Abstract： Objective To investigate the effects of hierarchical management with responsibility system on nursing efficiency and nursing dispute occurrence at emergency observation ward. Methods A total of 70 patients from emergency observation ward between May 2013 to November 2013 were retrospectively selected as the control group. Since December 2013, the hierarchical management with responsibility system was performed in emergency observation ward, and another 70 patients were enrolled as the observation group between December 2013 and May 2014. The nursing quality, occurrence rate of nursing errors and nursing disputes were compared between two groups. Results The observation group had a better outcome in admission assessment accuracy, nursing measure implementation, primary care, critical care, health education, life care and nursing records accuracy compared with the control group (P＜0.05). The occurrence rate of nursing errors and nursing disputes were significant lower in the observation group than those of controls (P＜0.05). Conclusion The hierarchical management with responsibility system can improve the nursing efficiency and reduce the nursing dispute occurrence at emergency observation ward.
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