分级护理在临床实施中存在问题与对策的探索性研究

目的探讨分级护理在综合医院临床实施中存在的问题,分析原因并提出建议。方法对我院内科系统、外科系统共9个病区的住院患者2812例、84名医师进行分级护理知识知晓情况调查及对138名护士对分级护理执行情况进行调查。结果医嘱护理级别在划分及实施中存在医师对分级护理知识了解片面,护士在被动执行医嘱过程中与患者实际情况不符合,医嘱护理级别与Bathel指数分级比较在医嘱为一、二级护理期间差异有统计学意义（P〈0．01）。结论分级护理的划分和实施需要全面评估患者的病情及生活处理能力,应加强对分级护理知识的培训并进一步完善其内容,使临床易于操作。

Grading nursing care in clinical research on problems and countermeasures of the implementation

Objective To explore the problems and strategies in implementation of grading nursing in general hospitals.Methods Questionnaire surveys were conducted in 84 doctors on the awareness of grading nursing and 138 nurses on the implementation of grading nursing,and comparison was made between the grading nursing under the doctor`s order and Bathel index of Systems of internal medicine,in our hospital system 2 812 patients in a total of 9 wards.Results The doc-tors` recognition of grading nursing was unclear.The grading nursing in the implementation was imcompatible with the ac-tual situation of patients.and compared with Bathel index rating in order as there are significant differences between pri-mary and secondary care(P < 0.01).Conclusion The comprehensive assessment on the patients`conditions and the ability of daily life and adjustment should be made promptly.At the same time,the training should be strengthed and the con-tents of grading nursing.