CAJ | 학술논문

目的探讨医护共同决策分级护理对患者护理质量和疾病转归的影响,评价护理核心制度在此种护理模式中应用的可行性.方法 2011年1月至2012年1月,在我院A、B2个不同院区,分别选取内分泌科和骨外科病区,住院患者379例,其中男220例,女159例,平均年龄(53.7±12.8)岁.按院区接诊情况将院区A为常规分级护理组(常规组),院区B为医护合作型分级护理组(合作组),比较2组对护理质量和护理效率,以及对患者疾病转归的影响.结果基础护理质量、护理计划实施合格率、患者健康教育覆盖率和患者满意度合作组均高于常规组；2组医嘱执行完整率、患者疾病知晓率、平均住院日、遵医依从性和患者因相同或相关疾病3个月内再入院率比较差异均有统计学意义.上述4项指标在合作组获得满意的提高；与常规组比较,合作组明显改善了护理级别与病情匹配、专科知识了解、护理记录填写、护理流程欠缺、生活知识沟通能力5项指标评分情况,2组间比较差异均有统计学意义.结论医护合作共同决策分级护理模式可明显提高患者分级护理级别界定和患者的整体治疗效果,显著提高了分级护理质量.
목적 탐토의호공동결책분급호리대환자호리질량화질병전귀적영향,평개호리핵심제도재차충호리모식중응용적가행성.방법 2011년1월지2012년1월,재아원A、B2개불동원구,분별선취내분비과화골외과병구,주원환자379례,기중남220례,녀159례,평균년령(53.7±12.8)세.안원구접진정황장원구A위상규분급호리조(상규조),원구B위의호합작형분급호리조(합작조),비교2조대호리질량화호리효솔,이급대환자질병전귀적영향.결과 기출호리질량、호리계화실시합격솔、환자건강교육복개솔화환자만의도합작조균고우상규조；2조의촉집행완정솔、환자질병지효솔、평균주원일、준의의종성화환자인상동혹상관질병3개월내재입원솔비교차이균유통계학의의.상술4항지표재합작조획득만의적제고；여상규조비교,합작조명현개선료호리급별여병정필배、전과지식료해、호리기록전사、호리류정흠결、생활지식구통능력5항지표평분정황,2조간비교차이균유통계학의의.결론 의호합작공동결책분급호리모식가명현제고환자분급호리급별계정화환자적정체치료효과,현저제고료분급호리질량.
Objective To discuss the influence of grading nursing care by physician-nurse cooperation decision-making on the quality of patient care and disease outcomes,and evaluate the application feasibility of nursing core system in this nursing mode.Methods 379 patients were admitted to departments of orthopedics and endocrinology from two hospital areas of our hospital from January 2011 to January 2012.Patients were divided into two groups according to nursing process.Patients who were given conventional grading nursing were set as the routine group,and patients receiving physician-nurse collaboration grading nursing were set as the collaboration group.The nursing quality and nursing efficiency,and the disease outcome of patients were compared between the two groups.Results The quality of care,the qualified rate of care plan implementation,the coverage rate of health education of patients and the patient satisfaction rate were higher in the collaboration group than those in the routine group.The performing rate of doctor's orders,the awareness rate of patient disease,the average length of hospital stay,compliance of medical orders and re-admission rate of patients with the same or a related disease within three months were significantly different between two groups.The collaboration group improved the matching degree of nursing grade with disease condition,understanding of professional knowledge,recording of nursing records,deficient nursing process,and communication ability of life knowledge,compared with those of the routine group.Conchusions Nursing grading mode by physician-nurse collaboration decision-making can obviously improve the defmition of grading nursing and the general treatment effect of patients,it significantly improved the quality of grading nursing.