加强护理风险管理的做法与效果

目的降低护理风险的发生率,确保医疗护理安全。方法加强护理安全教育,提高护士的风险意识和风险防范能力;完善护理规章制度,制定护理应急预案与程序;加强护理风险监控,注重护理记录检查。结果护士的风险意识提高,两年来,全院无护理纠纷和严重护理差错事故发生,一般护理差错明显减少。结论注重护理风险管理,加强风险教育、检查,可有效化解护理风险,减少护理纠纷和护理事故的发生。     

科学化管理方法在提高护理质量中的实践与效果

目的提高我院的护理质量,保证护理安全。方法通过护理科研立项研究,探讨改进护理质量的方法,规范护理服务流程,建立危重症评估、检测技术网络和护理风险危机管理系统。结果提高了护理质量,病人对护理服务的满意度由2000年的89.6%上升至2005年的95.1%。结论护理管理与护理科研及信息技术相结合是不断提高护理质量的重要保障。     

Integrating preparation for care trajectory management into nurse education: Competencies and pedagogical strategies

Nurses make an important contribution to the organisation and coordination of patient care but receive little formal educational preparation for this work. This paper builds on Allen's care trajectory management framework to specify evidence‐based and theoretically informed competencies for this component of the nursing role and proposes how these might be incorporated into nursing curricula. This is necessary so that at the point of registration nurses have the expertise to realise their potential as both providers and organisers of patient care and are better able to articulate and develop this aspect of nursing practice.     

A conceptual framework contributing to nursing administration and research

The health care system has undergone major changes in the last decade. With greater acuity and complexity of illness, the adoption of innovative technologies and the shortage of health care personnel, the coordination and integration of health care services has become increasingly demanding for administrators. Growing dissatisfaction and concerns about safety issues are being expressed by the users of care who need to navigate through an increasingly complex system and by health care personnel who feel less efficient within the organization. Nursing administrators have a responsibility to address these issues but there is little scientific evidence to guide their actions. There are also few comprehensive models highlighting the main components of nursing administration - models that could guide nursing administration research. This paper presents a conceptual framework for nursing administration and research that links patient health care needs, nursing resources and the nursing care processes to the context of the health care system, and the social, political and cultural environments of care. A selected review of the oncology and cancer care literature is presented to demonstrate how this framework can organize existing knowledge about these concepts in the context of cancer care.     

Economic crisis and challenges for the Greek healthcare system: the emergent role of nursing management

notara v., koupidis s.a., vaga e. & grammatikopoulos i.a. (2010) Journal of Nursing Management 18 , 501–504
Economic crisis and challenges for the Greek healthcare system: the emergent role of nursing management Background Despite several reform efforts, the Greek health care system still faces problems related to misdistribution of trained health staff and finance between geographical areas. Aim The objectives of the present study were to describe the current situation of the delivery of the healthcare service in Greece, to explore the basic implications of the economic crisis from a nursing management perspective and to examine future practices opening a debate in policy developments. Key issue The principal finding of this study was the serious shortage of trained nurses, the imbalances in nursing personnel, an excess of doctors and the complete absence of a Primary Healthcare System in civil areas provided by general doctors. Conclusion It is important that health care policy makers become aware and seriously consider rearranging the Health Care System to become more effective and efficient for the population (client). Special attention should be paid to strengthening areas such as primary health care, public health and health promotion in the direction of minimizing the demand of hospital services. Implications for nursing management Any implementation of major health care reforms should consider seriously the role of the nursing management which formulates the substantial link between the health services and the patient.     

Pediatric palliative care: a conceptual analysis for pediatric nursing practice

Although there have been significant advances in medical technology, thousands of children continue to die annually. Pediatric palliative care is a relatively new field and has not been well defined in the literature. Therefore, the purposes of this article were to provide a concept analysis of pediatric palliative care that presents pediatric nurses with fundamental information regarding this concept and to increase their ability to understand, identify, provide, and subsequently meet and enhance the needs of those children with a life-limiting illness and their families. With this enhanced understanding of pediatric palliative care, pediatric nurses will continue to improve and provide quality, safe nursing care for this vulnerable population of children with life-limiting illnesses.     

Care of the pediatric oncology patient in a laminar air flow setting. A conceptual framework for nursing practice

The care of patients in a protected environment can be enhanced by using a conceptual framework for nursing practice. A philosophy of care that includes the essentials of patients' rights and values can be implemented through specified goals of care. The net result of this approach is that the patient feels successfully supported, the family and significant others recognize their value as contributors to the well-being of the patient, and the multidisciplinary team has increased feelings of professional worth.     

