通过患者满意度调查评价护理质量

目的：通过患者满意度调查,进一步了解我院护理工作中的成效及存在问题,评价护理工作的质量,探索医院管理中护理科学管理方法。方法：①住院病人：采用问卷调查法;②出院病人：采用电话或上门随访方法;两种方法共对568例进行满意度调查,针对病人反馈的问题进行原因分析,提出改进措施并落实。结果：在疾病宣教及护理质量方面存在问题。结论：以医院管理年及创建优质护理服务为契机,以病人为中心,以质量为核心,逐步完善各项护理规章制度,加强护理安全管理,强化“三基三严”的训练,努力改善护理管理,提高护理服务质量。     

绩效考核在护理管理中的应用现状调查

为了解我院护理人员对绩效考核的评价及满意度,以更好的修订和完善绩效考核评价指标体系.方法:采用任意抽样的方法,运用医院护理人员对绩效考核评价调查问卷,对我院262名护理人员进行调查.结果:基本工资和奖金是护理主要收入来源;工作能力和工作年限是培训和晋升机会主要依据;护理人员对医院绩效考核满意度较低.结论:对护理人员绩效考核评价体系进行全面改革,以调动护理人员积极性,提高满意度.     

军队医院中患者对医护工作的评价及需求调查

目的：本文通过调查部分军队医院患者对护理工作的评价及需求,为提高军队医院的护理服务质量提供有利资料。方法：随机抽取四所三级甲等军队医院的380名住院患：考进行问卷调查,调查患者对护理工作的满意程度及需求。结果：患者对护理服务技术满意度为43．2％,对态度满意度为37．3％,对环境和健康教育满意度分别为59．5％和55％;患者最需要的知识为康复知识,占46．1％;患者对护理人员热情工作态度的期许和需求最高,达到38．2％;其次为熟练工作技能,占28．4％。结论：从患者角度出发,真正落实以民文本的原则,切实为患者服务,改善护理服务质量已经成为护理领域的核心内容,应得到各个军队医院的重视,落实优质护理服务工作。     

绩效考核管理对护理服务质量的影响

?????? 目的 探讨科学有效的绩效考核管理方案,与护理人员分配体系挂钩,以调动护士工作的积极性和主动性,提高护理质量。方法 以2011年开展绩效考核管理的护理单元为研究对象,从护理人员岗位层级、完成护理工作数量、护理工作质量、病人对护理服务的满意程度等方面量化考核,并与未进行绩效管理前的考核成绩进行比较。结果 各护理单元实行绩效考核后,各项护理指标、病人的满意度均明显提高,差异有显著性（P <0.01）。结论 实施护理人员的绩效考核管理,能有效地提高护理质量,提高病人的满意度,有利于提升优质护理服务内涵,促进优质护理服务的深入持续发展。     

基层医院合同制护理人员的聘用与管理

目的：为保证“医院管理年”活动各项工作的深入开展,满足病人对护理服务和护理质量越来越高的要求;保证护理工作的蓖好运行,不断扩大整体护理工作的内涵和外延,提高病人的满意度。方法：5次招聘活动中,护理部通过对外宣传、理论笔试、操作考核、面试考评、综合评分、考察聘用等程序进行招聘活动,并对合同制护理人员进行规范化管理。提高了护理人员的综合素质,提高了护理质量和病人的满意度。体会：护理管理者通过对合同制护理人员的引进和管理,搞活了用人机制,使“优胜劣汰”成为可能,增加了护理人员的危机意识,激发了护理人员的内趋力。     

