The first model of "Nurses' Professional Quality Improvement Plan";
High-quality nursing service depends on good professional quality. In the future, high-quality nursing should be promoted in both breadth and depth, and can reflect the connotation and value of nursing specialty. The quality and ability of young nurses need to be improved urgently, and the task of clinical training and teaching is very heavy. In order to promote young nurses to learn and master basic nursing theory, basic knowledge and basic skills, and effectively apply them to various clinical nursing work, this work plan is formulated.
I. Work objectives
Establish the principle of "applying what you have learned" and "integrating knowledge with practice", reform the training and assessment methods of clinical teaching rotation and "three basics", pay attention to the cultivation of thinking ability, practical ability and humanistic quality, guide young nurses to use professional knowledge to guide clinical work, strengthen the ability of disease observation, operational skills and specialist symptomatic treatment, change passive work into active work, truly solve patients' problems, be competent for clinical nursing work, and promote the in-depth and lasting quality nursing service.
Second, the scope of the object.
Scope: It is fully implemented in hospitals above the second level in the province.
Object: Newly recruited nurses in medical institutions at all levels.
Third, the main content
Standardized training
The standardized training period of new nurses is three years, which is divided into three stages: novice adaptation period (0 ~ 6 months), skill maturity period (7 ~ 18 months) and clinical rotation period (19 ~ 36 months). The following arrangements are proposed:
1, novice adaptation period (0 ~ 6 months)
1 month: pre-job training.
Fixed department after two-way selection.
The second month: take care of 6 ~ 8 people with the clinical guidance teacher.
The third month: take care of 8 ~ 12 people together with the clinical guidance teacher or 4 ~ 6 people independently under the guidance of the clinical guidance teacher.
4 ~ 6 months: take care of 6 ~ 8 people independently under the guidance of clinical tutor. Familiar with all kinds of rules and regulations, job responsibilities, workflow, master the main operating skills of basic nursing, master the thinking method of nursing procedures, and be familiar with the basic knowledge of common disease nursing, inspection, drugs and hospital infection prevention and control.
In-department examination. Evaluation forms: clinical performance evaluation and surgical evaluation.
Hospitals can also organize "personal duty qualification examination". Only those who pass the exam can enter the next stage of standardized training and work alone. Those who fail the examination can extend the training time until they pass the examination.
2. Skill maturity (7 ~ 18 months)
Fixed department.
Under the guidance of the head nurse, the responsible team leader or the clinical guidance teacher, 8 ~ 12 people were cared independently according to the patient's condition, mainly the critically ill patients. Regularly arrange new nurses to take part in the ward rounds of internal medicine, business study, reading reports and evidence-based nursing rounds of critically ill patients by department directors (mainly patients in the group). Conditional hospitals can organize outdoor development training every year.
Master the basic operation skills of specialist nursing, be familiar with the Three Basics of Practical Clinical Nursing (which should be divided into volumes), skillfully use nursing procedures to evaluate the condition, analyze nursing problems and take appropriate nursing measures.
Hospitals can choose departments with more professional technical operations or more critically ill patients as clinical training bases, assess designated clinical teaching, train basic operation of specialized nursing (general project base assessment, special project internal assessment), train critically ill patients with common diseases and frequently-occurring diseases to evaluate their condition, organize the implementation of assessment, and strengthen new nurses' thinking ability, critical care ability and communication ability.
Training base evaluation. Examination forms: bedside ward round and surgical examination.
3. Clinical rotation period (19 ~ 36 months)
Clinical rotation. The departments to be transferred are ICU and emergency department, and other departments are arranged according to the situation. The rotation time is determined by each hospital according to the actual situation.
Under the guidance of the head nurse and the responsible team leader, 8 ~ 12 people were cared independently according to the patient's condition, mainly critically ill patients. The department appointed 1 senior nurses or specialist nurses as tutors. The rotating nurse takes work notes in each diary and communicates with the tutor regularly. Tutors give comprehensive guidance to students' work and study.
Regularly arrange rotating nurses to participate in medical rounds of department directors (mainly patients in the group), professional study or participation in special popular science group activities, reading reports, evidence-based nursing rounds of critically ill patients, etc. Conditional hospitals can organize off-campus study.
