层级责任制护理模式在儿科中的应用

目的探讨层级责任制护理模式在儿科临床工作中的应用。方法将儿科病区13名护士进行分层级管理责任于人进行管床，设立护士长一高位责任护士一初级责任护士，按岗位分管床位，全面负责患儿的病情观察、治疗、护理、病区安全及家属沟通，使患儿得到及时、最适合的治疗和护理措施。结果基础知识技能、专业技能、急救技能、综合能力、病区安全管理、护理质量、护理文书等项目，实施层级责任制后显著优先实施前（P〈0．05）。患者对护理服务满意度差异有统计学意义（P〈0．05）；护士压力感降低。结论护理人员分层级管理，充分调动护士工作积极性，加强工作责任感，护士的综合素质和护理质量得到提升，充分利用现有护理人力资源，能提高工作质量和效率，使患儿得到更好更全面的照料，患者满意度提高，进一步提高了儿科优质护理服务的内涵。

Application of nursing mode of responsibility system guided by hierarchical management in pediatrics

Objective To explore the application of nursing mode of responsibility system guided by hierarchical management in pediatrics. Methods Thirteen nurses were arranged to take care of patients under the nursing mode of responsibility system guided by hierarchical management. They were graded into one head nurse, advanced responsible nurses and primary responsible nurses, and they were assigned with different duty according to their grades. They were responsible to observe the change of the illness, treatment, nursing, safety of the wards and communication with patients＇ family members, to make sure patients can get prompt as well as suitable treatment and nursing. Results After the implement of responsibility system guided by hierarchical management, there were obvious improvements on basic knowledge, specialty skill, first aid, comprehensive ability, management of ward＇s safety nursing quality, nursing document, and so on（P〈0.05）. There was statistical significance in patients＇ satisfaction to nursing（P〈0.05）. Nurses also felt less pressure. Conclusion With the implement of responsibility system guided by hierarchical management, nurses are encouraged to work hard, work duty is strengthened, and comprehensive ability of nurses and nursing quality are enhanced. It could also make full use of current nursing resource, increase the efficiency, quality and patients＇ satisfaction. Therefore, it could provide the patients with the best nursing and care.