分级护理服务内容实施现况调查研究

目的调查临床实践中分级护理服务内容的执行状况,探讨分级护理制度服务内容存在的实质性问题。方法采用分层抽样的方法,将广州某三级甲等医院8个普通成人病区的患者和护士作为调查对象,采用观察法记录患者得到的分级护理服务及护士对分级护理内容的执行情况。结果 8个病区一、二级护理患者构成比具有显著性差异（P=0.000）;各病区一、二级护理患者日班所得分级护理时间平均为12.32分钟、4.81分钟,分别占总护理时间的50%和39%。各病区间执行分级护理时间无显著性差异（P=0.344）,各班次间执行分级护理时间有显著性差异（P=0.000）,其中责任班护士执行分级护理时间显著高于其他班次。临床实践中,护士对分级护理内容的执行项目：一、二、三级护理分别为21项、15项、11项。结论原分级护理制度服务内容标准已不能完全适应临床护理实践,需要顺应新的医学模式和临床护理的发展,对其进行补充和完善。

The Cross-sectional Investigation of the Service Content of Nursing Classification System in Practice

Objective To investigate the service content of nursing classification system in practice and explore the existing problem of the system.Methods With stratified sampling,patients and nurses in eight departments were chosen in a Grade Ⅲ-A General Hospital in Guangzhou as studying objects.Both the service patients got and the items nurses served related in grading nursing system were recorded.Results By Chi-square test,there were significant deviation among the 8 departments in the constituent ratio of grade I and II（P=0.000）.The average grading nursing service time during a day,which patients of grade I and II got in 8 departments,was 12.32 min and 4.81 min respectively,which accounted for 50% and 39% of total nursing time patients got in a day.There were no statistical differences in time for daytime-nurse performing for grading nursing service in the 8 departments（P=0.344）.While there was significant deviation among the time offered by different shifts of nurses（P=0.000）.With SNK for multiple comparisons,the time which the duty-shift nurse offered to patient was significantly higher than other shifts of nurses did.The related practical items nurses served for patients were 21,15 and 11 for grade Ⅰ,Ⅱ and Ⅲ.Conclusion The old service standard of grading nursing system is not practicable.So,it is necessary to supplement the service items to perfect the content standard of the system.