陈华英，王惠平，戴余凡，薛水兰

(1.南京军区福州总医院第一附属医院 神经科,福建 莆田 351100;2.南京军区福州总医院第一附属医院 护理部)

·护理管理·

脑卒中康复期患者护理等级细化标准及其临床应用

陈华英1，王惠平1，戴余凡1，薛水兰2

(1.南京军区福州总医院第一附属医院 神经科,福建 莆田 351100;2.南京军区福州总医院第一附属医院 护理部)

目的 探讨实施脑卒中康复期患者细化护理等级对护理质量、患者及护士满意度的影响。方法 应用Barthel指数量表评估患者的自理能力，根据患者的自理能力和疾病的特点制定护理级别的评定标准，明确服务标准，由责任护士组织实施。选择脑卒中康复期患者100例，分为对照组和观察组，对照组按医嘱执行护理等级，观察组按细化护理等级为患者提供护理。结果 观察组护理质量评定总分、患者和护士满意度均明显高于对照组(均P<0.05)。结论 对脑卒中康复期患者应用护理等级细化标准实行分级护理，可提高患者护理质量和服务满意度。

脑卒中康复期；护理质量；满意度；分级护理

【 Abstract 】 Objective To discuss the effect of the implementation of refined criteria in nursing grade for stroke patients during rehabilitation period on nursing quality,patients and nurses’ satisfaction.Methods By using Barthel index scale to evaluated the patient’s self-care ability,and the refined criteria in nursing grade for patients with stroke was decided according to the disease characteristics and patient’s self-care ability,and clearly stated the service criteria and implemented by primary nurses.Totally 100 stroke patients in rehabilitation stage were selected and randomly divided into control group and observation group.The normal nursing grade was implemented according to doctors’ order in control group and in observation group applied with refined nursing grade.Results The total scores of nursing quality,satisfaction of patients and nurses in observation group were higher than that of control group (allP<0.05).Conclusion The application of refined criteria in nursing grade for stroke patients during rehabilitation period can improve the nursing quality and service satisfaction.

【 Key words 】 stroke rehabilitation;nursing quality;satisfaction level;nursing grade

[Nurs J Chin PLA,2015，32(24)：50-54]

脑卒中由于其高发病率及高致残率，一直是严重威胁人类生命健康的疾病之一[1]。随着护理工作范围的扩大，现代护理理论不断注入到护理实践中，分级护理制度内容显得相对陈旧，在临床实践中存在诸多问题[2]。脑卒中患者在治疗过程中，当病程进入康复期阶段，护理等级往往更改为二级护理，但是由于患者因高级神经中枢受损生活自理能力仍较差，常存在不同程度肢体活动功能和吞咽功能障碍、语言能力下降、日常生活能力缺陷等问题，护理等级与患者的护理需求极不相符，导致护理质量提高不明显，患者满意度低[3]。……