黑龙江省强制戒毒医疗机构人力资源现状分析

目的:通过对黑龙江省强制戒毒医疗机构--安康医院人力资源现状调查,掌握该院人力资源数量、质量的特点;了解其医护人员培训状况、流动情况及工作状况;找出目标医院人力资源中存在的问题,并提出改进策略。方法:采用文献法,了解国内外戒毒医疗机构人力资源现状;采用现场问卷调查法、个人深入访谈法对目标医院进行人力资源现状调查;采用头脑风暴法,针对存在的问题,提出改进对策。结果:目标医院医护人员总数为100人,医护比为1:0.85,医护床比为1:0.85:2.78;准入方式为通过公务员考试;目标医院近五年医生年平均调入2.4人,护士年平均调入1.4人;医生年平均调出0.2人;护理人员每天工作超过15小时的占43.3%,每月工作超过22天的占63.3%;医护人员对培训满意度较差,医护人员亟待培训的内容为用药知识、心理治疗、精神科专业知识和最新护理技术与信息的动态知晓、心理护理、仪器设备的操作与简单故障排除;医护人员压力较大,压力源主要为工作环境压力、工作繁忙假期少、患者原因、人际关系及职业发展;职业防护不足;医生、护理人员对工作的总体满意度分别为80%、93.3%,医生、护理人员对薪酬的满意度分别为50%、44%。结论:目标医院医护人员队伍比较稳定;医生数量基本满足工作需要,护理人员匮乏,且工作负荷、压力过大;医护人员培训没有满足实际培训需求;医护人员职业防护的力度、医护人员工作满意度较低。     

绩效考核在神经内科护理管理中的应用

目的探讨绩效考核在神经内科护理管理中的应用效果。方法制定护士绩效考核实施方案,每月量化考核,考核结果与绩效奖金挂钩,比较实施前后护理质量、护士工作态度和病人满意度情况。结果实施绩效考核后,护理质量、业务水平和病人满意度明显提高。结论科学合理的护理绩效考核,充分调动了护士的工作积极性,提高了工作效率,提高了护理服务质量,促进了护患和谐,同时也促进了医院良性持续发展。     

护士绩效考核与激励机制在基层医院的构建与评价研究

目的：评价护士绩效考核与激励机制在基层医院的构建及应用效果,为基层综合医院的绩效考核与评价体系的构建提供科学依据。方法在护理部宏观指导下确立绩效考核指标,成立科室绩效考核小组。选择我院外一科护理人员作为考评对象,从工作量、工作质量、护理安全、培训考核、病人满意度等5个方面进行考核,考核小组采用日常工作中随时考评和月底通报公布综合考评相结合,并以绩效考核结果进行月绩效工资分配。结果绩效考核充分调动了护士的工作积极性,提高了护理工作效率及护理质量,提升了护理人员的整体素质,同时也提高了病人的满意度。结论实施绩效考核管理能有效提高护士工作积极性,改善整体护理质量,保障护理安全,发挥护理人力资源最大效应,促进护理管理效能的提高。     

北京某三级甲等医院ICU 患者家属满意度调查研究

目的:了解ICU患者家属对现有医疗护理服务质量的满意程度,为今后医疗护理服务质量的改善提供科学的依据。方法:采用Wasser的"危重患者家属满意度量表"中文版对符合入选标准的危重患者家属进行问卷调查。运用SPSS17.0进行统计分析。结果:共145名ICU患者家属完成问卷,其中男性83名,女性62名。危重患者家属满意度量表总得分很高(91±9),五个因子得分从高到低依次是舒适(5±0.50)、病情保证(4.75±0.625)、获得支持(4.67±0.50)、获取信息(4.40±0.60)和接近患者(4.33±0.67);其中满意度最高的一项"护士护理病人的质量情况",满意率高达100%;满意度最低的一项是"探视时间的弹性"。结论:ICU患者家属对现有医疗护理服务质量具有较高的满意度;更好的提高ICU患者家属满意度,改善医疗护理质量,需加强医务人员与家属的沟通,增进医护间的合作。     

开展优质护理服务示范病房的实践与体会

目的探讨开展"优质护理服务示范病房"对促进医院护理工作的效果。方法通过转变护理观念,实行责任制整体护理,合理调整排班模式,推行APN班及弹性排班,把亲情式服务与相应配套措施相结合,有计划、有步骤的开展临床护理工作。结果增加了护士之间的合作意识,使护理工作得到持续改进,全面提升了护理服务品质,提高病人满意度。结论在儿科护理过程中实施优质护理服务不仅明显提高患者的满意度,同时也提高了护士对工作的满意度,提高了护理工作质量,取得了良好的社会效益和经济效益。     

Combining specialist and primary health care teams for HIV positive patients: retrospective and prospective studies.

