临床护理实践中的护理文化建设研究

为探讨护理文化建设对提高护士自身素质和护理质量的作用 ,采用前后对比的方法分析比较干预前后护理文化建设对护士自我发展、护理质量、病人满意度等方面的影响。结果 :护理文化建设可有效地提高护士的自身素质 ,改善护士的职业形象 ,促进护士的自身发展 ,进一步提高护理质量和病人的满意度 ,有利于医院整体形象的改善。护理文化建设是提高护士素质的有效手段 ,对护理质量的提高和护理事业的可持续发展起到了积极的推动作用。     

护理服务文化建设在呼吸重症监护室中的实践应用

[目的]提供更优质的护理服务,提高护士的职业素质,提高病人对护士的满意度,提高护理质量。[方法]在呼吸重症监护室(ICU)进行1年的护理服务文化的建设,在实施护理服务文化建设前后调查护士的护理质量、“三基”理论及操作考试成绩,同时,比较实施前后病人对护理服务的满意度。[结果]实施护理服务文化建设后护士理论及操作考试成绩优于实施前,病人对护理满意度高于实施前。[结论]实施护理服务文化建设可提高病人对护理满意度及护士职业素质,从而提高护理质量。     

推进优质护理服务 塑造护士良好社会形象对护理质量的影响研究

目的:探讨重塑护理人员形象对护理质量的影响。方法:将3个优质护理试点病房在实施重塑护理人员形象后(2010年7～12月)的护士综合素质评价、护理质量评分和病人、医师对护理工作满意度与2010年实施前的同期进行比较,分析重塑护理人员形象对护理质量的影响。结果:实施重塑护理人员形象前后,护士综合素质评价、护理质量评分和病人、医师对护士工作满意度比较有统计学意义(P<0.05)。结论:重塑护理人员形象的实施,提高了护理质量,推动了优质护理服务进程。     

人性化护理对病人满意度的影响

[目的]探讨人性化护理服务与病人满意度之间的关系,分析影响病人满意度的原因并探讨其对策。[方法]加强本科室护士人性化服务理念的培训,对病人发放问卷调查表,将154例我科住院病人满意度进行比较。[结果]人性化护理可有效地改善护士的职业形象,提高护士的自身素质,进一步提高护理质量和病人满意度。[结论]开展以人文关怀为主的人性化护理可提高病人满意度。     

人性化护理对病人满意度的影响

[目的]探讨人性化护理服务与病人满意度之间的关系，分析影响病人满意度的原因并探讨其对策。[方法]加强本科室护士人性化服务理念的培训，对病人发放问卷调查表，将154例我科住院病人满意度进行比较。[结果]人性化护理可有效地改善护士的职业形象，提高护士的自身素质，进一步提高护理质量和病人满意度。[结论]开展以人文关怀为主的人性化护理可提高病人满意度。     

妇科肿瘤病区实施人性化护理服务的体会

目的妇科肿瘤病区实施人性化护理,提高病人满意度。方法在人性化护理服务中开展"微笑和微小"护理服务,应用护理语言、护理行为、改进环境和工作流程、以品牌服务于病人。结果科室整体护理质量、护士素质、病人满意度提高。结论妇科肿瘤病区实施人性化护理服务有利于提高专科护理质量,提升护士综合素质和病人满意度。     

住院病人满意度调查对护理管理的启示

住院病人满意度是衡量护理质量服务水平高低的一个重要因素。新病人人院接待者首先是护士，与病人接触最多的也是护士，因此，护士的素质、形象无疑会影响医疗、护理服务的质量。我院护理部对住院病人每月进行一次护理工作满意度的调查，现将2003年月-2003年12月住院病人满意度调查的方法、结果介绍如下：     

妇产科病房护理文化建设的探索与成效

目的开展护理文化建设,提高护理质量。方法提高认识,确立目标,全员培训,转变观念,实施人性化护理服务,营造温馨舒适的病房人文环境,规范护士言行,优化护理服务流程,创新护患沟通方式,拓展护理服务项目,满足病人需求,护理科研立项与人性化护理服务相结合。结果融洽了护患关系,提高了病人满意度,增强了护士团队凝聚力,提高了护理科研水平和护理质量,社会效益和经济效益同步提高。结论护理文化建设有利于提高护士综合素质、专科护理水平和护理质量。     

文化建科 提高护理服务质量

目的 开展护理服务文化建设,提高护理服务质量.方法 确立工作目标,制定服务计划,全员培训,创造医院人文环境,规范护士言行,完善规章制度,注重细节服务、延伸服务,提升护理内涵.结果 提高了病人的满意度,增加了社会效益和经济效益,减少了护理差错和投诉的发生,提高了护士的外在和内心素质,提高了护理质量.结论 护理服务文化建设有利于提高护理工作质量.     

