【摘要】 目的探索三甲医院对"托管"二级医院实施护理管理改革的有效措施。方法通过调研,结合当地医院实际,采取组织培训、对被托管医院的护理管理者及护理骨干轮换到托管医院进修学习、并由托管医院委派一名护理部副主任到被托管医院具体把关、沟通交流等措施,协助被托管医院建立健全各项规章制度,落实APN排班制度、大包干责任制,开展护士床边工作制,建立和完善护理质量标准体系与安全管理体系、护理质量持续改进的长效机制、护士培训体系等。提高被托管医院优质护理服务工作。结果被托管医院管理人员及患者的满意度调查结果显示,医院管理者、医生对护理工作满意度较以前提高,医护沟通协作密切,基础护理较以前到位,护士对护理工作总体感觉满意。病区管理质量、护士技术操作、护理文书质量、护理安全管理、护理服务满意度均优于实施前(p<0.001),差异有统计学意义。结论有效的托管能提高二级医院的护理水平,对提高区域内护理服务水平、将优质护理服务向三级医院靠近有着积极的意义。更多还原

【Abstract】 Objective To explore the nursing management reform and effective measures implementing three level AAA hospital"trusteeship"of the two level hospital. Methods Through research,combined with the local hospital practice,to organize training,the hosted hospital’ s nurse managers and nursing backbone being rotated to the AAA hospital for further study; a Deputy Director of the Department of Managed Care in trusteeship hospital being appointed to hosted hospital to check on and communicate,helping hosted hospital to establish and improve various rules and regulations,implement APN scheduling system,round contract responsibility system,to carry out bedside nurses working system. Establish and improve the quality of care standards and safety management systems,continuous improvement of quality of care for long- term mechanism,nurses training system and so on. Improve hosted hospital’s quality care. Results Investigation of the satisfaction degree shows hosted hospital manager and patients’ satisfaction to nursing work increased than before,the doctor- nurse communication and coorperation being osculated,basic nursing was put in place than before,nurses overall feeling of satisfaction with the work of nursing,Ward quality of management,technical operations of nurses,nursing instrument quality,care and safety management,nursing service satisfaction were better than before the implementation( p < 0. 001),the difference was statistically significant. Conclusion Effective hosting can improve the level of care of the two level hospitals,it has a positive meaning to improve the standard of care within the region,to put the quality nursing service close with the three level hospital.更多还原