of particular aspects of nursing care. Nurses may need to communicate more effectively with older patients and their family carers about the particular roles they will play during the patient's hospital episode, the expectations they have of patients in the process of healing and recovery, and the reasons for the actions they take in aiding this process. The findings are useful in making nurses more aware of the expectations and needs of older hospital patients and their carers. They provide evidence for developing both new models of nursing care for this patient group, and nursing education programmes.     

Emotional support for dying patients--the nurses' perspective.

This study describes and explains the provision of emotional support to the dying patients from the nurses' viewpoint. The results are part of a questionnaire survey concerned with terminal care on inpatient wards at community health centres in Finland. The sample consisted of 328 nurses from 32 health centres. The data were collected using a structured questionnaire in which emotional support was measured by multiple-choice items and one open-ended question. The data were analysed using content analysis. Listening, touching, expressing empathy, attending to the patients' wishes, comforting, encouraging and being present were the most common forms of emotional support. The support was mainly provided in connection with basic care. Problems concerning the provision of emotional support were focused on organisational resources, nursing staff, patients and family members. The size of the health centre, further training in the care of terminal patients and reading the literature were associated with the provision of support. In conclusion, nurses feel they need time as well as sufficient skills and competencies so that they can provide emotional support to the extent and in the way that they themselves want to.     

Nursing care at night: an evaluation using the Night Nursing Care Instrument

INTRODUCTION: Night nurses carry overall nursing responsibility for approximately half the time that patients spend in hospital. However, there is a paucity of literature that focuses on nursing care provided at night. AIM: The aim of this study was to evaluate nursing care provided at night from the perspective of both nurses and patients. METHODS: The study, which had an evaluative and a comparative design, was carried out using the Night Nursing Care Instrument at a hospital in southern Sweden. Nurses (n = 178) on night duty were consecutively selected, while the patients (n = 356) were selected by convenience sampling. RESULTS: The results showed a statistically significant difference between nurses' assessments and patients' perceptions of the nursing care provided at night in nursing interventions (P < 0.0001). In the areas of medical interventions and evaluation, no statistically significant differences were found between nurses and patients. For eight of 11 items, patients reported that they were satisfied (> or =80%) with the nursing care provided at night. CONCLUSIONS: These findings suggest that night nurses need to improve their ability to assess patients' needs for nursing care at night. A first step in this direction is for them to become aware of how patients perceive night nursing. As a second step, nurses need to increase their knowledge of which nursing actions promote patients' rest at night.