CAJ | 학술논문

目的：将精细化管理应用于临床护理路径，使其形成模式化并有效推进。方法围绕精细化管理模式中的分层管理、流程制度、培训实施、绩效考核4要素，通过每日实时评价、中期评价、终末评价进行临床护理路径管理。将使用精细化管理前后的试点病种患者及病区护士，分别设为对照组和干预组。采用患者满意度问卷调查、护理质量考核及临床工作能力考核，比较患者满意度、护理质量及护士临床综合能力。结果应用CNP精细化管理模式后，患者平均住院天数（8．62±0．41）d，平均住院费用（12920．54±415．19）元，均低于实施前的（10．46±0．54）d，（14061．74±423．17）元，差异有统计学意义（t分别为37．41，24．35；P＜0．01）；患者满意度从（86．18±3．41）％提高到（95．27±3．62）％，护士临床综合能力总分从（73．21±4．21）分提高到（81．24±4．37）分，差异均有统计学意义（t 分别为-23．12，-13．23；P＜0．01）。结论在临床护理路径推进过程中应用精细化管理模式切实可行。
목적：장정세화관리응용우림상호리로경，사기형성모식화병유효추진。방법위요정세화관리모식중적분층관리、류정제도、배훈실시、적효고핵4요소，통과매일실시평개、중기평개、종말평개진행림상호리로경관리。장사용정세화관리전후적시점병충환자급병구호사，분별설위대조조화간예조。채용환자만의도문권조사、호리질량고핵급림상공작능력고핵，비교환자만의도、호리질량급호사림상종합능력。결과응용CNP정세화관리모식후，환자평균주원천수（8．62±0．41）d，평균주원비용（12920．54±415．19）원，균저우실시전적（10．46±0．54）d，（14061．74±423．17）원，차이유통계학의의（t분별위37．41，24．35；P＜0．01）；환자만의도종（86．18±3．41）％제고도（95．27±3．62）％，호사림상종합능력총분종（73．21±4．21）분제고도（81．24±4．37）분，차이균유통계학의의（t 분별위-23．12，-13．23；P＜0．01）。결론재림상호리로경추진과정중응용정세화관리모식절실가행。
Objective To apply meticulous management in clinical nursing pathway so as to make it scale and effectively advance .Methods The management of clinical nursing pathway focusing on hierarchical management , process system , training implementation and performance appraisal in meticulous management were carried out through the daily , mid-term, terminal evaluation .The patients with pilot disease and ward nurses who did not receive or received the meticulous management were divided into the control group and the intervention group .The patient satisfaction , the nursing quality and the comprehensive ability of clinical nursing were respectively evaluated by the questionnaire about patient satisfaction , the nursing quality assessment and the clinical skills assessment .Results The average hospital days and costs after the application of meticulous management were respectively (8.62 ±0.41) d, (12 920.54 ±415.19)yuan, and were lower than (10.46 ± 0.54) d, (14 061.74 ±423.17) yuan before the application of meticulous management , and the differences were statistically significant (t =37.41, 24.35, respectively;P <0.01).The patients satisfaction after the application of meticulous management was increased from (86.18 ±3.41) % to (95.27 ±3.62) %, and the score of the comprehensive ability of clinical nursing was increased from (73.21 ±4.21) to (81.24 ±4.37), and the differences were statistically significant (t=-23.12, -13.23, respectively;P<0.01).Conclusions The application of meticulous management in the process of clinical nursing pathway is practical .