心血管专职护士护理缺失现状及影响因素分析  

Analysis of the current situation and influencing factors of missed nursing care of cardiovascular nurses

作　　者：韩琼 陈媛 林媛媛 范维英 HAN Qiong;CHEN Yuan;LIN Yuanyuan;FAN Weiying(Department of Nursing,Xiamen Cardiovascular Hospital Xiamen University,Fujian Province,Xiamen361006,China)

机构地区：[1]厦门大学附属心血管病医院护理部,福建厦门361006

出　　处：《中国当代医药》2023年第3期120-124,130,共6页China Modern Medicine

基　　金：国家重点研发计划项目(2019YFE0113900);福建省厦门市临床重点专科建设项目(厦卫科教〔2021〕215号);福建省厦门市医疗卫生指导性项目(3502Z20214ZD1182)。

摘　　要：目的调查心血管专职护士护理缺失现状,并分析其影响因素。方法采用便利抽样法,于2021年11月至2022年1月选取福建省9个地级市22所医院的心血管内科、外科相关科室的640名在岗护士为研究对象。采用一般资料调查表、护士版护理缺失量表对其进行调查。结果共614份有效问卷,结果显示心血管专职护士护理缺失得分为(22.46±15.83)分,其中最常缺失的前5个项目分别为全面完整地进行护理记录(64.5%)、对患者和/或家属提供情感支持(心理护理)(55.2%)、及时为患者更换床单位(53.6%)、给患者进行饮食指导(51.3%)、每2小时协助患者翻身(49.7%)。医院等级、医院类型、不同科室、长期工作、年龄、学历、职称、科室任职、加班时间、不同工龄护士的护理缺失得分比较,差异有统计学意义(P<0.05)。多元逐步回归结果显示,人力维度(B=0.587,P<0.001,95%CI:0.329~0.844)、医院等级(B=-2.221,P<0.001,95%CI:-3.378~-1.064)、职称(B=2.146,P<0.001,95%CI:1.065~3.227)、管理维度(B=0.237,P=0.011,95%CI:0.055~0.420)是护理缺失的独立影响因素,可解释22.4%的变异。结论血管专职护士存在不同程度的护理缺失,护理管理者应针对护理缺失影响因素,积极探索有效的管理措施,减少护理缺失的发生,保障患者安全。Objective To investigate the nursing deficiency of cardiovascular nurses and analyze its influencing factors.Methods Convenience sampling method was adopted to select 640 nurses from cardiovascular medicine and surgery departments in 22 hospitals in 9 prefecture-level cities in Fujian Province from November 2021 to January 2022 as research objects.General data questionnaire and nursing deficit scale were used to investigate them.Results A total of 614 valid questionnaires were collected.The results showed that the nursing deficit score of full-time cardiovascular nurses was(22.46±15.83)points.The top 5 most frequently missed items were comprehensive and complete nursing records(64.5%),emotional support for patients and/or family members(psychological care)(55.2%),timely change of bed units for patients(53.6%),dietary guidance for patients(51.3%),and assistance to turn patients every 2 hours(49.7%).There were statistically significant differences in nursing deficiency scores among nurses of hospital grade,hospital type,different departments,long-term work,age,educational background,professional title,department tenure,overtime hours and different working years(P<0.05).The results of multiple stepwise regression showed that manpower dimension(B=0.587,P<0.001,95%CI:0.329-0.844),hospital grade(B=-2.221,P<0.001,95%CI:-3.378--1.064),professional title(B=2.146,P<0.001,95%CI:1.065-3.227)and management dimension(B=0.237,P=0.011,95%CI:0.055-0.420)were independent influencing factors of care loss,which could explain 22.4%of the variation.Conclusion There are different degrees of nursing deficiencies among vascular full-time nurses.Nursing managers should actively explore effective management measures according to the influencing factors of nursing deficiencies to reduce the occurrence of nursing deficiencies and ensure the safety of patients.

关 键 词：心血管 护士 护理缺失 护理安全 

分 类 号：R192.6[医药卫生—卫生事业管理]