【摘要】 目的 探讨基于SMART原则的“4+X”护士长综合目标考核方案的建立及应用效果。方法 成立护士长综合目标考核领导小组，以医院发展规划、关键业绩指标法（KPI）理论为指导，遵循SMART原则制定“4+X”护士长综合目标考核标准。按照考核标准对全院49名护士长进行核心能力考核，比较实施前后护士长护理管理各维度及满意度评分。结果 “4+X”护士长综合目标考核实施1年后（2023年）护理安全、护理教学科研、团队建设、岗位胜任能力、护理服务质量关键指标得分高于实施前1年（2022年），差异有统计学意义（P<0.05）；“4+X”护士长综合目标考核实施1年后（2023年）医生对护士满意度、护士对工作满意度、护士对护士长满意度、上级对护士长满意度、患者对护理工作满意度得分均高于实施前，差异具有统计学意义（P<0.05）。结论 由护理安全、护理教学科研、团队建设、岗位胜任力维度考核指标和护理单元护理服务质量关键指标组成的“4+X”的护士长综合考核模式更具客观性、公平性、指向性，有利于提高护士长管理水平、护理质量和护理科研能力，以防止不良事件的发生，提升患者满意度。更多还原

【Abstract】 Objective To explore the establishment and application of the ’4+X’ comprehensive target assessment programme for nurse leaders based on the SMART principle.Methods To set up a comprehensive goal assessment leading group of nurse leaders,hospital development planning,guided by the key performance indicators(KPI) theory,follow the SMART principle to formulate the ’4+X’ comprehensive goal assessment standards for nurse leaders.In accordance with the assessment standards,49 nurse leaders in the hospital were assessed on their core competencies,and the nursing management dimensions and satisfaction scores of the nurse leaders were compared before and after the implementation of the standards.Results 1 year after the implementation of the ’4+X’ comprehensive goal assessment for nurse leaders(2023),the scores of key indicators of nursing safety,nursing teaching and research,team building,job competence,and nursing service quality were higher than that of 1 year before the implementation(2022),and the difference was statistically significant(P<0.05);After 1 year of "4+X" nurse leaders compreheshive goal assessment(2023),doctors’ satisfaction with nurses after the implementation was higher than that of 1 year before the implementation(2022).the scores of doctors’ satisfaction with nurses,nurses’ satisfaction with their jobs,nurses’ satisfaction with the head nurse,supervisors’ satisfaction with the head nurse,and patients’ satisfaction with nursing care were higher than before implementation,and the difference was statistically significant(P<0.05).Conclusion The ’4+X’ comprehensive assessment model of nurse manager consisting of four-dimensional assessment indexes of nursing safety,nursing teaching and research,team building,job competence and key indexes of nursing service quality of nursing unit is more objective,fair and directional,which is conducive to improving the management level,nursing quality and nursing research ability of nurse manager to prevent the occurrence of adverse events and improve the patients’ satisfaction.更多还原