护理管理

013494我国建立临床护理实践标准的意义/袁剑云…//中华护理杂志一2001,36(1)一5一9 通过在实践中贯彻护理程序来实现护理的专业化,同时让护士成为在人类健康服务中能够独立思考、决策和行动的专业角色,已经是世界护理发展的目标与潮流。中国护理的历史与现实,决定了必须经过以“护理临床与管理同时系统地贯彻护理程序”为基本特征的护理改革,才能实现这样的目标。该文借鉴美国的“临床护理实践标准”,认为建立中国临床护理实践标准是目前中国护理改革的一项紧迫任务。重点讨论 314了护理程序作为中国护理实践的基础,建立临床护理实践标准在…     

专家寄语

当前,我国的护理专业改革,一方面需要继续坚定不移地坚持“系统化地贯彻护理程序”;一方面需要积极地重建“护理实务标准”和新的“护士伦理守则”。     

护理教育理念

根据“理念”及护理教育“理念”：人,环境,健康,护理,护士,护理程序,教学的理论,论述了护理教育理念在现代护理教育课程设计中的指导作用;在护理教育“理念”的指导下,建立概念框架,设置课程目标,进行科目选择,确定科目目标,计划教学活动和评价,护理教育“理念 ”可以在护理教学实践中建立教师的认同感和信念,在共识的前提下更好地体现教师在护士培养中的价值和行为取向,利于克服教学中只见局部不见整体的盲目性和     

关于举办“2014中国护理管理大会——品质提升与职业发展”的通知

各省、自治区、直辖市护理质控中心，各相关医院，各护理院校：护理管理是以提高护理质量和工作效率为主要目的的活动过程，品质管理与护士职业发展是护理管理的核心。随着公立医院改革不断深化以及优质护理服务的推进，护理管理已基本实现了“转模式、重临床”的转变，优质护理服务走向常态化。然而，要持续推进护理事业的发展，我们不得不面临许多深层次的问题：如何评价优质护理服务的品质？如何通过循证去建立我国的护理专业标准？如何才能培养出符合临床需求的护理专业与管理人才？如何为护士搭建职业发展的平台？……     

护理技能考核模式创新探讨

护理程序是一种系统而科学地安排护理活动的工作方法，将护理程序真正落实到临床护理服务中，使临床护理技术以科学理论为指导，工作实现程序化、系统化、整体化，充分体现护理实践的实质，这无疑对提高临床护理质量有重要的现实意义。通过省级护理技能竞赛全过程，看到了近年来护理专业的发展和变化。首先，所有选手在技术操作中体现出较强的病人意识，能够以病人健康为中心展开服务，改变了以操作为中心的局面；第二，选手们能够按护理程序步骤为病人服务。同时也发现考核中有待改进的问题，并提出了“仿真护理考核模式”的改革新思路。     

分级护理与临床护理实践的碰撞及思考

随着历史的变迁,分级护理在临床应用出现诸多问题,导致护士依从性差,使分级护理失去临床指导意义。因此,需要医护人员认真面对和理性的思考。从目前的实际出发,建立患者分类系统、探索科学的护理分级标准、纠正护理工作认识与行为的偏差,只有从专业发展的角度审时度势,大胆的实践与改革,才有助于护理专业沿着正确的方向发展。     

中专护生骨科病房的实习目标与带教程序

为了适应护理教育改革的需要，更好地培养“实用型”中级护理人才，作者积极探索了适合骨科的新的临床带教方法：即首先根据实习目标的总体要求。确定专科实习目标体系，包括知识、技能、态度三个方面，然后根据实习目标，设计带教程序及安排带教内容；且在出科时采用综合考核方式对学生的专业理论、护理技能、护士素质进行综合评定。实践表明：明确专科实习目标，对临床带教和护生实习均起到良好的导向作用，提高了临床教学质量。同时要求护生按照护理程序对病人进行身心整体护理，不仅强化了学生整体护理的意识，而且培养与提高了护生的综合能力。     

护理教育理念

根据“理念”及护理教育“理念”：人、环境、健康、护理、护士、护理程序、教学的理论,论述了护理教育理念在现代护理教育课程设计中的指导作用;在护理教育“理念”的指导下,建立概念框架,设置课程目标,进行科目选择,确定科目目标,计划教学活动和评价;护理教育“理念”可以在护理教学实践中建立教师的认同感和信念,在共识的前提下更好地体现教师在护士培养中的价值和行为取向,利于克服教学中只见局部不见整体的盲目性和随意性,提高护理教育的整体性效益     

迎接信息时代的挑战—护理信息学的兴起与发展（续）

4护理信息学专业人才的培养与标准 虽然信息学在护理专业中是一门相当新的专业,但护理信息学高级实践护士却很快得到了承认。从1995年11月起美国护理联盟将“护理信息学”作为特定的资格认证领域[4]。     