OBJECTIVE: To develop and evaluate a model of health care for HIV positive patients involving specialist, hospital based teams and primary health care teams. DESIGN: One year retrospective and a 2 1/2 year prospective study. SETTING: Two hospitals in West London and 88 general practitioners in 72 general hospitals. SUBJECTS: 209 adults with HIV infection. INTERVENTION: General practitioners enrolled in the project were faxed structured outpatient clinic summaries. When hospital inpatients were discharged, a brief discharge summary was faxed. General practitioners had access to consultant physicians skilled in HIV medicine through a 24 hour mobile telephone service. An HIV/AIDS management and treatment guide containing relevant local information was produced. Quarterly discussion forums for general practitioners were held, and a regular newsletter was produced. MAIN OUTCOME MEASURES: Hospital attendance and general practitioner consultations; perceived benefits and problems of patients and general practitioners. RESULTS: The average length of a hospital inpatient stay was halved for those patients who had participated in the project for two years, and the average number of visits to the outpatient clinic per month fell for patients with AIDS. There was a substantial increase in the number of visits to general practitioners by patients with AIDS and symptomatic HIV infection. Patients and general practitioners both felt that the standard of health care provided had improved. CONCLUSIONS: This model of health care efficiently and effectively utilised existing teams of hospital and primary health care professionals to provide care for HIV positive patients. Simple, prompt, and regular communication systems which provided information relevant to the needs of general practitioners were central to its success.     

心内科住院患者心理问题分析与护理对策研究

目的:了解心内科住院患者的心理问题,找出心内科住院患者常见的心理问题以及产生心理问题的原因,探讨改善心内科住院患者心理问题的有效护理措施。方法:对我院2011年1月-2011年4月心内科802例住院患者采取问卷调查及深入访谈相结合的方式进行调查。结果:对802例目标患者进行数据分析,心内科患者常见的心理问题为:焦虑与抑郁、多疑、恐惧紧张、绝望与悲哀;产生心理障碍的原因在于患者自身疾病、经济状况、环境等。结论:心内科住院患者心理问较为严重,通过实行有针对性的护理措施,有效治疗心内科患者的心理问题,减轻患者心理压力,促进患者的健康,保护患者安全。     

Effect of a geriatric consultation service on management of patients in an acute care hospital.

Elderly patients present particular management challenges. We conducted a randomized clinical trial of the effect of a geriatric consultation service on the management of elderly patients in an acute care hospital. A total of 113 patients aged 75 years or more who met certain criteria were assigned to either receive (57 patients) or not receive (56) care by the service. At the end of their hospital stay the patients were assessed with regard to predetermined outcomes. The patients were followed up for 1 year after discharge to determine death rates and direct health care expenditures. The intervention group showed significantly greater improvement in mental status (p less than 0.01), were receiving fewer medications at discharge (p less than 0.05) and had lower short-term death rates (p less than 0.05) than the control group. A geriatric consultation service can improve the hospital care and health of the elderly.     

Guías clínicas de fractura de cadera. Comparación de sus principales recomendaciones

Hip fracture is the most severe complication of osteoporosis, and despite being a frequent health problem, there is a wide variability in both the health care provided to these patients and the results achieved after their treatment. Clinical guidelines are a tool that helps to reduce this variability. The authors of this review try to give a panoramic and comparative view of the key recommendations proposed by the main guidelines for the hospital care of hip fracture patients. Recommendations on the care in the acute phase are reviewed, particularly the initial hospital management, use of tools, preventive measures to avoid medical complications, surgery related aspects, treatment of usual clinical problems, and shared orthopaedic and geriatric care. Circulating and putting into practice the main recommendations will help to improve the health care provided to these patients and obtain better outcomes.     