Master the nursing operation skills of various specialties, master the use of various instruments and equipment, master the "three basics" of practical clinical nursing (you should know how to divide books), master the nursing routine of common diseases and frequently-occurring diseases in various specialties, skillfully use nursing procedures to evaluate the condition, analyze nursing problems and take appropriate nursing measures.
College-level assessment is the main method, supplemented by off-campus assessment. Examination forms: theoretical examination, real case analysis and operation examination.
(2) provincial sampling inspection
Since 20 12, the provincial health department has organized a sampling test for young nurses in tertiary hospitals every year, replacing the "three basics" sampling test activities for nurses in tertiary hospitals with "excellent", "qualified" and "unqualified" grades. Specific related matters are as follows:
1, sampling time
It will be arranged together with the annual "three basics" inspection activities of medical staff in tertiary hospitals in the province or the special inspection of nursing work, and the time will be notified separately.
2. Sampling object
Nurses (including contract nurses) who have obtained on-the-job professional qualifications in tertiary hospitals (including traditional Chinese medicine hospitals) and provincial government hospitals.
Nurses who have worked for 3 ~ 10 years were randomly selected from the national nurse qualification database, including 6 general hospitals and 3 specialized hospitals. The list selection was made one week in advance, and the participants could not adjust according to the situation for some reason.
3. Sampling form
Real case analysis and operation evaluation.
The Provincial Health Department entrusted the Provincial Nursing Association to enrich some clinical backbones on the basis of members of professional committees and professional study groups, and established the "Jiangsu Province Young Nurses' Professional Ability Sampling Expert Database", which was divided into several specialist groups, and determined the common and frequently-occurring diseases and operation assessment types of each specialist, and determined the grading evaluation standards and other matters. According to the number of nurses drawn from all over the country and the types of specialties involved, organize a sampling inspection expert group to the ward where the nurse is located or the rotating ward for real-life case analysis and operational assessment.
4. Examination scope
Based on the "three basics" of practical clinical nursing (Southeast University Press, 20 12 edition) and "three basics" of practical clinical nursing (operation) (Southeast University Press, 2004 edition), combined with the relevant documents and connotations of clinical nursing routine and "quality nursing service", the provincial health department organized the compilation.
5. Examination time and method
15 ~ 20 minutes per person. Mainly severe patients, including evaluating the condition, analyzing nursing problems and taking corresponding nursing measures (including surgical evaluation). For specific methods, please refer to the "case tracking method" in the "Guidelines for the Implementation of Evaluation Criteria for Tertiary General Hospitals" (20 1 1 Edition) of the Ministry of Health, focusing on disease care.
6. Test results
The examination results will be announced within 4 weeks after the end of the examination, and the unit results will be notified in the province. Personal performance feedback to the hospital nursing department.
The sampling test of young nurses' clinical practical working ability in secondary hospitals can be formulated and implemented by the municipal health bureaus with reference to the above measures.
Model essay on nurses' professional quality improvement plan II;
I. Methods and Steps 1. 1 Making a Plan
Provide learning materials, nursing technology practice platform and qualification examination information, formulate relevant policies, arrange working hours reasonably, encourage nursing staff to pay close attention to business study, so that nursing staff of all ages can improve their professional quality and pass the qualification examination as soon as possible. Arrange the workload of each class reasonably, so that the nurses in charge and nurses can provide "one-on-one" and "one-on-one" help to junior nurses while completing their own work and study tasks, or designate specific teachers to ensure the quality of work and nursing in each class is up to standard. In order to enter the PDCA cycle of nursing management as soon as possible, the following steps are taken.
(1) Analyze the quality of nursing records in each shift, the knowledge structure and professional quality of nursing staff, find out the existing problems, such as whether nursing records are standardized, whether professional and technical operations are skilled, analyze the service attitude and the shortcomings in nursing work, and give individual guidance and help in time for the existing problems. If the nursing records are improperly filled in, the medical terms are inaccurate, the handwriting is unclear, the sentences are not concise, irrelevant, and the nursing operation is not standardized, the superior teaching teacher will urge them to modify them in time to improve their own quality and nursing service quality as soon as possible.
(2) Identify the reasons that lead to low satisfaction with nursing services and easily lead to problems, such as lack of professional knowledge or unskilled operation skills, incorrect service attitude or improper service methods. Teaching teachers should guide and improve the existing problems in time.
