Keywords: hierarchical management mode, nursing satisfaction, nursing quality
Since 20 13, our hospital has applied hierarchical management model to clinical nursing management and achieved good results.
1 data and methods
1. 1 general information
Select 64 nursing staff in our hospital. Among them, there are 4 deputy directors, 20 supervisors, 4 nurses/kloc-0 and 26 basic nurses. The average age was (29.3 8.65438 0) years. Among them, undergraduate students 15, junior college students 32, technical secondary school 17. Using digital odd and even numbers, they were divided into control group and research group, with 32 people in each group.
1.2 nursing methods
In the control group, the routine nursing management mode was adopted, and the shift system was implemented to manage all nursing staff in a unified way. The research group adopts hierarchical management.
1.2. 1 level setting. The personal ability, professional and technical ability, work experience and education level of nursing staff were comprehensively assessed, and according to the assessment results, the hierarchical management model of junior responsible nurses, senior responsible nurses, nursing team leaders and head nurses was established [1]. The contents of division of responsibilities and cooperation were carried out for each level, and the work content, post responsibilities and workflow of nurses at different levels were constructed to achieve the purpose of continuously improving the quality of nursing.
1.2.2 hierarchical division of labor. The primary nurse in charge is mainly responsible for providing patients with comprehensive, systematic and complete nursing work from admission to discharge, including health education, rehabilitation training, psychological nursing, various nursing and treatment, illness observation, basic nursing and life nursing. Senior responsible nurses are mainly responsible for evaluating patients at different stages from admission to discharge, making corresponding nursing plans according to patients' existing or potential psychological problems or nursing feedback, and doing targeted health education, psychological nursing and basic nursing at the same time, guiding and checking the development of nursing work for junior responsible nurses; The nursing team leader mainly assists the head nurse in department management, guides senior nurses and junior nurses to deal with difficult cases, arranges and organizes nursing consultation and nursing rounds, is mainly responsible for some difficult nursing technical operations, and is also responsible for supervising and guiding senior nurses; The head nurse is mainly responsible for the nursing management of the whole department and regularly checks the development of nursing work.
1.2.3 Different work treatment and authority. To be promoted to senior responsible nurse or above, one must have rich clinical nursing experience and solid theoretical knowledge system, and be able to give full play to his professional and technical guiding role in various activities such as nursing quality control, nursing consultation and nursing rounds. We should strictly follow the principle of the unity of responsibility and rights, organically integrate the performance distribution, hierarchy and promotion of professional titles of nursing staff, and conduct performance appraisal according to each nursing staff's satisfaction with nursing services, the number of patients in charge and the quality of nursing.
1.2.4 scheduling mode. Flexible scheduling method is adopted for the scheduling of nursing staff. According to the actual situation of hospital outpatient service, effectively increase the manpower of nurses in night shift, peak period and weak period, and ensure the balance of technology, experience and manpower in each class.
1.3 evaluation criteria
The questionnaire of nurses' nursing satisfaction was made by our hospital. The main contents of the survey include patients' satisfaction with nursing service, health education, nursing defects and errors, basic nursing quality, ward management quality and overall nursing quality. The specific methods of investigation: patient evaluation, back-to-back evaluation between superiors and subordinates, and cross-anonymous evaluation among nurses. Nursing satisfaction is divided into very satisfied, satisfied and dissatisfied.
2 discussion
In the traditional nursing management mode, there is no strict division of labor according to the qualifications, professional titles and professional abilities of nurses, and nurses in each class only complete their own nursing work on duty, lacking systematic and continuous nursing services for patients; The manpower allocation of nurses in each class is unbalanced. Single shift system is adopted in night shift and middle shift, which leads to great pressure on nurses and can not effectively guarantee the quality of nursing service. After adopting the hierarchical management mode, the setting of corresponding posts matches the nurses' abilities in coordination, communication, skills, qualifications and professional titles, so that each nurse's initiative can be fully mobilized, thus effectively meeting the growing service needs of patients and doctors [2]. Under the hierarchical management mode, the corresponding functions, responsibilities and authorities are divided according to different nursing posts, which makes the responsibilities and division of labor extremely clear, thus effectively improving the cohesion of the nursing team, ensuring the standardization and standardization of all nursing work, and effectively improving the quality of nursing. By constructing the nursing quality control system of junior responsible nurse-senior responsible nurse-nursing team leader-head nurse, the relevant measures and systems can be effectively guaranteed to be implemented in actual nursing work. Through the hierarchical management mode, nurses have more time for the corresponding patients, and can further grasp the actual situation and related needs of the patients in charge, which can provide predictive nursing for patients, facilitate the early detection of disease changes and improve the connotation of nursing quality. In this group of research data, the total nursing satisfaction of the research group with hierarchical management mode reached 93.75%, which was significantly better than that of the control group with traditional management mode (78. 13%), which was consistent with the research results of related literature. To sum up, applying hierarchical management model to nursing work in primary hospitals can effectively improve nursing quality and patient satisfaction, which is worthy of clinical application.
refer to
1, Li, Zheng. Application of grouping and hierarchical management mode in nursing management of intensive care unit in our hospital [J]. Journal of TCM Management, 20 13, (10):1135-165438.
2 Zhang Wei. Application effect of hierarchical management of nurses in obstetric clinical practice [J]. China Cosmetic Medicine, 20 12, (18): 843.
Author: Lu