扁平化包干护理工作模式的实践

[目的]探索以扁平化包干为特点的护理模式的实施效果.[方法]在心脏重症监护病房实行扁平化包干护理工作模式,探讨实施前后病人对包干护士及护理工作的满意度、护士自身满意度及病区护理质量的改善情况.[结果]提高了病人和护士的满意度,和谐了护理关系,同时提高了护理质量.[结论]扁平化包干护理模式的实施提高了护理质量,有利于构建高品质的服务文化.     

Putting policy into practice: pre- and posttests of implementing standardized languages for nursing documentation

Aims and objectives. To describe the change in documentation of the nursing process in all inpatient wards in a 900‐bed university hospital. Major research question was what are the differences between before and after implementation of documentation policy related to the steps of the nursing process? Background. Implementation of standardized languages has been shown to be difficult to accomplish in clinical practice. Patients are the source of data and their conditions, responses and well‐being should be reflected in the nursing record. As such, nursing documentation can create the premises for the development of new knowledge in nursing and the improvement of nursing performance and can provide data and information necessary for nursing researchers to evaluate the quality of interventions and participate in the formulation of healthcare policy. This study is part of longitudinal project to prepare nurses for electronic documentation within the interdisciplinary health record and to improve documentation of nursing using standardized languages. Design and method. A cross‐sectional study design was used: a pretest (n = 355 nursing records) for baseline status of nursing documentation, an intervention and a post‐test (n = 349 nursing records) to obtain data on nursing documentation. The year‐long intervention comprised planned work in groups, and educational and supporting efforts. Results. A statistically significant improvement was found in the use of Functional Health Patterns for documentation of nursing assessment, NANDA for nursing diagnoses and Nursing Interventions Classification for nursing interventions in documentation of daily nursing care for inpatients. Conclusion. At all organizational levels intervention aimed at putting policy regarding documentation into clinical practice considerably improved daily use of standardized nursing languages. Relevance to clinical practice. Nurses need to use standardized language to document patient care data in the electronic health record and to demonstrate contributions to nursing care.     

Structure and content in Norwegian nursing care documentation.

In 1994, the Norwegian Board of Health (NBH) published recommendations for nursing care documentation. The two-fold purpose of the present study was to see if 5 wards in 2 Norwegian hospitals fulfilled the proposed NBH recommendations and guidelines regarding documentation, and to evaluate them in terms of the proposed structure and key words of the VIPS model. Results showed that all nursing records (n = 55) had an admission assessment. A nursing care plan was present in 62% of the records. Nursing goals were lacking in the remaining 38%, diagnosis and planned interventions were absent in 18%, and 45% of the diagnoses lacked information concerning patient progress or outcome. The nursing care plans were updated in only 40% of the records and discharge notes were present in 35%, confirming that NBH recommendations were not met in this sample. The key words of the VIPS model covered all information present in the records, and high interrater reliability was obtained for the majority of key words categorized by two independent researchers. It is suggested that the VIPS model components and key words can contribute to a reliable and uniform model for nursing care documentation and enhance comprehensive and systematic documentation, which is presently lacking in Norwegian records.     

提升护理服务综合价值的研究

目的:研究护理综合价值的提升。方法:分析护理价值研究背景,阐述护理价值研究进展结果:提出护理价值研究途径。结论:有利于达成一种共识,使广大护理人员认识护理价值、研究护理价值、开发护理价值,重视护理综合价值研究和提升。 护理服务价值是护理服务劳动产品的价值和服务本身所创造的价值的总和,即使用价值与价值的统一。目前日本、美国、德国和中国都在加强护理价值研究的探索,但仍存在使用价值与价值研究分离问题。因此,我们应不断加强护理综合价值研究,以适应卫生事业改革对护理管理的挑战。本研究主要在分析国内外护理价值研究的基础上,提出综合护理价值研究途径,以达到合理评价护理价值的目的。     

Towards an aesthetics of nursing

Towards an aesthetics of nursing This paper re-appraises the work of Barbara Carper on aesthetics and the art of nursing. It identifies serious flaws in Carper's original arguments and the way in which she and subsequent authors have conflated the concepts of art and aesthetics in nursing. The paper explores a broader approach to aesthetics and proposes a way in which a theoretical approach to nursing aesthetics could be developed. The paper concludes that nursing is a fit object of aesthetic appreciation and that aesthetic quality is a necessary attribute of good nursing practice.     

Research and the configuration of nursing services

• ? This paper is concerned with the way in which nursing research has influenced changes in the organization of nursing services, particularly the shift from so-called traditional nursing to new nursing. To this end published research and professional literature are selectively reviewed.
• ? The case is made to support the view that change in nursing has been driven forward by the evangelical zeal of opinion leaders rather than evidence.
• ? It is suggested that holistic care as embodied in new nursing is no longer affordable. Market pressures have precipitated a revisiting of the task basis of nursing. An effective anchor would have been a solid body of research evidence pointing up the value new nursing may have. Regrettably not enough research was done prior to the diffusion of new nursing. What was done was not always adequate, and what was adequate was not effectively deployed by nurse leaders.
• ? Nursing is the largest workforce in the NHS and has attracted a great deal of policy interest. It is suggested that it will become increasingly important for nursing to be more strategic, and develop its own professionally driven research agenda.
• ? The future of the nursing profession is uncertain. It is clear that evidence-based practice is centre stage, and there is a need for nursing to re-negotiate its professional boundaries and to develop intellectual partnerships in order to move the knowledge base of practice forward.