(3) Find out the objective factors that affect the quality of nursing service. If the nursing staff is in poor physical health or mental health, they should be given treatment and rest adjustment in time. If they lack professional knowledge or practical experience, provide them with relevant learning materials and explain them in time. They also need to provide supplies and places for nursing operations, arrange teachers' guidance and ensure that nursing staff have good working conditions.
(4) According to the causes of poor nursing service effect, plan measures and implementation plans, predict the effect and time schedule, and determine the responsible person, executor and completion method. Check the nursing records of each shift, feedback and correct the problems in time; Find out the weak links in each shift and strengthen them in time; Hold lectures in departments and hospitals regularly; Equipped with relevant study materials, practical articles and places for nursing technology operation to improve the theoretical knowledge learning and nursing technology operation proficiency of nursing staff; Summarize the omissions and deficiencies in the work in time to prevent similar problems from happening again.
1.2 The implementation stage was carried out strictly as planned. The supervision of nursing quality should start from every shift, the supervisors should do their duty, and the graded management should always be unremitting. Timely assessment, the assessment must strictly refer to the evaluation standards of "Evaluation Standard of Nursing Quality" and "Operation Standard of Nursing Technology", with special personnel to give key explanations, difficult guidance and operation comments, and record the assessment results for reference in the next cycle. Establish a reward and punishment system and implement it, strive for everyone to pass the standard, and improve the quality of nursing staff while improving the quality of nursing.
1.3 In the inspection stage, compare the implementation results with the predetermined objectives, check the implementation of the predetermined objectives, find problems with a serious, responsible and scientific attitude, sum up successful experiences and lessons, and guide the next work. Every shift, every day, every week, every month, every quarter and every year, there are inspections, records, information feedback, summaries and improvements.
1.4 In the processing stage (1), rewards and punishments will be implemented according to the qualified rate and satisfaction rate of nursing services obtained from irregular spot checks or anonymous questionnaires. Affirm the successful experience, form a standard, resolutely judge the work effect according to this standard and implement rewards, so as to carry forward the successful experience.
Summarize the lessons of failure, record and severely punish them, and prompt them in time in the warning column of the department to prevent similar situations from happening.
(2) Put the unsuccessful and remaining problems into the next cycle to solve. In this cycle, the nursing quality of each class reaches the standard as soon as possible, the patient satisfaction is constantly improved, and the nursing quality and the quality of nursing staff are steadily improved.
Second, the results and discussion department nursing work inspection to implement three shifts, that is, early shift? Afternoon shift? Night shift, follow up in shifts. Hospital nursing management is classified, that is, teaching teachers Head nurse? Head nurse? Nursing supervision team? Nursing department, step by step supervision, step by step control. After the PDCA cycle of nursing management was implemented in our hospital, the quality of nursing staff and nursing work was obviously improved. In the "secondary" assessment, and successfully passed the "secondary" assessment, upgraded to "secondary hospital". This is the affirmation of the jury of the Provincial Health Department on all aspects of our hospital's work, and it is also a powerful witness that our hospital's nursing management adheres to PDCA cycle to effectively improve the quality of nursing and the quality of nursing staff. At present, our hospital has developed from 1 general internal medicine to internal medicine, internal medicine, surgery, obstetrics and gynecology, pain department, anorectum department, orthopedics department and rehabilitation department, and other departments are also in preparation, and the number of nursing staff has increased from 10 to 32. Of course, this is complementary to the synchronous development of other fields in our hospital, which has won good social and economic benefits for our hospital. While the scale of our hospital is expanding and the workload of nurses and nursing staff is increasing, only by strictly following PDCA cycle in nursing management can we improve the quality of nursing, improve the qualified rate and satisfaction rate of nursing services, increase the benefits of patients, and make the hospital carry out medical nursing work in an orderly manner and gradually expand its scale.
The third model of the Nurses' Professional Quality Improvement Plan;
First, the training target: nursing staff who have worked for 3-5 years.
Second, training objectives: pay attention to the cultivation of young nurses' thinking ability, practical ability and humanistic quality, master professional knowledge, strengthen the ability of disease observation, operational skills and specialist symptomatic treatment through the skilled application of nursing procedures, and promote the in-depth and lasting development of quality nursing services.
Third, the training content:
(1) Nurses who have worked for 3 years.
The standardized training period of new nurses is three years, which is divided into three stages: novice adaptation period (0 ~ 6 months), skill maturity period (7 ~ 18 months) and clinical rotation period (19 ~ 36 months).
