综合ICU实行医护一体化模式下责任护理组长负责制的管理实践

刘静兰，刘琼，田玉凤

摘要:[目的]探讨综合ICU实行医护一体化模式下责任护理组长负责制实施效果。[方法]在综合ICU实行“医护一体化模式下的责任护理组长负责制”,明确其岗位职责和工作流程，制定并实施绩效考核方案，对护士分层培训。比较实施前后护理文件书写合格率、专科护理操作考核合格率、特级护理落实合格率、抢救成功率、治疗目标达成率检查结果；通过自设问卷调查医生、病人及家属对护理工作的满意度。[结果]实行医护一体化模式下责任护理组长负责制后护理满意度及各项危重护理质量指标得到提高。[结论]医护一体化模式下责任护理组长负责制的实行,激发了护士的工作积极性，从而提供更专业的护理服务、规范化的培训，并推动科室团队文化的良性发展，但人力资源分配及绩效考核等仍需进一步探讨。

关键词：ICU；医护一体化;小组责任制;护理管理

中图分类号：R197.323

基金项目：2013年—2014年度湖北省卫生厅护理科研项目，编号：HL2012-12。

作者简介：刘静兰,副主任护师,硕士研究生在读,单位:443003,三峡大学第一临床医学院&湖北省宜昌市中心人民医院；刘琼、田玉凤(通讯作者)单位：443003，三峡大学第一临床医学院&湖北省宜昌市中心人民医院。

收稿日期：(2014-07-30；修回日期：2014-12-17)

Management practice of group leader responsibility system based on medical integration model in comprehensive ICU

Liu Jinglan，Liu Qiong，Tian Yufeng(First Clinical Medical College of China Three Gorges University，Yichang Central People’s Hospital of Hubei Province，Hubei 443003 China)

AbstractObjective：To probe into the effects of the group leader responsibility system based on the medical integration model in comprehensive ICU.Methods：Group leader responsibility system based on medical integration model was carried out in comprehensive ICU，then to determine their duties and work flow，make and fulfill performance assessment scheme and classification training for different nurses.The pass rate of nursing file writing，specialist care operations examination pass rate，pass rate of implementation of intensive care，the survival rate，the treatment goal achievement rate and test results，the satisfaction of doctors，patients and their families to nursing work were compared before and after the implementation through self-designed questionnaires.Results：This nursing satisfaction and the various quality indexes of critical care were improved.Conclusion：The implement of group leader responsibility system based on the medical integration model has inspired the enthusiasm of nurses，provided a more professional care services and standardized training.It promotes the healthy development of team culture in Geriatrics Department.Nevertheless，the human resources allocation and performance appraisal still need to be studied further.

Key wordsICU(intensine care unit)；medical integration；group responsibility system；nursing management

护理质量的优劣直接关系到病人的生命安全[1]。ICU作为医院集中救治危重病人的特殊单元，是衡量一个医院技术水平的重要标志，因而医疗护理质量管理水平显得尤为重要[2]。……