APN排班在新生儿监护病房护士层级管理中的应用  

Application of APN schedule in nurses＇ hierarchy management in neonatal intensive care unit

作　　者：商明霞[1] 董建英[2] 雷娜[1] 程莉萍[1] 

机构地区：[1]北京军区总医院附属八一儿童医院新生儿中心,100700 [2]北京军区总医院附属八一儿童医院护理办,100700

出　　处：《中华现代护理杂志》2012年第29期3551-3554,共4页Chinese Journal of Modern Nursing

摘　　要：目的探讨在新生儿监护病房（NICU）通过APN排班实现护士层级管理的效果。方法在NICU通过实施APN排班，划分护士层级，确定层级护士岗位、能力标准和工作内容，从而实现护士的全层级管理。选择2011年5—7月实施APN排班与护士层级管理前397名患儿家属作为对照组，2011年8—11月实施APN排班与护士层级管理后382患儿家属作为观察组。比较分层管理前、后患儿家属满意度和护士满意度。结果观察组患儿家属对护理工作满意度在质量及安全（4．574-0．32）分、服务可及性（4．13±0．27）分、健康教育（4．52±0．33）分、人文关怀评价（4．67±0．45）分4个方面均高于对照组的（4．47±0．62），（3．92±0．5），（4．12±0．48），（4．56±0．48）分，两组比较，差异有统计学意义（t分别为2．830，7．033，13．5，3．29；P〈0．05）；实施APN排班实现护士层级管理后，护士对选择自己工作方式的自由度（2．83±0．39）分、护士的收入（2．664-0．49）分、发挥自己能力的机会（3．67±0．49）分、承担职责（4．10±0．71）分方面的满意度较实施前（2．35±0．87），（2．25±0．86），（3．25±0．43），（3．63±0．66）分显著提高，前后比较，差异有统计学意义（t分别为3．7237，3．2086，4．9903，2．7556；P〈0．05）。结论在NICU通过实施APN排班来实现护士的层级管理，既有利于提高患儿家属和护士的满意度，又有利于护理质量的提高。Objective To explore the effect of nurses＇ hierarchy management through APN schedule in neonatal intensive care unit （NICU）. Methods To achieve the goal of nurses＇ hierarchy management by means of APN schedule, different hierarchy nurses were classified, and correspondent post responsibility, criterion of competence and work scope were drawn up. 397 cases of children＇ s family from May to July 2011 before nurses＇ hierarchy management by APN schedule were chosen as the control group, while 382 cases of children＇ s family from August to November 2011 after nurses＇ hierarchy management by APN schedule were chosen as the observational group. And the satisfaction of both nurses and children＇ s family were compared between two groups. Results The satisfaction of children＇ s family in 4 aspects, including quality and safety, nursing availability, health education and humanity care, were higher in the observational group than in the control group [ （4.57 ±0.32） vs （4.47 ±0.62）, （4.13 ±0.27） vs （3.92 ±0.52）, （4.52 ±0.33） vs （4.12 ± 0.48）, （4.67 ± 0.45 ） vs （4.56 ± 0.48 ） ], and the differences were statistically significant （ t = 2. 830, 7. 033,13.50,3.29, respectively ;P 〈 0.05）. After nurses＇ hierarchy management by APN schedule, nurses＇ satisfaction in free choice of working style, salary, achievement of self - worth, taking responsibility were improved [ （2.35 ± 0. 87） vs （2.83 ± 0. 39）, （2.25 ± 0. 86） vs （2.66 ± 0.49）, （3.25 ± 0.43） vs （3.67 ± 0.49）, （ 3.63 ± 0.66 ） vs （4.10 ± 0.71 ） ], and the differences were statistically significant （ t = 3. 723 7, 3. 208 6,4. 990 3,2. 755 6, respectively; P 〈 0. 05 ）. Conclusions To achieve nurses＇ hierarchy management by APN schedule can enhance the satisfaction of both nurses and children＇ s family, as well as improve the nursing quality.

关 键 词：重症监护 新生儿 护士 APN排班 层级管理 

分 类 号：R47[医药卫生—护理学]