急诊科护士分层级管理对护士职业生命质量、护理质量、护理风险的影响  

Effect of nurses' hierarchical management on nurses' professional life quality, nursing quality and nursing risk in emergency department

作　　者：李晓英 安晓红 郭海燕 刘洋 张援月 杨秀兰 张慧 李颖 Li Xiaoying;An Xiaohong;Guo Haiyan;Liu Yang;Zhang Yuanyue;Yang Xiulan;Zhang Hui;Li Ying(Emergency Department of Internal Medicine,Tangshan Gongren Hospital,Hebei Province,Tangshan 063000,China;Department of Pediatrics,Tangshan Gongren Hospital,Hebei Province,Tangshan 063000,China;Department of Oncology Surgery,Tangshan Gongren Hospital,Hebei Province,Tangshan 063000,China;Nursing Department,Tangshan Gongren Hospital,Hebei Province,Tangshan 063000,China;First Department of Critical Care Medicine,Tangshan Gongren Hospital,Hebei Province,Tangshan 063000,China)

机构地区：[1]河北省唐山市工人医院急诊内科,063000 [2]河北省唐山市工人医院儿科,063000 [3]河北省唐山市工人医院肿瘤外科,063000 [4]河北省唐山市工人医院护理部,063000 [5]河北省唐山市工人医院重症医学一科,063000

出　　处：《中国实用护理杂志》2021年第33期2611-2616,共6页Chinese Journal of Practical Nursing

基　　金：河北省医学科学研究重点课题计划(20160848)。

摘　　要：目的探讨急诊科护士分层级管理对护士职业生命质量、护理质量、护理风险的影响。方法选取2018年2月至2020年5月河北省唐山市工人医院急诊科在岗的40名护士进行研究。于2018年2月至2019年2月对急诊科护士行常规管理,2019年5月至2020年5月行护士分层级管理,按照护士实践经验、学历,将其分成5个层级,分别为N0级助理护士(n=12)、N1级注册护士(n=9)、N2级责任护士(n=10)、N3级专科护士(n=5)、N4级专家层(n=4)。分别在急诊科护士分层级管理前、后利用护士职业生命质量(QNWL)量表评价护士的职业生命质量,经护理服务质量问卷评估护理质量。分析护理过程中差错发生率,用于评估护理风险。结果护士分层级管理实施前的工作环境、工作家庭平衡、社会环境、工作量评分及QNWL总分分别为(46.33±8.52)、(30.01±6.07)、(21.45±4.60)、(94.52±8.06)、(192.31±12.46)分,实施后分别为(51.29±4.75)、(34.62±4.68)、(25.89±3.58)、(109.43±6.15)、(221.23±10.03)分,实施后各评分均高于实施前(t值为3.216~11.435,P<0.05)。护士分层级管理实施前的人力资源配置、病房管理、操作规程、基础护理、护士培训、护理效率、护理记录书写、急救物品管理评分分别为(84.29±9.75)、(80.39±12.46)、(83.02±5.63)、(80.93±9.84)、(87.14±6.12)、(85.91±8.46)、(88.20±6.76)、(83.51±7.18)分,实施后分别为(92.38±4.66)、(94.67±3.89)、(91.25±6.37)、(94.78±3.56)、(95.01±3.78)、(93.81±4.11)、(95.13±3.07)、(93.57±4.62)分,实施后各评分均高于实施前(t值为4.735~8.371,P<0.001)。护士分层级管理后的护理差错发生率为4.44%(8/180),显著低于实施前的10.00%(18/180)(χ^(2)值为4.146,P<0.05)。结论急诊科护士分层级管理的应用能提高护士的职业生命质量,改善护理质量,降低护理差错发生率,值得急诊科推广应用。Objective To explore the impact of nurses'hierarchical management on nurses'professional life quality,nursing quality and nursing risk in emergency department.Methods A total of 40 nurses who were on duty in the Emergency Department of Tangshan Gongren Hospital from February 2018 to May 2020 were selected for the study.Our hospital performed routine management of emergency department nurses from February 2018 to February 2019.After a 3-month wash-out period,nurses were managed hierarchically from May 2019 to May 2020.According to the practical experience and educational background of nurses,they were divided into 5 levels,namely N0 level assistant nurse(n=12),N1 level registered nurse(n=9),N2 level responsible nurse(n=10),N3 level specialist nurse(n=5),N4 expert level(n=4).Before and after the hierarchical management of nurses in the emergency department,the Quality of Nursing Work Life(QNWL)scale was used to evaluate the nurse′s quality of life,and the nursing quality was assessed by the Nursing Service Quality Questionnaire.Analyze the incidence of errors in the nursing process to assess the nursing risk.Results The scores of work environment,work family balance,social environment,workload score and QNWL total score before the implementation of hierarchical management were 46.33±8.52,30.01±6.07,21.45±4.60,94.52±8.06,192.31±12.46,respectively.After implementation,the scores were 51.29±4.75,34.62±4.68,25.89±3.58,109.43±6.15 and 221.23±10.03,respectively.The scores after implementation were higher than those before(t value was 3.216-11.435,P<0.05).The scores of human resource allocation,ward management,operating procedures,basic nursing,nurse training,nursing efficiency,nursing record writing,and first-aid goods management were 84.29±9.75,80.39±12.46,83.02±5.63,80.93±9.84,87.14±6.12,85.91±8.46,88.20±6.76 and 83.51±7.18,respectively.After the implementation,the scores were 92.38±4.66,94.67±3.89,91.25±6.37,94.78±3.56,95.01±3.78,93.81±4.11,95.13±3.07,93.57±4.62,respectively.The scores afte

关 键 词：急诊科 护士分层级管理 职业生命质量 护理质量 护理差错 

分 类 号：R47[医药卫生—护理学]