泰安市岱岳区公立医院护士核心能力自评现状研究

发布时间：2019-05-14 12:22

【摘要】：研究背景随着医疗技术的快速发展和生活水平的提高,人民群众对医疗健康的需求日益增高,对护士的能力也提出了更高的要求,原来的功能制护理已不能满足临床需要,取而代之的是责任制护理,这就要求护士掌握多学科、多专业的知识和技能,提高自身能力和综合素质,实施以人为本的整体护理,提高临床护理质量和患者满意度。研究目的了解岱岳区公立医院注册护士核心能力现状,比较不同层级医院、不同年龄、聘用方式、工作年限、职称、学历、科室等护士核心能力的水平及特点,分析其影响因素,提出改善护士核心能力的措施和建议,为护理教学与管理提供理论依据。研究方法按照整群抽样的方法,对辖区内19家公立医院注册护士进行问卷调查,分两部分,第一部分为一般资料;第二部分为测试部分,应用刘明博士编制的《注册护士核心能力量表》(Competency Inventory for Registered Nurse,CIRN),从评判性思维/科研、临床护理、领导能力、人际关系、法律/伦理实践、专业发展、教育咨询7个维度进行核心能力调查。应用EXCEL2003录入数据,SPSS17.0统计分析软件进行分析,采用描述性统计、x2检验、t检验、线性回归等统计方法,P0.05认为有统计学意义。共发放问卷630份,收回615份,回收率97.62%,有效问卷604份,有效率95.87%。主要结果泰安市岱岳区公立医院护士核心能力平均自评得分为159.28±33.83,七个维度的得分分别是:临床护理28.71 ±6.23、领导能力26.53 ±5.93、伦理/法律实践24.42±5.25、人际关系23.45±5.19、评判性思维/科研21.95±5.18、教育/咨询17.20±4.15、专业发展17.02±4.02;各个维度转换成百分比后得分最高的是伦理/法律实践,得分最低的是评判性思维/科研。不同级别医院护士核心能力得分最高的是二级综合医院,得分最低的是二级妇幼保健院;不同科室护士核心能力得分最高的是内科,得分最低的是儿科;工作16-20年的护士得分最高,工作1-5年的护士得分最低;在编护士得分最高,其次是合同制护士,得分最低的是临时护士;不同层级、职称、年龄护士之间得分存在差异,层级、职称、年龄越高,护士核心能力得分越高。通过多元线性回归分析显示:影响护士核心能力的显著因素是单位、科室、层级、聘用方式、月均夜班数以及是否为带教老师。结论与对策建议泰安市岱岳区公立医院护士核心能力处于中等水平,评判性思维/科研维度得分较低,不同医院、年龄、工作年限、聘用方式、层级、职称、科室以及月均收入等因素影响护士核心能力得分。医院要注重在职培训,实施因人而异的培训方式,促进低能力护士尽快成长,满足临床需要。
[Abstract]:Background with the rapid development of medical technology and the improvement of living standards, the people's demand for medical health is increasing day by day, and the ability of nurses is also put forward higher requirements. The original functional nursing can no longer meet the clinical needs. Instead, responsibility nursing is required, which requires nurses to master multi-disciplinary and multi-professional knowledge and skills, improve their own ability and comprehensive quality, implement people-oriented holistic nursing, and improve clinical nursing quality and patient satisfaction. Objective to understand the present situation of the core competence of registered nurses in Daiyue District Public Hospital, and to compare the level and characteristics of the core competence of nurses in different levels of hospitals, different ages, employment methods, working years, professional titles, academic qualifications, departments and so on. This paper analyzes the influencing factors, and puts forward some measures and suggestions for improving the core competence of nurses, so as to provide theoretical basis for nursing teaching and management. Methods according to the method of cluster sampling, a questionnaire survey was conducted among the registered nurses of 19 public hospitals in the jurisdiction, which was divided into two parts. The first part was the general data. The second part is the test part, using Dr. Liu Ming's "registered nurse core competence scale" (Competency Inventory for Registered Nurse,CIRN), from critical thinking / scientific research, clinical nursing, leadership ability, interpersonal relationship, legal / ethical practice, Professional development, educational consultation seven dimensions of core competence survey. EXCEL2003 input data, SPSS17.0 statistical analysis software were used for analysis, descriptive statistics, x2 test, t test, linear regression and other statistical methods, P05 think that there is statistical significance. A total of 630 questionnaires were sent out, 615 questionnaires were recovered, the recovery rate was 97.62%, 604 valid questionnaires, the effective rate was 95.87%. Results the average self-evaluation score of core competence of nurses in Daiyue District of Tai'an City was 159.28 卤33.83. The scores of seven dimensions were as follows: clinical nursing 28.71 卤6.23, leadership 26.53 卤5.93, Ethics / legal practice 24.42 卤5.25, interpersonal relationship 23.45 卤5.19, critical thinking / scientific research 21.95 卤5.18, education / consultation 17.20 卤4.15, professional development 17.02 卤4.02; After the conversion of each dimension to percentage, the highest score is ethics / legal practice, and the lowest score is critical thinking / scientific research. The highest score of core competence of nurses in different levels of hospitals was in the secondary general hospital, and the lowest score was in the second level maternal and child health care hospital, and the highest score in the core competence of nurses in different departments was in internal medicine, and the lowest score was in pediatrics, and the score of core competence in different departments was the highest in internal medicine and the lowest in pediatrics. Nurses who worked for 16-20 years scored the highest, nurses who worked for 1-5 years scored the lowest, nurses in charge scored the highest, followed by contract nurses, and temporary nurses scored the lowest. Different levels, professional titles, age nurses have differences in scores, grade, professional title, the higher the age, the higher the core competence score of nurses. Multivariate linear regression analysis showed that the significant factors affecting the core competence of nurses were unit, department, grade, employment mode, monthly average number of night shifts and whether or not they were teaching teachers. Conclusion and countermeasures suggest that the core competence of nurses in Daiyue District of Tai'an City is in the middle level, the score of critical thinking / scientific research dimension is low, different hospitals, ages, working years, employment methods, levels, professional titles, The score of nurses' core competence was affected by department and monthly average income. Hospitals should pay attention to on-the-job training, implement training methods that vary from person to person, and promote the growth of incompetent nurses as soon as possible to meet clinical needs.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R47

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