开展分层护理绩效评估体系的实践

目的:开展分层护理绩效评估体系,规范护理行业人员管理。方法:建立分层护理绩效系统评估,将护士长管理能力、工作质量、专业目标等进行综合绩效考核;护士采取将工作量(特别是危重患者的数量)、工作质量、风险系数与患者满意度相结合,充分体现多劳多得、优劳优酬、公平公正。与护理奖金分配、各种考评、评优挂钩,替代以单纯经济收入的原则,实现科学分配绩效。结果:调动护理人员的积极性,树立竞争意识,真正实现了护理自身的管理,优化了护理队伍建设。对护士长进行绩效管理,强化了管理责任,增强了竞争意识,稳定了护理领导队伍;对护士实行绩效同酬制管理,从而稳定了护士队伍,规范了行业管理,激励了护士工作积极性,带动了行业理性发展。     

实施聘用制护士规范化管理稳定护理队伍

[目的]探讨聘用制护士有效的管理方法,达到稳定聘用护士队伍的目的.[方法]针对我院2004年新毕业聘用护士主动离职(29.6%)的状况,依法建立劳动关系,实行目标管理、岗位绩效考评、优胜劣汰、有效的激励机制.[结果]2005年-2008年聘用制护士主动离职率明显下降.[结论]对聘用制护士依法建立劳动关系,实行目标管理、岗位绩效考评、有效的激励机制对稳定护理队伍起到了有效的作用.     

实施聘用制护士规范化管理 稳定护理队伍

[目的]探讨聘用制护士有效的管理方法,达到稳定聘用护士队伍的目的。[方法]针对我院2004年新毕业聘用护士主动离职（29．6％）的状况,依法建立劳动关系,实行目标管理、岗位绩效考评、优胜劣汰、有效的激励机制。[结果]2005年-2008年聘用制护士主动离职率明显下降。[结论]对聘用制护士依法建立劳动关系,实行目标管理、岗位绩效考评、有效的激励机制对稳定护理队伍起到了有效的作用。     

对聘用护士实施绩效评价管理的方法与效果

目的探讨对聘用护士综合素质培养的管理方法。方法对聘用护士实施绩效考评，制定绩效评价标准，加强考核力度，建立绩效奖惩制度：结果聘用护士的专业知识水平、病区护理质量、病人满意度均明显上升。结论强化绩效考核，可以提升聘用护士的综合素质。     

我科对聘用护士实施年度评价的实践与效果

目的建立科学、公平的年终考核制度，提高护士素质和护理质量。方法采取自我评价、科室评价、他人评价3方面综合考评的方法，对聘用护士实施年终考核，分为优、良、中、差4个等级。结果对聘用护士实施年度综合评价后，护理工作质量较实施前提高，差异具有统计学意义（P〈0.05）。结论3方面综合评价可以激发聘用护士的工作积极性，提高护理队伍的整体素质，提示全面、公正、公开的考评制度有利于提高护理质量。     

护理垂直管理体系下绩效考评的做法与效果

目的探索护理垂直管理体系下绩效考评的做法与效果。方法根据各岗位的技术含量、风险、责任、工作量等要素,确定护理绩效分值,实行护理单元考评和护士个人考评。根据工作效率、工作质量和工作效益的权重比例进行护理单元绩效考评;根据护士个人工作效率、工作质量、工作业绩的权重比例进行护士个人考评。结果护士对工作满意度提高（P〈0．05）;患者对护理工作的满意度提升（P〈0．01）。结论绩效考评可以充分调动护士的工作积极性,提高护理管理的效率。     

绩效考核在神经内科护理管理中的应用效果

目的:探讨实施护理人员绩效考核的方法,通过绩效考评激励机制调动护士工作主动性,提高护理质量管理效果。方法:制定适合神经内科护理人员奖金分配的考核标准,把每月奖金定为岗位奖金、职称奖金和绩效奖金。结果:实施绩效分配6个月(2011年7～12月)后,护理质量及医、护、患满意度明显提高,护理质量管理得到提升。结论:绩效管理是护理管理的发展趋势,绩效考评可以明显调动护士工作主动性,提高护理质量管理效果。但在实施时应因地适宜,并不断持续改进,才能更好地发挥其节约成本、激励先进的作用。     

