神经内科病房实施优质护理服务管理的研究

目的探讨符合神经内科病房实际护理需求的优质护理服务的管理方案。方法 2010年6月采用自制问卷,调查神经内科病房医护人员对责任制护理相关问题的认同度,以及护士分工、排班方式、岗位职责和护士业绩考核4个方面的问题;用观察测量方法测定危重患者的护理时数;用护士自我记录确定对非危重患者的护理时数及每名护士包干患者的例数。依据护士工作能力、责任心及不依等级分工来细化护士的工作内容和职责,实行3班制并安排护理人员上早晚2班;根据每个月患者的出院数量、危重程度、护理级别、护理的质量和患者的满意度评价护士绩效。结果护士履行基础护理职责的认可率为59.3%;不认可的原因主要有:①护士数量不够来不及做基础护理;②做基础护理不收费,科室要亏本;③基础护理技术含量低,降低护士的职业形象;④基础护理可依赖家属或护士。平均每天每例重危患者平均需护理时数534.0 m in、非重危患者平均护理时数114.2 m in,每名护士包干危重患者1例,非危重患者6～8例。结论在神经内科病房实施护理包干责任制具有可行性,改变了单纯以床护比来配置护理人数的模式。实行优质护理服务需采用护理包干责任制,护理管理者要根据实际护理需求,实施适宜的管理方案。

Study on management model of high quality nursing care in neurology ward

Objective To investigate the management model of high quality nursing care that meets the actual care needs in neurology ward.Methods In June 2010,the self-designed questionnaire was used to investigate 10 doctors and 18 nurses in the neurology ward in our hospital on the primary nursing-related issues,as well as the division of labor,work schedule,job responsibilities and performance evaluation.The nursing care hours of critically ill patients were determined by observation measurement method,and the nursi...