实施护士能级管理提升透析质量的探索与实践
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摘要
目的通过对护士实施能级管理,更有针对性地护理不同风险层级的患者,提升透析治疗质量,减少并发症的发生,延长透析患者的生命。方法在2016年11月19日～2017年11月19日期间选取200例透析患者为此次研究对象,随后实施随机化分组,对照组选用常规护理管理措施,观察组选用能级管理,并比较实施前后收缩压、舒张压、血红蛋白、白蛋白、血钾、血磷、血肌酐、血尿素、体重、动静脉瘘栓塞率、低血糖率、低血压率、护理服务态度满意度、护理质量满意度。结果观察组收缩压(151.11±15.77)mm Hg、舒张压(75.68±12.79)mm Hg、血红蛋白(118.26±12.77)g/L、白蛋白(44.54±4.69)g/L、血钾(5.05±0.70)mmol/L、体重(61.31±12.04)kg、动静脉瘘栓塞率(7.00%)、低血糖率(17.00%)、低血压率(15.00%)均优于实施前(P <0.05),护理服务态度满意度(98.00%)、护理质量满意度(97.00%)高于对照组(P <0.05)。结论实施护士能级管理,从护理管理层面保证了临床护理规范要求,同时也提高了护士的工作积极性,可以促进护士积极自发地提升自身核心能力,提高护理质量,减少护理不良事件。
Objective To improve the quality of dialysis treatment, reduce the occurrence of complications and prolong life of patients by implementing class management of nurses and offering targeted services for patients at different risk levels.Methods 200 patients who underwent dialysis from November 19, 2016 to November 19, 2017 were selected as research objects and they were randomly divided into two groups. The control group was given routine nursing management measures while the observation group was given class management. Systolic blood pressure, diastolic blood pressure, hemoglobin, albumin, serum potassium, blood phosphorus, serum creatinine, blood urea, body weight, embolization rate of arteriovenous fistula, hypoglycemia rate, hypotension rate, satisfaction with nursing service attitude and satisfaction with nursing quality were compared between two groups before and after implementation. Results Systolic blood pressure(151.11±15.77)mm Hg, diastolic blood pressure(75.68±12.79)mm Hg, hemoglobin(118.26±12.77)g/L, albumin(44.54± 4.69)g/L, serum potassium(5.05±0.70)mmol/L, body weight(61.31±12.04)kg, embolization rate of arteriovenous fistula(7.00%), hypoglycemia rate(17.00%) and hypotension rate(15.00%) after implementation of the observation group were all better than those before implementation(P < 0.05). Satisfaction with nursing service attitude and satisfaction with nursing quality of the observation group were both higher than those of the control group(P < 0.05). Conclusion Implementation of class management of nurses can ensure the clinical nursing standard requirements from the aspect of nursing management and improve the work enthusiasm of nurses. It can promote nurses to actively and spontaneously improve their core competence, improve the nursing quality, and reduce adverse nursing events.
Objective To improve the quality of dialysis treatment, reduce the occurrence of complications and prolong life of patients by implementing class management of nurses and offering targeted services for patients at different risk levels.Methods 200 patients who underwent dialysis from November 19, 2016 to November 19, 2017 were selected as research objects and they were randomly divided into two groups. The control group was given routine nursing management measures while the observation group was given class management. Systolic blood pressure, diastolic blood pressure, hemoglobin, albumin, serum potassium, blood phosphorus, serum creatinine, blood urea, body weight, embolization rate of arteriovenous fistula, hypoglycemia rate, hypotension rate, satisfaction with nursing service attitude and satisfaction with nursing quality were compared between two groups before and after implementation. Results Systolic blood pressure(151.11±15.77)mm Hg, diastolic blood pressure(75.68±12.79)mm Hg, hemoglobin(118.26±12.77)g/L, albumin(44.54± 4.69)g/L, serum potassium(5.05±0.70)mmol/L, body weight(61.31±12.04)kg, embolization rate of arteriovenous fistula(7.00%), hypoglycemia rate(17.00%) and hypotension rate(15.00%) after implementation of the observation group were all better than those before implementation(P < 0.05). Satisfaction with nursing service attitude and satisfaction with nursing quality of the observation group were both higher than those of the control group(P < 0.05). Conclusion Implementation of class management of nurses can ensure the clinical nursing standard requirements from the aspect of nursing management and improve the work enthusiasm of nurses. It can promote nurses to actively and spontaneously improve their core competence, improve the nursing quality, and reduce adverse nursing events.
引文
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[14]何玮,徐艳梅,黎赟,等.能级管理在儿科急诊管理中的应用观察[J].齐鲁护理杂志,2014,15(20):39-40.
[15]陈玲,濮英娜,申文荣,等.护士能级管理模式在优质护理服务应用中的效果评价[J].山西医药杂志,2018,47(8):955-956.
[16]蓝月,李剑媚,郑英英.以护士为主导的分组管理模式对血液透析护理质量的影响分析[J].中外医学研究,2018,16(15):74-76.
[2]孟秀云,岳英,姜立萍,等.护士岗位管理模式在血液透析护理中的应用[J].北京医学,2013,35(7):578-579.
[3]许秀君,周美玲,沈华娟,等.“三定”管理模式对诱导透析患者并发症的影响[J].护士进修杂志,2017,32(4):344-345.
[4]陈爽,王林林.血液透析的安全管理及讨论[J].心理医生,2017,23(34):328-329.
[5]王新美,朱小玲,张勤,等.透析管道护理小组联合舒适护理在血液透析患者管理中的应用[J].实用临床医药杂志,2017,21(22):106-107,110.
[6]罗怡欣,黄燕林,刘玲玲,等.奥马哈系统个案管理对腹膜透析患者透析相关性腹膜炎的影响[J].中国血液净化,2018,17(1):25-29.
[7]张喜维.护理分组管理对血液透析质量及安全性的影响[J].血栓与止血学,2017,23(1):143-145,149.
[8]王翠香,李静.能级管理下弹性排班对神经外科护士工作倦怠感和压力的影响[J].国际护理学杂志,2016,35(8):1091-1094.
[9]瞿春华.护士能级管理在手术室护理质量管理中的应用[J].上海护理,2014,14(5):79-81.
[10]顾建芬.能级管理在新护士带教中的应用[J].齐鲁护理杂志,2015,28(11):115-117.
[11]孙彦.优质护理服务在能级管理中应用的效果[J].国际护理学杂志,2014,11(10):2839-2841.
[12]徐凤,李艳达,张文雅,等.能级管理在临床护理管理中的应用[J].国际护理学杂志,2018,37(6):838-840.
[13]朱海英,朱雪凤,蹇英,等.能级管理在儿童输液室管理中的应用[J].护理实践与研究,2013,10(24):77-78.
[14]何玮,徐艳梅,黎赟,等.能级管理在儿科急诊管理中的应用观察[J].齐鲁护理杂志,2014,15(20):39-40.
[15]陈玲,濮英娜,申文荣,等.护士能级管理模式在优质护理服务应用中的效果评价[J].山西医药杂志,2018,47(8):955-956.
[16]蓝月,李剑媚,郑英英.以护士为主导的分组管理模式对血液透析护理质量的影响分析[J].中外医学研究,2018,16(15):74-76.