江蘇省優(yōu)質(zhì)護(hù)理服務(wù)工作方案

1、2011年江蘇省“優(yōu)質(zhì)護(hù)理服務(wù)示范工程”工作方案為貫徹落實衛(wèi)生部關(guān)于公立醫(yī)院改革要求，全面加強(qiáng)臨 床護(hù)理工作，促進(jìn)“優(yōu)質(zhì)護(hù)理服務(wù)示范工程”（以下簡稱“示范 工程”）活動在廣度和深度方面不斷發(fā)展，加快工作進(jìn)度，擴(kuò)大實施范圍，惠及更多患者，根據(jù)衛(wèi)生部關(guān)于推進(jìn)優(yōu)質(zhì)護(hù) 理服務(wù)的工作方案的要求，結(jié)合我省實際，特制定本工作 方案。一、總體要求根據(jù)衛(wèi)生部關(guān)于“示范工程”的總體部署，在總結(jié)經(jīng)驗的 基礎(chǔ)上，以“落實責(zé)任制整體護(hù)理”為核心內(nèi)容，在廣度和深 度兩方面加大優(yōu)質(zhì)護(hù)理服務(wù)推進(jìn)力度，充分調(diào)動護(hù)士積極 性，探索建立優(yōu)質(zhì)護(hù)理服務(wù)的長效機(jī)制，使公立醫(yī)院為更多 患者提供安全、專業(yè)、全程的優(yōu)質(zhì)護(hù)理服務(wù)。二、工作目標(biāo)（

2、一）在全省范圍內(nèi)全面開展優(yōu)質(zhì)護(hù)理服務(wù)。以良好的護(hù)理態(tài)度、規(guī)范的護(hù)理行為和全程的護(hù)理責(zé)任 作為優(yōu)質(zhì)護(hù)理服務(wù)的基礎(chǔ)，按開展的不同程度分A、B、C三個類別（具體要求見“主要內(nèi)容”），全面開展、分階段達(dá)到。1、到2011年6月69所省級重點聯(lián)系醫(yī)院（含所有三級醫(yī)院）60%的病房 開展優(yōu)質(zhì)護(hù)理服務(wù)，其中A類病區(qū)至少5個；二級醫(yī)院50% 的病房開展優(yōu)質(zhì)護(hù)理服務(wù)，其中 A類病區(qū)至少2個。2、到2011年12月69所省級重點聯(lián)系醫(yī)院（含所有三級醫(yī)院） 所有病房全 面開展優(yōu)質(zhì)護(hù)理服務(wù)， 其中A類病區(qū)810個，其中三級專 科醫(yī)院A類病區(qū)5個；二級醫(yī)院所有病房開展優(yōu)質(zhì)護(hù)理服務(wù)，-eves dr-in eepi -

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5、 ngS a.”.， te a gren, lowcS opeain, ul of humane cae of a . powe ge neain cm ,ay and wk had!，eoS FeSva,my Sncee wi Stha w.a,go. healh, h.py hap.其中A類病區(qū)3個。（二）立足專業(yè)發(fā)展深化優(yōu)質(zhì)護(hù)理內(nèi)涵。1、創(chuàng)建省、部級“136”工程。在全省范圍內(nèi)繼續(xù)創(chuàng)建 510所省、部級“優(yōu)質(zhì)護(hù)理服 務(wù)先進(jìn)單位”、3050個省、部級“優(yōu)質(zhì)護(hù)理服務(wù)先進(jìn)病房” 和50100名省、部級“優(yōu)質(zhì)護(hù)理服務(wù)先進(jìn)個人”。2、創(chuàng)建國家級護(hù)理重點?？?。遵循“以人為本”的整體護(hù)理理念，落實醫(yī)院

