县级医院护理质量与安全管理现状分析

目的了解陕西省县级医院护理质量与安全管理现状，为进一步制定质量改进措施提供参考。方法采用整群抽样法抽取陕西省10个地市57家县级医院，通过实地查看、文档查阅、人员访谈、抽查考核等方式对护理质量与安全管理进行综合评价。应用SPSS 17.0统计软件进行数据分析。结果在调研的57家县级医院中，66.67%的医院护理人力资源配置不足，54.39%的医院无人力资源储备和弹性调配；45.61%的医院后勤保障支持不到位；61.40%的医院护士排班不合理；31.80%的医院责任护士年资低，50.66%的医院质控员质控职责分工不明晰；15.79%的医院质量标准内容不具体，28.07%的医院护理质量指标滞后；64.91%的医院高危风险预防措施落实不到位；63.16%的医院护理不良事件分析不到位；对于高警示药品管理，10.53%的医院标识不规范，40.36%的医院储存和放置未按要求区分。结论陕西省县级医院护理质量与安全管理有较大的提升空间。医院应合理配置人力资源，运用科学管理方法，以护理不良事件管理为契机，系统改进问题，保障患者安全。

Analysis on Nursing Quality and Safety Management in County Hospitals:A Cross-Sectional Study

Objective To investigate the nursing quality and safety management in county hospitals in Shaanxi province,and to provide evidence for the development ofqualityimprovement strategies.Methods 57 county hospitals located in ten cities of Shaanxi province were investigated using the cluster samplingmethod.Comprehensive evaluation of nursing quality and safetymanagementwas carried out through field investigation,document check,personnel interview,and spot examination,etc.The SPSS 17.0 software was used for data analysis.Results Among the 57 county hospitals surveyed,66.67%of hospitals nursing human resources were not configured,and 54.39%of hospitals had no human resources reserve and flexibility allocation,45.61%was not fully supported with logistics.61.40%was not reasonable on nursingwork arrangement;31.80%of hospital nurses have low years of service,and 50.66%of hospital quality controllers'responsibility for quality control is unclear.15.79%of hospital quality standards were less than the quality of hospital care,and 28.07%of the nursing quality index were poor.64.91%of the high-risk prevention measures not suitable.63.16%of hospital nursing adverse events were unreasonable analyzed.Regarding the management of high-alert drugs,10.53%of the hospital logos were not standardized,and 40.36%of the hospitals did not distinguish between storage and placement as required.Conclusion There was much room for improvement of nursing quality and safety in county-level hospitals in Shaanxi province.The hospital should properly distribute human resources to use the scientific management method to improve the problem and ensure the safety of patients.