我国临床护理现状的研究

我国1997年由卫生部向全国护理界推行实施“以病人为中心的整体护理”，临床护理工作发生了深刻的变化。同时，高等护理教育和继续教育的发展使得临床护理人员中护理专业本、专科学生比例增加，护士的综合素质也在逐步提高，为临床护理工作的开展和改革奠定了良好的基础。     

Mistrust of academic knowledge among nurses in Slovenia

DOMAJNKO B. & PAHOR M. Mistrust of academic knowledge among nurses in Slovenia. International Nursing Review 57 , 305–311 Aim: The paper discusses the negative attitudes of some nursing assistants in Slovenia towards higher nursing education and academic (theoretical and research based) knowledge. Background: The topic is discussed in the context of traditional hierarchical and patriarchal relations in the health‐care sector, professionalization of nursing and the evidence‐based debate in nursing. Methods: A secondary analysis of data gathered in 2005 was carried out. The topic of the original research was the interprofessional collaboration between medical and nursing care professionals in Slovenia. The secondary study looked closely into the relations within nursing care. Specifically it focused on the nursing assistants' perspective. Five hundred ninety‐two answer to two open‐end questions (307 from nurses and 285 from nursing assistants) and five semi‐structured interviews (with three nurses and two nursing assistants) were re‐analyzed (with the new focus), applying inductive qualitative content analysis and the pragmatic approach to interpretation. Findings: In nursing assistants' view, the difference between themselves and graduate nurses was described in terms of the distinction ‘work – non‐work’. Higher education was associated primarily with striving for higher social status. Academic knowledge was not perceived to include the right competencies for either practising or improving the quality of nursing care. Conclusions: The mistrust of the academic nurse on the part of some nursing assistants is interpreted as a barrier to full professionalization of nursing care and also interprofessional collaboration in the health‐care sector.     

居家脑卒中患者护理等级简易判定卡的研制

目的 研制居家脑卒中患者护理等级简易判定卡,为社区卫生服务中心开展对居家脑卒中患者护理等级划分及其专业化照护服务提供依据。 方法 利用前期研制的居家脑卒中患者护理分级评估指标体系,综合评估210例居家脑卒中患者,采用层次分析法和加权秩和比法探索居家脑卒中患者护理等级划分方式。 结果 加权秩和比法构建的回归方程为Y=0.807 1-0.060 8 × probit,需要进行一、二、三、四级护理的居家脑卒中患者的例数分别为66例、31例、32例和81例,进而形成居家脑卒中患者专业医疗照护相关症状、自理能力、神经功能、社会支持与心理状态的四级型护理等级简易判定卡。 结论 居家脑卒中患者护理等级简易判定卡科学合理、操作便捷,可指导合理分配社区卫生人力资源,满足居家脑卒中患者的专业化照护需求。     

Mandatory continuing professional education: what is the prognosis?

Each year registered nurses apply for registration renewal. The Nursing and Midwifery Board of Australia stipulate all nurses and midwives are expected to take responsibility and accountability for participating in continuing professional development (CPD) as a declaration that their practice is current, safe and competent. The code of professional conduct and Australian Nursing and Midwifery Council (ANMC) competencies governing registered nurses and midwives, outline the professional and personal responsibility nurses hold in order to maintain clinical competence; which may be achieved through continuing nurse education and professional development. As the health care industry shifts focus to keep up with changes in technology, economics, demographics and culture, the nursing profession must respond accordingly.With the implementation of a national registration scheme in Australia, this paper provides a review of the literature relating to mandatory CPD and how CPD may assist nurses to respond to the changing needs of the health care system and its consumers, to ensure the best possible health outcomes. Suggestions of possible avenues of research into the concept of CPD are also offered.     

Madagascar nursing needs assessment: education and development of the profession

Purpose: To address how Madagascar is improving nursing education and the profession to strengthen their nursing workforce. Background: The sub‐Saharan Africa nursing workforce shortage is more than 600 000. Madagascar measures among affected countries. Nursing in Madagascar with reference to the Malagasy Lutheran Church Health Department (SALFA) is examined in this paper. The Malagasy Lutheran Nursing School (SEFAM) was established in 1956 to prepare nurses and midwives. The school recently relocated to better meet SALFA goals to increase nurses in the system and improve nursing education. A US nursing faculty and the SEFAM director proposed to conduct programme assessment to ensure that nursing and midwifery education meet health, social and community needs in Madagascar. Data source/methods: An in‐depth needs assessment of the school programme, facilities and resources occurred. Site visits and informal interviews were held. Field study visits to nursing schools and health‐care facilities in Kenya and Tanzania assisted the authors in learning how nursing developed in those countries. Data analysis included comparison of the authors' comprehensive notes for congruity and accuracy. Outcomes: Strategies are needed to support and maintain quality education, improve quality and quantity of nursing care services in hospitals and dispensaries, and improve conditions for nurses and other health‐care workers. Compared with Madagascar, Kenya and Tanzania have more well‐developed systems of nursing education and professional development. Limitations: There were limited written sources for some information but methods, such as verbal accounts, compensated for this limitation. Implications/conclusions: Implications include advantages, disadvantages, facilitators and barriers to nursing educational and professional development in Madagascar. Development of nursing education, regulation and the profession will continue with support from key stakeholders. Kenya and Tanzania can serve as role models for Madagascar nurses. Countries with similar nursing education and professional development issues can be informed by lessons learned in this project.     

