临床分级护理现状及存在问题的调查研究

目的了解住院医师对患者分级护理相关内容的掌握程度,为临床护理提供较为客观、准确的护理等级评定方法。方法对63名住院医师进行问卷调查;对188例住院患者分别按医嘱护理分级、标准护理分级及Barthel指数分级法,进行一、二、三级护理登记与评分,并进行统计学处理。结果住院医师对各护理级别的内容及要求掌握不确切;医嘱护理分级与标准护理分级、Barthel指数分级的差异具有统计学意义(P<0.01),住院医师多用惯性思维提出护理级别,影响护士规范化的护理行为。结论住院医师应加强对分级护理内容的学习,提高对分级护理等级判断的准确性;同时应补充完善标准护理分级的内容,以人为本,确定患者对护理服务的依赖程度,突出个体差异与针对性,提高护理服务的效果及满意度。

Study on the current status of nursing grade and present problems

Objectives To investigate the doctors' knowledge about the contents of different nursing grades,and to explore the objective and accurate evaluation ways of grade nursing.Methods A questionnaire survey was conducted in 63 doctors.At the same time,188 hospitalized patients were rated using the three methods respectively,which were the doctors' order,the standards of nursing grade and Barthel index,and then compare the difference of the nursing grades rated by the three methods.Results The doctors' recognition to the contents of different nursing grades were relative unclear.There were significant difference in the nursing grades rated by the doctors,standards of nursing grades and Barthel index(P<0.01).The doctors tended to rate the nursing grades by their own experience,which influenced the standardized nursing behaviors.Conclusions The doctors need to strengthen their knowledge about the contents of grade nursing and improve the rating accuracy of nursing grades.At the same time,we need to complete the contents of standards of nursing grades,so as to identify the patients' dependence on nursing service,focus on the individuality and pertinence of nursing service and to improve the effectiveness of nursing service and patients' satisfaction.