上海市医疗机构改善护理服务行动计划践行现状分析  

Implementation Status of the Action Plan to Improve Nursing Services in Medical Institutions in Shanghai

作　　者：王莉[1,2] 陆梅 王静怡 孔晓倩 施雁 WANG Li;LU Mei;WANG Jingyi(Nursing Department of Shanghai Tenth People's Hospital,Shanghai,200072,China;不详)

机构地区：[1]上海市第十人民医院护理部,上海200072 [2]上海市护理质量控制中心,上海200072 [3]上海市普陀区宜川街道社区卫生服务中心,上海200065

出　　处：《中国卫生质量管理》2025年第4期3-9,14,I0003,共9页Chinese Health Quality Management

基　　金：国家自然科学基金面上项目(编号:72274136);上海市2024年度“科技创新行动计划”软科学研究项目(编号:24692110500)。

摘　　要：目的了解上海市二三级医院改善护理服务行动计划实施情况,为上海市进一步改善护理服务,提升患者就医体验提供参考。方法于2024年2月使用自行设计的问卷对上海市105所二三级医院护理部主任或护理工作主要负责人进行调查。结果在加强临床护理方面,所有医院均做到责任制整体护理全覆盖和基础护理有效落实,仅19.05%医院制订了病区护理人文关怀质量评价表。在提高护理质量方面:>90%医院开展医护联合查房、护士参与死亡病例讨论,二级医院护士参与患者术前讨论占比为74.51%,明显低于三级医院92.59%;80.95%医院开展中医护理服务技术和中医护理人才培养;护理信息化建设以护理文书系统(96.19%)、护理管理系统(87.62%)和移动PDA(80.00%)为主,三级医院建设优于二级医院。在拓展护理服务领域方面,58.10%医院开发护理随访系统,仅有10.48%医院开展“互联网+护理服务”。在医院支持力度方面:有50.98%二级医院静脉用药调配中心无下送服务;护士从事的非护理工作以申领物品(63.81%)、送取药物(40.95%)和结账(24.76%)为主;医疗护理员管理部门以第三方公司(86.67%)和护理部(57.14%)为主,>90%医院医疗护理员须持证上岗且建立了日常培训考核机制。结论上海市二三级医院在基础护理和护理质量方面总体落实情况较好,还需进一步加强护理人文关怀及中医护理人才培养;拓展护理服务领域的力度不够,应通过加强医院-社区联动、完善护理随访系统等,促进护理服务贴近社会。同时,应加强智慧护理建设,减少护士从事非护理工作,促进护理服务贴近患者、贴近临床、贴近社会。Objective To investigate the implementation status of the action plan to improve nursing services in secondary and tertiary hospitals in Shanghai,and to provide reference for further enhancing nursing services and improving patients'medical experience in Shanghai.Methods In February 2024,a self-designed questionnaire was used to survey the directors of nursing departments and the main personnel in charge of nursing work in 105 secondary and tertiary hospitals in Shanghai.Results In terms of strengthening clinical nursing,100%of the hospitals achieved full coverage of responsibility system holistic nursing and effective implementation of basic nursing.Only 19.05%of hospitals have established a ward-level nursing humanistic care quality evaluation form.Regarding the improvement of nursing quality,more than 90%of the hospitals conducted joint ward rounds by doctors and nurses,and nurses participated in discussions on fatal cases.The proportion of nurses from secondary hospitals participating in preoperative discussions with patients was 74.51%,significantly lower than that in tertiary hospitals(92.59%).Additionally,80.95%of the hospitals developed traditional Chinese medicine(TCM)nursing service techniques and cultivated TCM nursing talents.Nursing informatization construction primarily focused on nursing documentation systems(96.19%),nursing management systems(87.62%),and mobile PDA(80.00%),with tertiary hospitals outperforming secondary hospitals.In terms of expanding the scope of nursing services,58.10%of the hospitals developed nursing follow-up system,and only 10.48%of the hospitals provided"Internet+Nursing Service".Regarding hospital support,50.98%of secondary hospitals did not have a delivery service for intravenous drug dispensing centers.The non-nursing tasks performed by nurses mainly included item requisition(63.81%),medication delivery and retrieval(40.95%),and billing(24.76%).The management of nursing assistants was predominantly handled by third-party companies(86.67%)and nursing departments(57.14%).M

关 键 词：护理服务行动计划 上海市 护理人力资源 护理信息化 护理质量 

分 类 号：R47[医药卫生—护理学]