Envisioning a National Board of Nursing Specialties: an interview with Jeanette Hartshorn

The Committee for the National Board of Nursing Specialties was recently established to explore ways of enhancing the professionalization of nursing through a unified approach to strengthening the process for certifying specialty nurses. In this interview, Jeanette Hartshorn, PhD, RN, FAAN, project director of the committee, explains the need for the proposed National Board of Nursing Specialties and the effects the board would have on nursing, certifying organizations, health care providers, and consumers.     

Introduction and development of NCP using ICNP in Pakistan

BACKGROUND: Traditionally, nursing care has been described as performing nursing tasks and often focused on nurses carrying out doctors' orders. In many countries of the world, including Pakistan, nurses do not document care in a standardized manner. Because of this limitation many health administrators, policy makers, and consumers make inadequate assumptions about nursing work, often regarding nurses as any other 'health care technician' who can be easily replaced by more economical health care workers. PURPOSE: To overcome this problem, standardized documentation is being introduced into the Aga Khan University School of Nursing and hospital, Aga Khan Health Services, Public Health School in Karachi, and government colleges of nursing, using the International Classification for Nursing Practice (ICNP). The purpose of this paper is to highlight the process of introducing and developing standardized nursing care plans (NCP) using ICNP in Pakistan. PROCESS: The process for introducing ICNP consists of four components, including administrative planning, development, teaching and training, and testing. Subsets of the ICNP for (i) maternity: antenatal, postnatal and natal care; and (ii) cardiology were developed using standardized NCPs. The subsets were developed by nurse experts and introduced at the testing sites. The testing will be conducted as a pilot project. Findings from the pilot will be used to continue and expand standardized nursing documentation using the ICNP across Pakistan. CONCLUSION: Through this project, nurses, midwives and lady health visitors (midwives, vaccinator and health educators) will test standardization of documentation and begin to evaluate efficiency and effectiveness of clinical practice.     

Nursing professionalization and welfare state policies: A critical review of structural factors influencing the development of nursing and the nursing workforce

Nursing professionalization is both ongoing and global, being significant not only for the nursing workforce but also for patients and healthcare systems. For this reason, it is important to have an in‐depth understanding of this process and the factors that could affect it. This literature review utilizes a welfare state approach to examine macrolevel structural determinants of nursing professionalization, addressing a previously identified gap in this literature, and synthesizes research on the relevance of studying nursing professionalization. The use of a welfare state framework facilitates the understanding that the wider social, economic, and political system exercises significant power over the distribution of resources in a society, providing a glimpse into the complex politics of health and health care. The findings shed light on structural factors outside of nursing, such as country‐level education, health, labor market, and gender policies that could impact the process of professionalization and thus could be utilized to strengthen nursing through facilitating increased professionalization levels. Addressing gender inequalities and other structural determinants of nursing professionalization could contribute to achieving health equity and could benefit health systems through enhanced availability, skill‐level, and sustainability of nursing human resources, improved and efficient access to care, improved patient outcomes, and cost savings.     

护理人力资源有效利用与可持续发展策略研究进展

在现代健康模式转变过程中,护理专业在造福人类健康事业中的作用也日益被人们所认识,护理照顾在很多方面已经被证实是人类健康照顾的核心.目前全球存在护理人力资源供需匹配、配置效率和资源质量严重不足,这些对护理质量产生较大影响.护理工作环境、人员的合理配置和护士的健康问题应引起起更多的关注.本文主要从护理人力资源定义,护理人力资源配置现况、存在问题,人力资源配置方法 ,护理人力资源管理等方面进行综述.     

“互联网+护理服务”平台的构建及应用研究

目的 设计开发“互联网+护理服务”平台（以下简称“平台”）,并评价其应用效果,以期为“互联网+护理服务”的开展提供借鉴。 方法 以“互联网+护理服务”试点工作方案为指导,设计开发的平台具有用户端、护士端、平台管理系统3个端口,可提供基础护理、母婴护理、专科护理3个方面共22项服务内容及30项检验服务,选择1所市级医院、5所乡镇卫生院作为合作单位试运行平台,采用焦点小组访谈法进行效果评价。 结果 截止至2020年3月,该平台共有注册护士247名、用户7 411名,完成服务1 941单,排名前3位的服务项目分别是新生儿经皮胆红素测定、更换胃管及鼻饲、普通换药。系统评价好评率及电话随访满意度均为100%,护士认为平台满足了居家患者的专业照护需求,促进了居家患者健康,提升了护士的专业价值感,但平台应用实践中存在的问题亟需解决。 结论 “互联网+护理服务”平台的运行为保障患者居家健康及提供延续性护理服务提供创新渠道,但还需进一步完善平台运行机制及服务人员配置,以保障平台的有效运行。