Factors affecting early unplanned readmission of elderly patients to hospital.

A random sample of 133 elderly patients who had an unplanned readmission to a district general hospital within 28 days of discharge from hospital was studied and compared with a matched control sample of patients who were not readmitted. The total group was drawn from all specialties in the hospital, and by interviewing the patients, their carers, the ward sisters, and the patients'' general practitioners the factors causing early unplanned readmission for each patient were identified. Seven possible principal reasons were found: relapse of original condition, development of a new problem, carer problems, complications of the initial illness, need for terminal care, problems with medication, and problems with services. There were also contributory reasons, and it was usual for several of these to be present in each case. The unplanned readmission rate was 6%; the planned readmission rate was 3%. It was thought that unplanned readmission was avoidable for 78 (59%) patients. Patients in the study group and in the control group showed significant differences in certain characteristics--such as low income, previous hospital admission, already having nursing care, and admission by general practitioners--and this might help to identify patients who are likely to be readmitted in an emergency.     

探讨分层级管理对医院护理管理的作用和意义

目的:随着生活水平的提升,人们对健康水平也越来越重视,对相关医疗水平的要求随之提升。针对护理工作中存在的问题,采取积极的应对措施是目前临床护理管理工作的重点。本文通过观察分层级管理用于医院护理管理的效果,探讨并分析该方法对医院护理管理的作用和意义。方法:2011年1月-2012年12月期间在我院呼吸科、消化科、骨科等7个主要病区,按照护理人员的技能水平、职业资历等进行分层级管理。根据不同层级的护理要求进行培训并定期考核。观察并比较实施分层级护理管理前后的临床效果,调查并分析患者对分层级护理的反馈情况及护理人员自身对其工作的满意度。结果:实施分层级管理后,护士的基本护理工作落实率、危重护理工作落实率、健康教育落实率、环境管理落实率均显著提高,差异具有统计学意义(P0.05);患者和护士自身对护理工作的满意率明显提高,差异具有统计学意义(P0.05);意外发生率和护理差错发生率均明显降低,差异具有统计学意义(P0.05)。结论:在医院护理管理工作中开展分层级管理,有助于促进护理工作的顺利进行,提升医院整体护理水平,有助于患者的身体恢复及精神健康,提高患者的满意度。     

“流程管理”在军队医院干部病房中的应用体会

目的：探讨军队医院干部病房实施流程管理的临床价值。方法：选取2012年5月至2013年2月入住我院干部病房的患者150例,随机分为对照组和观察组,每组75例。对照组患者采取常规护理管理,观察组患者实施流程化管理。观察并评价两组患者治疗期间的心理变化,调查患者对不同护理管理的满意度情况。结果：观察组患者心理状况良好,抑郁和焦虑程度明显低于对照组,对护理管理的满意度则明显高于对照组,两组比较差异明显,有统计学意义（P〈0．05）。结论,在军队医院干部病房实施流程管理是一种科学而有效的护理管理模式。     

Computer assisted shared care in hypertension.

A computer assisted shared care scheme for the long term management and follow up of hypertensive patients has been developed in the Grampian Region. The scheme aims at facilitating the exchange of clinically important information between doctors and at achieving target levels of blood pressure with treatment in patients at highest risk of cardiovascular events. The shared care scheme has been well received by the local practitioners. Two hundred and fifty seven patients (18%) of 1426 patients under current long term follow up are assigned to follow up in the hospital aspect of the scheme. At the most recent visit 32% of patients in the hospital aspect and 10% of 1169 patients in the general practice aspect had blood pressure recordings above the target levels of 160/95 mm Hg. The stratification of patients formerly attending hospital clinics into grades of risk has rationalised our follow up procedures to allow the specialist resources to be freed and concentrated on those patients at highest risk and with the most complex problems. This computer assisted patient records system could be applied to other groups of high risk patients in whom long term follow up and surveillance are necessary--for example, patients with diabetes mellitus--and has implications for optimising and monitoring the delivery and outcome of care without overwhelming limited hospital resources.