长春市三级甲等医院责任护士护理服务受限影响因素及对策研究

发布时间：2018-01-04 16:42

本文关键词：长春市三级甲等医院责任护士护理服务受限影响因素及对策研究　出处：《吉林大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本研究通过对长春市三级甲等医院(以吉林大学第一、二、中日联医院为主)的责任护士调查研究,分析临床责任护士护理服务受限水平及影响因素,对责任护士护理服务受限的预防策略进行探讨,为临床管理者进一步评估责任护士护理服务受限的水平,更好地开展优质护理服务,提高护理服务质量提供可参考的依据。方法:本研究采用便利抽样的方法,于2016年6月至2016年11月抽取长春市三级甲等医院(以吉林大学第一、二、中日联医院为主)的内科、外科、妇科、儿科、ICU5个科室410名责任护士作为研究对象。问卷由一般资料调查表、护理服务受限问卷、工作环境感知量表三部分组成。采用Epidata3.1数据录入,采用SPSS17.0数据分析,对调查数据应用统计描述、t检验、单因素方差分析、Kruskal-Wallis H test、Bonferroni两两比较、Pearson相关系数法、多元线性逐步回归分析。结果:1.责任护士护理服务受限水平的总均分为(2.16±0.60)分,得分最高的维度为文件书写(2.22±0.69)分,其次分别为基础护理维度(2.21±0.71)分,康复教育维度(2.20±0.69)分,病情观察维度(2.17±0.74)分,人文关怀维度(2.15±0.67)分,得分最低的为安全文化维度(2.06±0.69),得分最高的条目是“您不能密切监护神志不清患者,所以不得不对他们施以约束或应用镇静剂”(2.36±1.03)分,得分最低的条目是“你们不会讨论医疗中出现的错误,无法从中学习”(1.89±0.77)分。2.责任护士工作环境感知的总均分为(2.61±0.38)分,得分最高的维度为护理管理(2.70±0.59)分,其次分别为临床工作制度维度(2.67±0.47)分,专业实践维度(2.65±0.50)分,专业发展及参与决策维度(2.59±0.43)分,医护协作维度(2.48±0.65)分,得分最低的为人力物力维度(2.33±0.68)分。3.单因素分析结果显示,学历、职称、聘用方式、担任责任护士时间、科室、每周值夜班频率、每日上班时间、护理患者人数对责任护士护理服务受限总分具有显著的统计学意义(P0.01)。4.责任护士护理服务受限总分与工作环境感知总分呈显著负相关(r=-0.418),病情观察维度与工作环境感知负相关最明显(r=-0.417),基础护理维度与工作环境感知相关性最低(r=-0.332)。5.多因素分析结果显示,学历、担任责任护士时间、上班时长、每周值夜班频率、人力物力、医护协作最终进入回归方程,可解释责任护士护理服务受限总分的71.4%。结论:1.长春市三级甲等医院责任护士护理服务受限总体处于中度水平,说明降低责任护士护理服务受限水平仍有较大的空间。2.学历、职称、聘用方式、担任责任护士的时间、科室、每周值夜班频率、每日上班时长、护理患者人数是责任护士护理服务受限的影响因素。3.责任护士在工作中感知人力物力越不充足、医护协作水平越低,其责任护士护理服务受限水平越高。4.学历、担任责任护士时间、上班时长、每周值夜班频率、人力物力、医护协作是影响责任护士护理服务受限的显著预测因素。
[Abstract]:Objective: this study analyzed the limited level and influencing factors of nursing service of clinical responsible nurses through the investigation and study of the responsible nurses in Grade 3A Hospital of Changchun (the first and second hospitals of Jilin University and the hospitals of China and Japan). In order to evaluate the limited level of nursing service of responsible nurses further and carry out better quality nursing service for clinical managers the prevention strategy of nursing service limitation of responsible nurses was discussed. Methods: convenience sampling method was used to select Grade 3A Hospital of Changchun City from June 2016 to November 2016 (Jilin University first). Second, 410 nurses responsible for internal medicine, surgery, gynaecology and pediatrics in 5 departments of ICU were studied. The questionnaire was composed of general information questionnaire and limited nursing service questionnaire. The work environment perception scale was composed of three parts: Epidata3.1 data input, SPSS17.0 data analysis, statistical description t test and single factor variance analysis. Kruskal-Wallis H test Bonferroni was compared with Pearson correlation coefficient method. Multiple linear stepwise regression analysis. Results: 1. The total score of the limited level of nursing care for the responsible nurses was 2.16 卤0.60). The highest score was document writing (2.22 卤0.69), followed by basic nursing (2.21 卤0.71), rehabilitation education (2.20 卤0.69). The score of observation dimension was 2.17 卤0.74, that of humanistic care was 2.15 卤0.67, and that of safety culture was 2.06 卤0.69). The highest score item was "you can't closely monitor the mentally ill, so you have to restrain them or use sedatives" (2.36 卤1.03). The item with the lowest score is "you don't talk about errors in medicine." The score of "1.89 卤0.77). 2. The total score of perceived working environment of the responsible nurses was 2.61 卤0.38). The highest score was 2.70 卤0.59 in nursing management, 2.67 卤0.47 in clinical work system, 2.65 卤0.50 in professional practice. The scores of professional development and participation in decision-making were 2.59 卤0.43 and 2.48 卤0.65 respectively. The lowest score was 2.33 卤0.68) in the dimension of manpower and material resources. The results of univariate analysis showed that the degree, title, way of employment, time as a responsible nurse, department, weekly night shift frequency. Daily working hours. There was significant statistical significance between the number of nursing patients and the total score of nursing service limitation of responsible nurses (P < 0.01). There was a significant negative correlation between the total score of nursing service limitation and the total score of perceived working environment (P < 0.05). R-0.418). The negative correlation between observation dimension and work environment perception was the most significant (r = -0.417). The correlation between basic nursing dimension and work environment perception was the lowest. The results of multivariate analysis showed that: education, working hours, working hours, and weekly night shift frequency. Manpower and material resources, medical cooperation finally entered the regression equation. It can be explained that 71.4% of the total score of the limited nursing service of the responsible nurses. Conclusion: 1. The limitation of the nursing service of the responsible nurses in Grade 3A Hospital of Changchun City is generally at the moderate level. It shows that there is still a large space to reduce the limited level of nursing service of responsible nurses. 2. Education, professional title, employment methods, the time to be responsible nurses, the department, the weekly value of night shift frequency, the hours of daily work. The number of nursing patients is the influence factor of the limited nursing service of the responsible nurses. 3. The less adequate the perceived manpower and material resources in the work, the lower the level of medical cooperation. 3. The higher the limited level of nursing service of the responsible nurses, the higher the educational background, the working hours of the responsible nurses, the working hours, the weekly night shift frequency, the manpower and material resources. Nursing collaboration is a significant predictor of the limitation of nursing care for responsible nurses.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R47

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