绩效结合岗位层级设置管理在骨科护理管理中的应用

目的探讨绩效结合岗位层级设置管理在骨科护理管理中的实施效果。方法对护士从绩效分配结合岗位及层级系数、星级护士等级、技术职称、年资及奖惩5项内容进行综合考评,权重设置为65%、10%、10%、5%、10%,比较实施前后6个月的护理工作质量、患者及工作人员满意度情况。结果绩效结合岗位层级设置管理方案实施后,护理工作质量较实施前各指标均明显提高,差异均有统计学意义(P0.05);患者及工作人员满意度较实施前均明显提高,差异均有统计学意义(P0.05)。结论实施绩效结合岗位层级设置管理,不仅能提高护士工作积极性和主动性,还能提高护士业务素质和职业价值感,进一步保障了护理质量和安全,提高了患者满意度。     

内分泌科护士岗位管理的实践与探索

目的：探讨内分泌科护士岗位管理的效果.方法：对内分泌科全体护士进行分层管理及岗位竞聘的方法,实行按需设岗,因岗设人,定岗定责.结果：实施岗位管理后,有效地提高了护理质量,科室护士三基考核达标率、护士对职业的满意度、患者对护理工作满意度均高于实施前（P＜0.05）.结论：内分泌科实行护士岗位管理,可以提高临床护理质量,提高护士积极性及对护理工作满意度,保障患者安全,减少不良事件发生,提高患者满意率.     

360度绩效考评法在精神科星级护理服务模式中的应用

目的运用360度绩效考评法评价精神科护士的综合素质、护理质量及患者满意度情况,为进一步深化精神科星级护理和提高护理质量提供参考依据。方法制定星级护理服务模式的目标及相关考核标准,以护理部及护士长、护工、医生及护士、患者和家属、护士本人作为考评者,每季度对精神科护士的护理质量及服务质量进行综合评价。结果2007年精神科护士绩效考评总评分为（93．82±8．87）分,护理质量和服务质量分别是（46．13±3．17）分和（47．92±3．08）分。结论360度绩效考评法能从多角度反映精神科护士的综合情况,有利于精神科护士的个体职业发展和整体质量的提升。     

新入职护士规范化培训阶段工作体验质性研究的系统评价

[目的]系统评价新入职护士工作体验的质性研究,为其顺利过渡到合格临床护士提供干预依据。[方法]检索PubMed、EMbase、the Cochrane Library、JBI图书馆、知网、万方、维普数据资源系统中有关新入职护士工作体验、心理压力、情绪体验等的质性研究,检索时限从建库至2018年10月31日。将纳入文献按照澳大利亚JBI循证卫生保健中心质性研究的质量评价(2016)标准进行评价,采用汇集Meta整合的方法将研究结果进行整合。[结果]共纳入11篇质性研究文献,提取17个研究结果,归纳形成6个类别,整合形成2个结果。整合结果1:新护士规培初期角色适应不良,身心俱疲,渴望有效支持。整合结果2:规培后期新护士专业能力全面提升,职业认同感提高,逐渐适应护士角色。[结论]新护士在规范化培训阶段均经历从初期的焦虑、缺乏自信、角色适应不良到后期专业能力迅速提升,逐渐适应岗位的过程。护理管理人员应针对规培护士不同阶段出现的共性问题制定适宜的干预计划与规培方案,促进新护士到专业护士角色的顺利过渡。     

医护患对优质护理服务工作评价的调查研究

目的:了解医、护、患三者对优质护理服务工作的评价情况。方法:采用自行设计的调查问卷进行调查,了解优质护理服务试点病房的医生、护士、患者对优质护理服务相关问题的看法与评价及影响优质护理服务深入开展的因素。结果:医、护、患三者对优质护理服务的整体评价较高,对优质护理服务相关问题的看法表现在关于无陪管理、由护士承担基础生活护理等方面有所不同,对影响优质护理服务深入开展的因素评价大体一致,其中,护士认知不够,护理人力不足被认为是主要影响因素,但在收费与护士付出不符条目上,医生、护士、患者评价有统计学差异(P<0.01)。结论:优质护理服务得到绝大部分医、护、患三者的认同与肯定,但要进一步推进优质护理服务的深入开展,更好地落实优质护理服务,需要各级医疗卫生管理部门及相关部门高度关注各种影响与阻碍优质护理服务发展的因素,并采取相应的干预措施。     

Supernumerary status--an unrealised ideal

Supernumerary status, for pre-registration student nurses, should have fundamentally changed the way they learn in practice. Research suggests, however, that for many students the apprenticeship model still exists and that supernumerary status has created new challenges for learning in practice. Common themes found in the literature on supernumerary status are: confusion over the meaning of supernumerary status, the effect of supernumerary status on becoming part of the team, importance of the mentor, power relationships and operationalising supernumerary status. These themes are explored further with reference to the international literature and recommendations made as to how nurse education can respond to the challenges posed in order to ensure the quality of student learning in practice.     