1, novice adaptation period (0 ~ 6 months)
The first half of the month: pre-job training (nursing department). Fixed department after two-way selection. Month 1-2: Take care of 6-8 people with the clinical guidance teacher.
The third month: take care of 8 ~ 12 people together with the clinical guidance teacher or 4 ~ 6 people independently under the guidance of the clinical guidance teacher.
4 ~ 6 months: take care of 6 ~ 8 people independently under the guidance of clinical tutor. Specific training content: familiar with all kinds of rules and regulations, job responsibilities and workflow in wards, master the main operating skills of basic nursing, master the thinking method of nursing procedures, and be familiar with the basic knowledge of common disease nursing, examination, drugs and hospital infection prevention and control.
Specific training progress:
Week 65438 +0-2: Working procedures and standards of each shift.
Week 3-4: Observe the common diseases, nursing points, treatment principles, functions and adverse reactions of commonly used drugs, precautions, etc. (Hernia, appendicitis, thyroid, gallbladder, breast diseases, etc. )
Week 5-6: Explain the common intensive care (severe pancreatitis, gastrointestinal cancer, compound injury, etc.) in the specialty. ).
Week 7-24: Common nursing operations in our department and the use of various rescue instruments (ECG monitoring, oxygen inhalation, sputum aspiration, enema, catheterization, gastrointestinal decompression, etc. ), participate in hospital surgery teaching every month, and train and assess once a month in our department.
2. Skill maturity (7 ~ 18 months)
Under the guidance of the responsible team leader or clinical guidance teacher, 8 ~ 12 people were cared independently according to the patient's condition. Regularly arrange to participate in internal medicine rounds, business study, reading reports, and evidence-based nursing rounds for critically ill patients.
Master the basic operation skills of specialist nursing, be familiar with the Three Basics of Practical Clinical Nursing (which should be divided into volumes), skillfully use nursing procedures to evaluate the condition, analyze nursing problems and take appropriate nursing measures. Train critically ill patients with common diseases and frequently-occurring diseases in condition assessment, organize and implement assessment, and strengthen new nurses' thinking ability, intensive care ability and communication ability.
3. Clinical rotation period (19 ~ 36 months)
Under the guidance of the head nurse and the responsible team leader, 8 ~ 12 people were cared independently according to the patient's condition, mainly critically ill patients. The department appoints 1 senior nurses as tutors to guide students' work and study comprehensively.
Regularly arrange rotation nurses to participate in medical rounds of department directors, professional study or participate in special popular science group activities, read reports, evidence-based nursing rounds of critically ill patients, etc.
Master the operation skills of specialized nursing, the use of various instruments and equipment, the "three basics" of practical clinical nursing, and the nursing routine of common and frequently-occurring diseases in specialized nursing, skillfully use nursing procedures to evaluate the condition, analyze nursing problems and take appropriate nursing measures.
(2) Training contents of nursing staff who have worked for 3-5 years.
Specialized knowledge: 1. Master the observation and nursing points of various diseases in general surgery and the prevention and nursing methods of complications.
2. Master the contents of health education for various diseases in general surgery.
3, master the case rounds and case discussion implementation procedures.
4. Be familiar with new knowledge, new theories and related paper writing methods.
Specialist skills: 1. Skillfully use nursing procedures to care for patients.
2, organize and participate in the rescue of critically ill patients, difficult nursing operation and the use of various rescue instruments and equipment.
3. Participate in the discussion of critical and difficult cases in departments, and undertake professional lectures and teaching rounds.
4. Make targeted teaching plan for targeted teaching, participate in ward management, and complete special quality control.
Fourth, the assessment arrangement:
1. Nurses who have worked for 3 years:
(0-6 months) Monthly clinical performance evaluation, theoretical and operational evaluation. The head nurse carries out the "Personal Duty Qualification Examination". Only those who pass the exam can enter the next stage of standardized training and work alone. Those who fail to pass the examination shall extend the training time until they pass the examination.
(7-36 months) Monthly theoretical and operational assessment and monthly nursing plan. Record it in the rotating manual in time.
2. Nurses who have worked for 3-5 years
Professional knowledge: once a quarter.
Specialist skills: once a month.
(Note: All core systems, emergency plans and first aid skills must be mastered by general nurses. )
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