分层级管理对护士临床工作能力的影响

目的探讨分层级管理模式对护士临床工作能力的影响，为提高护理人才资源的利用效率提供科学指导。方法根据护理人员的职称、学历和工作能力，将其分为护士长、护理组长、高级责任护士、初级责任护士、助理护士5个层级进行管理，比较实施前后各层级护理人员理论知识、专业技术、综合能力的考核得分，并调查患者满意度。结果实施分层级管理后，护士长、护理组长、高级责任护士、初级责任护士、助理护士的理论知识考核均优于实施前（t分别为7．133，6．112，10．434，17．168，9．799；P〈0．01），专业技术考核均优于实施前（t分别为5．056，3．289，6．042，13．507，10．965；P〈0．05），综合能力考核优于实施前（t分别为4．895，5．333，8．901，10．981，6．854；P〈0．01）；实施后患者与家属满意度得分为（93．32±5．61）分优于实施前的（88．76±8．79）分，差异具有统计学意义（t=5．961，P〈0．05）。结论实现护士分层级管理，体现了护士的知识价值，有利于护理人才的培养，完善和健全医院护士培养机制，促进护士知识技能的巩固、提高和扩展，护士临床工作能力的提高，发挥了各层级护士应有的作用。

Effect of implementation of nurse stratification level management of clinical work ability

Objective To explore the effect of stratification level management model on clinical nurse ability, provide scientific direction for high utilization rate of clinical nurse. Methods According to professional titles, education, and ability, the nursing staffs were divided into five grades as head nurse, nursing group leader, senior primary nurse, primary nurse and assistant nurse, compared theoretical knowledge, professional technology level and comprehensive abilities in all grades nurses before and after the implementation of the nurse stratification management, investigated satisfaction degree of patients. Results After the implementation of stratification management, in all grades nurses, theory knowledge were better than before （t = 7. 133, 6.112, 10.434, 17. 168, 9. 799, respectively; P 〈 0.01 ）, the professional technology level were higher than before （ t = 5. 056, 3. 289, 6.042, 13. 507, 10. 965, respectively; P 〈 0.05 ）, the comprehensive ability were better than before （t = 4. 895, 5. 333, 8. 901, 10. 981, 6. 854, respectively; P 〈 0.01 ）, patients and their families are more satisfied （93.32 ：t：5.61 ） than that （88.76 ＋ 8.79） before the implementation the nurse stratification management（ t = 5. 961 ,P 〈 0.05 ）, the difference of two groups had statistical significance. Conclusions The nurse stratification management reflects the value of nursing knowledge, facilitates nursing training, refines and completes hospital nurse training system, consolidates, promotes and extends the nurses＇ knowledge skill, promote clinical ability, help nursing staffs of all levels give full play to their respective roles.