Staff nurses' perceptions of supernumerary status compared with rostered service for Diploma in Nursing students

BACKGROUND/RATIONALE: In the Republic of Ireland, the amount of clinical teaching expected of staff nurses has increased substantially in the wake of the transfer of nursing education to universities, and the advent of supernumerary status for students. A modicum of previous research noted that staff nurses are unclear about their role in relation to facilitating the clinical learning of supernumerary students. AIMS OF THE PAPER: To explore staff nurses' perceptions of their role in the facilitation of learning for university-educated diploma students in the clinical area and their attitudes towards these students. DESIGN/METHODS: Sixteen staff nurses were interviewed in depth using semi-structured interviews. Data were analysed qualitatively, using content analysis, with the help of the software package NUD*IST. FINDINGS: Among the central themes to emerge, upon which this article is focused, was participants' perceptions of supernumerary status compared with rostered service for diploma students. Data suggested that the rostered status of students was generally favoured by staff nurses over and above supernumerary status because, unlike supernumerary students, rostered students did not disrupt the existing social structure within the clinical setting. Both structuration theory and role theory are drawn upon to explain the reproduction of the prevailing social structure, where the concentration is on getting through nursing work with little emphasis on the supervised learning of supernumerary students. STUDY LIMITATIONS: This study is constrained by eliciting only the views of staff nurses. Further studies are required of student nurses' experiences of rostered service and supernumerary status. CONCLUSIONS: Because staff nurses are part of the system within which they work, they need to modify their role to include active student teaching as a legitimate component of that role.     

院前急救护士心理健康状况及其影响因素的研究

[目的 ]探讨院前急救护士心理健康状况及其影响因素。 [方法 ]运用症状自评量表、社会支持评定量表、焦虑特性询问表、生活事件量表及自编的一般情况调查表对 96名院前急救护士进行问卷调查分析。 [结果 ]院前急救护士心理健康水平低于一般人群 ,其中最突出的问题是人际关系敏感、躯体化、焦虑、强迫、敌对 ;多元线性逐步回归分析结果显示 :院前急救护士自评的心理问题与焦虑特性呈正相关 ;与急救工作时间、社会支持、职业认同感呈负相关。 [结论 ]对院前急救护士的心理健康问题应予高度重视 ,针对有关因素积极采取有效的干预措施 ,以维护护士的身心健康 ,促进急救护理专业的发展。     

360度绩效考核法在护士长能力评估方面的应用

目的：针对护士长在能力及管理上存在的不足加以干预,促进临床护理管理工作的发展。方法：以360度绩效考核法基本要点为基础,结合护理管理工作特点设计考核表,选择32名评估对象进行评定。结果：4种类型的评分者所给分数有统计学差异。3项得分中业务能力和工作绩效两者间高度相关。总分与护士长的任职年数间中度相关。结论：护士长管理组可在应用360度绩效考核法全面、客观地评估护士长能力及管理工作的基础上,对问题加以干预,促进护士长个人业务发展及护理队伍整体进步。     

Issues in nurses' practical skill development in the clinical setting

Generally, it is assumed that nurses are reasonably skilled in the performance of practical nursing actions by the end of their first year of practice. This article contests this assumption based on empirical data from a longitudinal study of newly graduated nurses. Three issues are discussed: the notion that experience (per se) can guarantee a positive development in practical skill performance; the failure to relate to inherent complexities in practical skill performance during evaluation of skill; and the significance of acknowledging differences in skill complexity during skill development. A reinstated focus on practical skill in nursing education and collaboration between education and practice is needed to secure quality in a nurse's actual performance.     

Examining the process of community development

AIM OF THE STUDY: To present the results of evaluation research investigating a successful community development project. RATIONALE: Many governments, health care agencies, and organizations require community participation in health care. As a result, nurses and other health professionals are often required to practice using a philosophy of community development. Although the theoretical, philosophical, and practical components of community development are well articulated, there is little evidence that exemplifies the experience of initiating and participating in a community development project. This paper provides evidence of how one organization successfully engaged the broader community on a respite care project. METHOD: Using qualitative research methods and guided by the principles and practices of participatory action research, this evaluation engaged with the community in data collection, analysis, dissemination of finding, and in promoting effective change. RESULTS: Four themes emerged that provide insight into how one HIV/AIDS organization successfully undertook community development. These themes include: (a) identifying a community need; (b) addressing the various components identified in the community development process; (c) highlighting the strategies used to engage in successful community development; and (d) attending to factors that influence community development. CONCLUSION: The results of this research contribute to the body of knowledge related to engaging in the process of community development. By highlighting the experiences of one community group, it is hoped that nurses can learn and incorporate this knowledge into practice.