本文關(guān)鍵詞：長春市三級甲等醫(yī)院責(zé)任護(hù)士護(hù)理服務(wù)受限影響因素及對策研究　出處：《吉林大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

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【摘要】：目的:本研究通過對長春市三級甲等醫(yī)院(以吉林大學(xué)第一、二、中日聯(lián)醫(yī)院為主)的責(zé)任護(hù)士調(diào)查研究,分析臨床責(zé)任護(hù)士護(hù)理服務(wù)受限水平及影響因素,對責(zé)任護(hù)士護(hù)理服務(wù)受限的預(yù)防策略進(jìn)行探討,為臨床管理者進(jìn)一步評估責(zé)任護(hù)士護(hù)理服務(wù)受限的水平,更好地開展優(yōu)質(zhì)護(hù)理服務(wù),提高護(hù)理服務(wù)質(zhì)量提供可參考的依據(jù)。方法:本研究采用便利抽樣的方法,于2016年6月至2016年11月抽取長春市三級甲等醫(yī)院(以吉林大學(xué)第一、二、中日聯(lián)醫(yī)院為主)的內(nèi)科、外科、婦科、兒科、ICU5個科室410名責(zé)任護(hù)士作為研究對象。問卷由一般資料調(diào)查表、護(hù)理服務(wù)受限問卷、工作環(huán)境感知量表三部分組成。采用Epidata3.1數(shù)據(jù)錄入,采用SPSS17.0數(shù)據(jù)分析,對調(diào)查數(shù)據(jù)應(yīng)用統(tǒng)計描述、t檢驗、單因素方差分析、Kruskal-Wallis H test、Bonferroni兩兩比較、Pearson相關(guān)系數(shù)法、多元線性逐步回歸分析。結(jié)果:1.責(zé)任護(hù)士護(hù)理服務(wù)受限水平的總均分為(2.16±0.60)分,得分最高的維度為文件書寫(2.22±0.69)分,其次分別為基礎(chǔ)護(hù)理維度(2.21±0.71)分,康復(fù)教育維度(2.20±0.69)分,病情觀察維度(2.17±0.74)分,人文關(guān)懷維度(2.15±0.67)分,得分最低的為安全文化維度(2.06±0.69),得分最高的條目是“您不能密切監(jiān)護(hù)神志不清患者,所以不得不對他們施以約束或應(yīng)用鎮(zhèn)靜劑”(2.36±1.03)分,得分最低的條目是“你們不會討論醫(yī)療中出現(xiàn)的錯誤,無法從中學(xué)習(xí)”(1.89±0.77)分。2.責(zé)任護(hù)士工作環(huán)境感知的總均分為(2.61±0.38)分,得分最高的維度為護(hù)理管理(2.70±0.59)分,其次分別為臨床工作制度維度(2.67±0.47)分,專業(yè)實踐維度(2.65±0.50)分,專業(yè)發(fā)展及參與決策維度(2.59±0.43)分,醫(yī)護(hù)協(xié)作維度(2.48±0.65)分,得分最低的為人力物力維度(2.33±0.68)分。3.單因素分析結(jié)果顯示,學(xué)歷、職稱、聘用方式、擔(dān)任責(zé)任護(hù)士時間、科室、每周值夜班頻率、每日上班時間、護(hù)理患者人數(shù)對責(zé)任護(hù)士護(hù)理服務(wù)受限總分具有顯著的統(tǒng)計學(xué)意義(P0.01)。4.責(zé)任護(hù)士護(hù)理服務(wù)受限總分與工作環(huán)境感知總分呈顯著負(fù)相關(guān)(r=-0.418),病情觀察維度與工作環(huán)境感知負(fù)相關(guān)最明顯(r=-0.417),基礎(chǔ)護(hù)理維度與工作環(huán)境感知相關(guān)性最低(r=-0.332)。5.多因素分析結(jié)果顯示,學(xué)歷、擔(dān)任責(zé)任護(hù)士時間、上班時長、每周值夜班頻率、人力物力、醫(yī)護(hù)協(xié)作最終進(jìn)入回歸方程,可解釋責(zé)任護(hù)士護(hù)理服務(wù)受限總分的71.4%。結(jié)論:1.長春市三級甲等醫(yī)院責(zé)任護(hù)士護(hù)理服務(wù)受限總體處于中度水平,說明降低責(zé)任護(hù)士護(hù)理服務(wù)受限水平仍有較大的空間。2.學(xué)歷、職稱、聘用方式、擔(dān)任責(zé)任護(hù)士的時間、科室、每周值夜班頻率、每日上班時長、護(hù)理患者人數(shù)是責(zé)任護(hù)士護(hù)理服務(wù)受限的影響因素。3.責(zé)任護(hù)士在工作中感知人力物力越不充足、醫(yī)護(hù)協(xié)作水平越低,其責(zé)任護(hù)士護(hù)理服務(wù)受限水平越高。4.學(xué)歷、擔(dān)任責(zé)任護(hù)士時間、上班時長、每周值夜班頻率、人力物力、醫(yī)護(hù)協(xié)作是影響責(zé)任護(hù)士護(hù)理服務(wù)受限的顯著預(yù)測因素。
[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 鹵0.60). The highest score was document writing (2.22 鹵0.69), followed by basic nursing (2.21 鹵0.71), rehabilitation education (2.20 鹵0.69). The score of observation dimension was 2.17 鹵0.74, that of humanistic care was 2.15 鹵0.67, and that of safety culture was 2.06 鹵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 鹵1.03). The item with the lowest score is "you don't talk about errors in medicine." The score of "1.89 鹵0.77). 2. The total score of perceived working environment of the responsible nurses was 2.61 鹵0.38). The highest score was 2.70 鹵0.59 in nursing management, 2.67 鹵0.47 in clinical work system, 2.65 鹵0.50 in professional practice. The scores of professional development and participation in decision-making were 2.59 鹵0.43 and 2.48 鹵0.65 respectively. The lowest score was 2.33 鹵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.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R47

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本文編號：1379251