     

我国护理行业的改革与发展

从我国护理行业的现状、卫生体制改革以及基本国情出发 ,着重探讨护理管理、护理教育、护理环境、护理经济与管理体系、护理立法等方面的发展途径     

Innovations in United States genetics nursing: Practice and research

Aim: Clinical and research applications from human genome discoveries are growing and creating both opportunities and challenges to the integration of genetic concepts into practice and research. Nurses have a long history of caring for individuals, families, and groups with genetic conditions. In the past two decades, a small group of nurses in the USA have used a variety of strategies to further develop the field of genetics nursing. In this paper we identify innovative approaches to identifying genetics‐related nursing roles and opportunities, as well as successful collaborative efforts beyond nursing to address the emerging health and societal challenges related to human genetics discoveries. Methods: The information presented here comes from a variety of sources where the authors or genetics nurses directly participated, including: (i) a systematic literature review of genetics nursing; (ii) a comprehensive research study of models of delivering clinical genetics services and the roles of health professionals; and (iii) participation in numerous national research, planning, programmatic, and advisory groups involved with clinical genetics‐related health services, research, education, and public policy. Results: Genetics nurses in the US have developed innovative responses to genetics‐related challenges within and beyond the profession of nursing. These include: (i) establishing an organization for nurses in genetics and gaining formal recognition of genetics as a specialty of nursing; (ii) defining the scope of genetics nursing practice and developing a new genetics nursing credential; (iii) establishing a multiprofessional genetics education coalition and defining genetic competency for health‐care practice; (iv) creating new clinical practice roles for nurses that integrate emerging genetics concepts and skills into diverse clinical practice areas; (v) expanding nursing involvement in genetics‐related research; and (vi) participation in high‐level genetics advisory groups. Conclusions: The US experience shows that nurses have made substantial progress in expanding their involvement in genetic services through visionary leadership, innovative approaches to challenges, establishing support with nurse colleagues, and engaging in multiprofessional efforts. The most important first step is developing a supportive environment for nurse advancement. In the US, the genetics nurses’ organization known as the International Society of Nurses in Genetics (ISONG) has provided this base.     

整体护理病房三级护理查房的体会

我院自1999年7月开始在整体护理模式病房中实施三级护理查房。1年多来,对800例危重病人进行了护理查房,查房的形式为责任护士每天查,主管护师或护士长每周查,副主任护师以上或科护士长每月抽查,护理部主任每季抽查。通过查房,明显提高了危重病人的护理质量,病人得到了更为优质的服务,护理服务满意率提高;对护理人员来说,提高了业务水平,锻炼了口头表达能力;对护理管理来说,及时了解护士对护理程序的应用情况,掌握危重病人的护理质量,对护理中存在的不足及时提出指导意见。     

基层医院整体护理的实施与对策

目的:总结实施整体护理的经验,提高护理质量。方法:全面综合分析实施整体护理的对策和措施。结果:经验:领导的高度重视和大力支持,是实现整体护理模式转变的坚实基础;提高人员整体素质,确保整体护理的有效开展;多做少写,以点带面,实行非模式病房开展整体护理工作;积极开展健康教育,巩固整体护理效果;实施整体护理质量管理的措施。体会:领导的重视和支持,是开展整体护理工作的根本保证;提高了社会公众对护理工作的认可程度和护士的社会地位;显示了护士的自身价值;改善了护患关系,提高了病人满意度,同时也密切了医护关系;护理队伍整体素质提高,敬业精神增强。结论:实施整体护理,促进了护理学科的发展。     

晨间护理缺陷分析及对策

目的提高晨间护理质量。方法通过向住院病人和护士发放问卷调查及每周不定期检查各病区晨间护理质量,了解晨间护理工作中存在的缺陷,提出整改的措施。结果晨间护理工作中存在的主要缺陷:51.8%的病人认为护士与病人的沟通少,进病房时未向病人问好,整理病房时未向病人解释,口腔清洁率70.3%,头发清洁率45.3%,皮肤清洁率69.5%,病房安静整洁率67.3%,床单位整洁率86.5%,病情关注情况67.9%,健康教育执行情况48.6%,协助生活不能自理的病人进食、入厕、更衣、床上排便等占75.4%,时间安排满意度75.6%,护士认为晨间护理重要的占30%,晨间护理内容知晓率占60.9%,认为工作量大来不及做的占56.7%。结论提高护士对晨间护理的认识,规范晨间护理内容和程序,加强与病人的沟通,提供符合个体化需要的晨间护理,合理安排护理人员、工作重点和时间,持续质量改进,有助于提高晨间护理质量。