分级护理决策主体的研究  

Study on decision main body of grading nursing care

作　　者：韩世范[1] 王旭梅[2] 张建祺[3] 郭纯岑[4] 

机构地区：[1]山西医科大学第一医院 [2]首都医科大学附属儿童医院 [3]山西医科大学护理学院(美国马里兰州立大学巴尔摩郡分校) [4]山西医科大学护理学院(美国约翰霍浦金斯医院系统--霍华郡医院)

出　　处：《护理研究（上旬版）》2009年第1期1-7,共7页Chinese Nursing Researsh

摘　　要：[目的]确立分级护理的最佳决策主体,探讨护士可否参与分级护理的决策及参与方式,以期以分级护理决策主体作为切入点为拓宽护士发展空间提供依据。[方法]运用访谈法,了解医院医生和护士对护士是否可以参与分级护理决策及对护士有无能力决策分级护理的认同;应用自拟的"护士参与分级护理决策的认同情况调查表",了解护士对护士决策分级护理的认同及意愿情况,总结护士所认为的最佳决策主体;运用层次分析法确立分级护理的最佳决策主体。[结果]访谈结果:护士组多数护士不认同医生下达的分级护理医嘱,而医生组则认为分级护理医嘱没有疑问;护士组认为护士决策分级护理可行,而医生认为护士决策分级护理也可以,但对护士决策分级护理的能力表示质疑,大多数护士认为自身已经具备下达分级护理的能力;在参与方式上,医生和护士都认为医护合作是比较理想的决策方式。调查结果:74.3%的护士认为护士应该参与分级护理的决策,96.6%的护士认为护士参与分级护理决策的方式是与医生合作,67.5%的护士认为自身有能力决策分级护理,75.0%的护士愿意决策分级护理。层次分析结果:护士组以护士独立决策合成权重最高,医生组以医护共同决策合成权重最高,医护组以医护共同决策合成权重最高。[结论]护士应该参与分级护理的决策,且有能力决策分级护理,并有决策分级护理的意愿;现行医生决策分级护理尚不能认为是最佳决策方式,护理专家认为分级护理应由护士独立决策,医生专家认为应由医护共同决策。Objective：To establish the optimal decision main body of grading nursing care,to probe into whether nurses can participate in decision- making of grading nursing and the way for nurses to participate,so as to provide a basis for broadening the scope for development of nurses with the point of decision - making of grading nursing care. Methods： By adopting interview method to know whether doctors and nurses can participate in grading nursing decision - making, and their recognition for whether nurses have decision - making ability of grading nursing care. By applying selflaying ＂Nurses par- ticipating grading nursing decision making identification inventory＂ to know the recognition and willing of nurses toward nurse making decision on grading nursing care, and to summarize the optimal decision main body. And then by adopting analytic hierarchy process, the optimal decision making main body of grading nursing care were established. Results： Interview result：Nurses did not agree with grading nursing order ordered by doctors. However, doctors believed that the grading nursing order had no doubt. Nurses thought that nurses participating in the grading nursing decision making were feasible. All doctors thought that nurses could participate in grading nursing decision making. However,they doubted nurses＇ ability to do it. The most of nurses believed that they were qualified to participate in grading nursing decision making. In terms of participating manner, both doctors and nurses considered that nurses cooperating with doctors were the best way for nurses to participate in grading nursing decision making. Investigation result： 74. 3% of nurses thought that nurses should participate in grading nursing decision making. 96.6 % of nurses thought that nurses should cooperate with doctors to make grading nursing decision. 67. 5% of nurses believed that they had the ability to participate in the grading nursing decision making. And 75.0% of nurses were willing to participate in grading nursing decision m

关 键 词：分级护理 决策主体 访谈法 调查法 层次分析法 

分 类 号：R47[医药卫生—护理学]