CAJ | 학술논문

目的：探讨医护协同管理方案在神经外科危重患者护理管理中的应用价值,为其临床应用提供可参考依据。方法选择2013年1月—2014年1月200例危重患者作为研究对象,采用随机数字法平均将研究对象分为观察组与对照组两组,分别给予医护协同管理方案与传统的护理管理方案。比较两种管理模式下护理质量、医护患对护理工作的满意度及护士的自我效能情况等。结果观察组病房管理、基础护理、专科护理、责任管理、交流沟通条目得分分别为(17.34±2.23),(18.00±1.65),(18.11±1.23),(17.25±2.43),(18.21±1.54)分,均高于对照组的(16.11±2.12),(13.43±2.44),(16.65±2.34),(15.45±2.22),(16.46±1.31)分,差异有统计学意义(t值分别为4.123,5.653,4.845,5.324,4.345；P<0.05)。观察组医师、护理人员及患者的满意度分别为90.0%,96.7%,98.0%,明显高于对照组的50.0%,76.7%,92.5%,差异有统计学意义(χ2值分别为3.810,5.192,6.687；P<0.05)。观察组发生医护患矛盾4例(4.0%),明显低于对照组的12例(12.0%),差异有统计学意义(χ2=4.348, P=0.037)。观察组护士积极性、责任心、自信心、沟通能力、解决问题能力得分及自我效能总分分别为(7.43±1.65),(7.25±1.65),(7.65±1.76),(7.65±1.98),(8.76±1.65),(36.34±2.44)分,分别高于对照组的(5.55±1.65),(5.34±1.65),(5.54±1.56),(5.87±1.87),(5.87±1.43),(30.54±3.34)分,差异有统计学意义(t值分别为4.542,5.545,4.765,4.234,6.065,4.534；P<0.05)。结论医护协同管理有效改变了医护人员的服务理念,更好地执行以患者为中心的服务,且提高了医护工作的满意度,进一步提高了医疗护理服务质量。
목적：탐토의호협동관리방안재신경외과위중환자호리관리중적응용개치,위기림상응용제공가삼고의거。방법선택2013년1월—2014년1월200례위중환자작위연구대상,채용수궤수자법평균장연구대상분위관찰조여대조조량조,분별급여의호협동관리방안여전통적호리관리방안。비교량충관리모식하호리질량、의호환대호리공작적만의도급호사적자아효능정황등。결과관찰조병방관리、기출호리、전과호리、책임관리、교류구통조목득분분별위(17.34±2.23),(18.00±1.65),(18.11±1.23),(17.25±2.43),(18.21±1.54)분,균고우대조조적(16.11±2.12),(13.43±2.44),(16.65±2.34),(15.45±2.22),(16.46±1.31)분,차이유통계학의의(t치분별위4.123,5.653,4.845,5.324,4.345；P<0.05)。관찰조의사、호리인원급환자적만의도분별위90.0%,96.7%,98.0%,명현고우대조조적50.0%,76.7%,92.5%,차이유통계학의의(χ2치분별위3.810,5.192,6.687；P<0.05)。관찰조발생의호환모순4례(4.0%),명현저우대조조적12례(12.0%),차이유통계학의의(χ2=4.348, P=0.037)。관찰조호사적겁성、책임심、자신심、구통능력、해결문제능력득분급자아효능총분분별위(7.43±1.65),(7.25±1.65),(7.65±1.76),(7.65±1.98),(8.76±1.65),(36.34±2.44)분,분별고우대조조적(5.55±1.65),(5.34±1.65),(5.54±1.56),(5.87±1.87),(5.87±1.43),(30.54±3.34)분,차이유통계학의의(t치분별위4.542,5.545,4.765,4.234,6.065,4.534；P<0.05)。결론의호협동관리유효개변료의호인원적복무이념,경호지집행이환자위중심적복무,차제고료의호공작적만의도,진일보제고료의료호리복무질량。
Objective To explore the application value of collaborative mode in nursing management to cope with neurosurgical critical patients and provide evidence for clinical management. Methods A total of 200 critical patients had been divided into control group ( traditional nursing management ) and experimental group ( medical collaborative management) on average during January 2013 to 2014 by random number table. We compared the quality of nursing, satisfaction of medical staffs and patients, and nurse′s self-efficacy. Results The scores of ward management, basic nursing, specialized nursing, responsibility management, communication in the experimental group were (17. 34 ± 2. 23), (18. 00 ± 1. 65), (18. 11 ± 1. 23), (17. 25 ± 2. 43), (18. 21 ± 1. 54) compared with (16. 11 ± 2. 12), (13. 43 ± 2. 44), (16. 65 ± 2. 34), (15. 45 ± 2.22), (16.46 ±1.31) in the control group (t=4. 123, 5. 653, 4. 845, 5. 324, 4. 345,respectively;P<0. 05). The satisfaction scores of physicians, nurses and patients in the experimental group were 90. 0%, 96. 7%, 98. 0%, respectively while these rate in the control group were 50. 0%, 76. 7%, 92. 5% (χ2 =3. 810, 5. 192, 6. 687; P <0. 05). The incidence of medical contradiction in the experimental group was 4 cases (4. 0%) lower than 12 cases (12. 0%) in the control group. The difference was statistically significant (χ2 =4. 348,P=0. 037). The total score of nurses′ initiative, responsibility, self-confidence, communication skills, problem solving ability, self-efficacy were (7. 43 ± 1. 65), (7. 25 ± 1. 65), (7. 65 ± 1. 76), (7. 65 ± 1. 98), (8. 76 ± 1. 65), (36. 34 ± 2. 44) respectively higher than those (5. 55 -1. 65), (5. 34 ± 1. 65),(5. 54 ± 1. 56), (5. 87 ± 1. 87), (5. 87 ± 1. 43), (30. 54 ± 3. 34) in the control group. The difference was statistically significant (t = 4. 542, 5. 545, 4. 765, 4. 234, 6. 065, 4. 534,respectively; P < 0. 05). Conclusions The medical collaborative mode not only meets the diversification of the patient′demands, builds a good relationship between the doctors, patients and nurses, but also improves the quality of nursing.