绩效管理在泌尿外科护理管理中的应用

目的探讨绩效管理在泌尿外科护理管理中的应用效果。方法制订绩效分配和考核方法,包括护理质量、服务态度、护理工作量,工作效益及技术职称等,将考核结果与绩效挂钩。结果实施绩效考核分配方案后医护患3者满意度及护理质量优于实施前,实施前后比较,均P<0.01,差异具有统计学意义。实施绩效考核分配方案后基础护理工作量较实施前提高。结论实施绩效管理可充分调动护士工作积极性,提高护理质量,是落实基础护理的保证。     

An ethic of the fitting: a conceptual framework for nursing practice

Nurses are expected to act within an ethos of care cognisant of duty, the right, and the good. Concepts of virtue theory, utilitarianism and deontology are used to outline a conceptual ethical framework for nurses in practice. This 'Moebius' framework aims to locate the virtues in a symbiotic relationship with the principles of utilitarianism and deontology. Under this framework, fitting ethical responses are sought. Within an ethic of the fitting, rules and principles do not guarantee the most ethically justifiable outcomes. Within the Moebius approach, the nurse ought to respond with a sense of compassion that befits the moment rather than adhere to a rule at all costs.     

Caring in nursing practice: the development of a conceptual framework

This article reports the results of a qualitative research study which explored patients' experience of caring. To elicit stories relating to the experience of caring, a hermeneutic approach was selected incorporating a narrative method. One-to-one interviews were conducted with 24 patients in their homes, shortly after discharge from hospital. The findings uncovered a number of categories comprising the experience of caring in nursing. This resulted in the development of the conceptual framework based on Donabedian's constructs of structure, process and outcome. Structures included nurse attributes, organizational issues, and patient attributes. Processes comprised the activities of caring, which included providing for patients' physical and psychological needs, being attentive, getting to know the patient, taking time, being firm, showing respect, and the extra touch. The outcomes emanated from the process of caring and included a feeling of well-being, patient satisfaction, and effect on the environment. The conceptual framework emphasizes a potential link between the three constructs. Data from narrative analysis suggest a positive linear relationship between the structures required for the process that lead to patient outcomes. When compared to current theoretical literature, the findings support elements of existing theories. These include the importance of the nurse attributes for professional caring (structure), the activities of caring, which can be viewed as nurse interventions and the dual nature of caring, which encompasses attitudes and actions (process).     

A conceptual framework for teaching research in nursing

Though research is often referred to the lifeblood, hallmark or cornerstone in the development of a profession (Brink, 1996:2), teaching research in nursing is a challenge. The challenge does not just lie in teaching the subject, but in resistance and unwillingness of students to engage in the subject. In the experience of the researcher, registered nurses identify themselves with being a nurse and a caregiver; the role of researcher has never been internalised. The challenge is to achieve the outcome envisaged, namely, nurses who are knowledgeable consumers of research as well as continuous productive scholars in their application of nursing. Research generates knowledge and knowledge is the basis of caring with excellence. Nursing is an art and a science and the science must produce the knowledge upon which the art is based. The purpose of this article is to propose a conceptual framework of how to teach research in order to achieve such a successful outcome. The conceptual framework proposed in this article is based on four pillars, theoretical knowledge of research, scientific writing, psychological support and experiential learning. The importance of the research facilitator, not just as a teacher but also as a positive role model, is also described.     

Understanding medication safety in healthcare settings: a critical review of conceptual models

Understanding medication safety in healthcare settings: a critical review of conceptual models Communication can impact on the way in which medications are managed across healthcare settings. Organisational cultures and the environmental context provide an added complexity to how communication occurs in practice. The aims of this paper are: to examine six models relating to medication safety in various hospital and community settings, to consider the strengths and limitations of each model and to explore their applications to medication safety practices. The models examined for their ability to address the complexity of the medication communication process include causal models, such as the Human Error Model and the System Analysis to Clinical Incidents Model, and exploratory models, such as the Shared Decision-Making Model, the Medication Decision-Making and Management Model, the Partnership Model and the Medication Communication Model. The Medication Communication Model provides particular insights into possible interactions between aspects that influence medication safety practices. The implications of all six models for healthcare practice and future research are also discussed.     

持续质量改进在护理质量管理实践中的应用

目的了解持续质量改进在护理质量管理实践中的应用效果。方法在护理质量管理中采用持续质量改进方法,内容包括评价标准、评价方式、过程监控、反馈与改进、安全保证5个环节,并观察推行持续质量改进前后护理质量各项指标情况。结果推行持续质量改进前后护理质量各项指标比较,经统计学分析,均P〈0.05,差异有统计学意义。结论持续质量改进是确保护理质量不断保持高水准的先进方法。     

风险管理在护理安全工作中的实施及效果

目的为了杜绝护理事故,减少护理投诉与纠纷,提高医院临床护理质量与管理水平。方法以风险管理知识为指导,以《护理安全》管理手册为媒介,有效地进行二级(护理部、科室)护理安全教育,不断总结经验和教训,开展新的项目防范措施与预案。结果护理缺点上半年与下半年比较差异具有统计学意义(P<0.05)。结论运用《护理安全》管理手册,有助于提高护士的风险意识和应对能力,对预防护理安全隐患的发生、减少护理纠纷具有重要作用。     

对陪护人员实施人性化管理的做法

目的探讨对陪护人员实施人性化管理。方法按照马斯洛需要层次论满足陪护人员的身心需求。帮助解决生活中存在的问题;定期、循序渐进地进行护理知识培训,建立陪护人员档案。结果 35例病人对陪护人员满意率为85.7%。结论对陪护人员实施人性化管理,可提升陪护质量和陪护人员的素质,促进医院社会效益和经济效益的提高。