三级医院护理垂直管理模式架构与实践策略集的构建

目的构建三级医院护理垂直管理模式架构与实践策略集,以推进护理管理改革。方法在文献系统评价和半结构式访谈的基础上拟订初稿,采用德尔菲法对来自全国16个省市三级医院的20名专家进行2轮咨询。结果2轮专家咨询的权威系数分别为0.93和0.94,肯德尔和谐系数为0.043～0.233。最终确立的三级医院护理垂直管理模式架构与实践策略集包含垂直联合扁平化的管理架构、转换型领导、标准化的护理专业实践、组织授权、创新与实践和支持系统6个维度、17个要素和60个要素特征及其实践策略。结论构建的护理垂直管理模式架构与实践策略集科学、实用、内容较全面,可为国内三级医院护理管理模式改革与实践提供依据。

Development of a vertical nursing administration model and practice strategies in tertiary hospitals

Objective To develop a vertical nursing administration model and practice strategies,so as to advance the reform of nursing management model in tertiary hospitals. Methods Based on a literature systematic review and semi-structured interviews,2 rounds of expert consultations with 20 experts in tertiary hospitals from 16 provinces and cities were conducted by Delphi method. Results The authority coefficients of 2 rounds were 0.93 and 0.94. The Kendall’s coefficients of coordination were ranged from 0.043 to 0.233. The vertical nursing administration model and practice strategies were finalized and they consisted of 6 dimensions（including vertical and flat organizational structure,transformational leadership,standardized nursing professional practice,organizational empowerment,innovation and practice,and support system）,17 elements and 60 implementing measures. Conclusion The vertical nursing administration model and practice strategies are scientific,practical and comprehensive,which could provide a guidance for nursing management reform in tertiary hospitals.