河北省某县级医院医护合作共同决策分级护理模式实施效果分析

摘要

目的：探讨医护合作共同决策分级护理模式的实施，分析其实施效果。方法：选取2014年11月1日－2015年4月31日河北省某县级医院胸外科全部住院患者372例，利用随机数字表，将患者随机分为试验组（186例）和对照组（186例），试验组由主管医生和责任护士合作共同决策患者的护理等级，而对照组则采用常规护理分级实施方法，比较2组患者护理级别、护理质量和满意度的差别。结果：试验组一级护理人数较对照组少（P＜0．05），差异有统计学意义；与对照组相比，试验组二级护理人数较多（P＜0．05），差异有统计学意义；2组患者三级护理的人数差异无统计学意义（P＞0．05）。试验组基础护理质量评分明显高于对照组（P＜0．05），差异有统计学意义；与对照组相比，试验组基础护理合格率和护理计划落实合格率明显升高（P＜0．05），差异有统计学意义；2组医嘱执行情况评分差异无统计学意义（P＞0．05）。在问题处理及时性、问题处理主动性、病房管理及护患沟通等项目上，试验组满意度明显高于对照组（均为P＜0．05），差异有统计学意义；2组护理操作、服务态度、隐私保护及健康教育等方面满意度差异无统计学意义（P＞0．05）。结论：医护合作共同决策分级护理模式适合临床护理的发展，能全面提高护理质量以及患者对护理工作的满意度。%Objective:To explore the practice and effect of physician -nurse collaboration grading nursing model.Methods: 372 cases of patients in the thoracic surgery from November 2014 to April 2015 were observed.Patients were randomly divided into experimental group (186 cases) and control group (186 cases) by the random number table.In the experimental group the nurses and the doctors together decided the pa-tients’ nursing grading according to patient's condition and their self-care ability.In the control group doctors consulted the patients’ nursing grading only according to patient's condition alone.Results:Number of patients with primary care in the trial group was less than that in the con-trol group (P<0.05).Number of patients with secondary care in the trial group was more than that in the control group (P<0.05).Number of patients with the three-level nursing was not statistically significantly different in the two groups (P>0.05).Based nursing quality of the trial group was significantly better than that of the control group (P<0.05).The passing rate of implementation of the care plan in the trial group was significantly higher than that in the control group (P<0.05).The qualification rate of basic nursing in the trial group was significantly greater than that in the control group (P<0.05); There was no statistical significance about orders score in the two groups (P>0.05); Satisfaction of the problems dealing with timeliness, initiative, ward management and communication between nurses and patients in the trial group was obviously higher than that of control group (P<0.05).There was no significant difference between the two groups in the aspects of nursing operation, serv-ice attitude, privacy protection and health education (P>0.05).Conclusion:Physician-nurse collaboration nursing grading model could fit the development of clinical nursing, fully improve the quality of nursing and the patients’ satisfaction.