6、實施優(yōu)質(zhì) 護(hù)理服務(wù)工作標(biāo)準(zhǔn)、江蘇省”優(yōu)質(zhì)護(hù)理服務(wù)示范工程”活 動考評標(biāo)準(zhǔn)等要求，以責(zé)任制整體護(hù)理為工作模式，深入 探索基礎(chǔ)護(hù)理和?？谱o(hù)理相結(jié)合的安全、專業(yè)的臨床護(hù)理服 務(wù)，在此基礎(chǔ)上創(chuàng)建 12個國家級護(hù)理重點?？?。已獲得 的國家級護(hù)理重點專科項目醫(yī)院達(dá)到年度工作目標(biāo)。三、主要內(nèi)容1、護(hù)理模式。A、B、C三類病區(qū)全面實施小組責(zé)任制 或個人責(zé)任制整體護(hù)理，每個責(zé)任護(hù)士（責(zé)任組長）都要直 接包干患者。護(hù)士平均包干床位不超過8人，包干患者相對固定，依據(jù)“白天責(zé)任護(hù)士 8小時在崗包干、晚夜間輪班護(hù)士 16小時全面負(fù)責(zé)”的原則，根據(jù)患者護(hù)理等級、自理能力由 護(hù)士承擔(dān)全部護(hù)理工作。危重患者由年資高、職稱高、

7、能力 強(qiáng)的護(hù)士負(fù)責(zé)。A、B、C三類病區(qū)都要限制家屬探陪及自聘護(hù)工數(shù)量， 保持病區(qū)管理有序，其中 A類病區(qū)可實施免陪或陪而不護(hù)， B類病區(qū)可暫時配給少量護(hù)理員（由責(zé)任護(hù)士指導(dǎo)）予以輔 助患者的各項生活護(hù)理，但不得從事護(hù)理技術(shù)工作。2、人力配置。A、B、C三類病區(qū)要確保一線護(hù)士數(shù)量 達(dá)標(biāo)，充分挖掘人力資源潛力，及時滿足病人需要，確保護(hù) 理安全。各臨床專科護(hù)士人力配比按省廳有關(guān)文件執(zhí)行，其a e e> ceetrp se eve. -ak ef- rlg-l g e s y ukfia y u- c afcetoi vl-eldlgit-k el-lgget si ss -e - ftesto

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9、na bility tomanage a nd contr ol,optimizebusiness processes,to ensure sm oot h processes,responsi bilities i npla ce;tofurt herstrengt hen i nternal contr ols, playacontrolpostinde pendent ov ersight role ofevaluation com plyingwit h thir d-partyresponsi bility; to a ctively make use of internala ud

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15、s planscov erto alllevel,e nsuret he busi ness can contr olin contr ol;to closeconcer n fina ncial,and coalele ctric li nkage, andenergy-savi ng scheduling, national policy trends,strengtheningtrack,activeshould;to implementation State -owned assetsmethod, furtherspecifi cation busine ss financialma

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17、formance management,to ensuret hatpote ntial empl oyees "zero fly". o strengt hen performance management,process control,e nha nceemploye e evaluati on andlevels ofeffectivecommunication toimproveperforma nce management.Tofurtherquantifyand refine employe estandards.Work,fullplaypart y,and

18、 branch,and membersin"fivetypeEnterprise"constructioni n the ofcore rol e,and fightingfortressrole and pioneermodelrol e;toconti nue stostrengt hening "fourgood" lea dership constr ucti on甲A類病區(qū)：實際開放床護(hù)比A 1:0.5, B、C類病區(qū)：平均實際開放床護(hù)比達(dá)到1:0.4 。遇有危重患者多、手術(shù)患者多等特殊情況，各醫(yī)院要及時調(diào)整增加護(hù)理人員。A、 B 類病區(qū)要結(jié)合

19、專科特點實行彈性排班，實現(xiàn)護(hù)士滿負(fù)荷工作，不得出現(xiàn)忙閑不均的情況，該兩類病區(qū)原則上不得排單班，確?；颊甙踩?、護(hù)理流程。A、 B、 C 三類病區(qū)要根據(jù)醫(yī)院臨床護(hù)理工作流程（試行），明確每個崗位的護(hù)理工作內(nèi)容，細(xì)化護(hù)理人員崗位職責(zé)，完善適合本專科的護(hù)理流程，規(guī)范服務(wù)內(nèi)容，加強(qiáng)細(xì)節(jié)管理，使護(hù)士工作具有執(zhí)行力和操作性。A、 B 類病區(qū)要開展床旁護(hù)理，護(hù)士有計劃地安排各項護(hù)理，運用床旁護(hù)理車，能將一個班次負(fù)責(zé)患者所需要的用品都存放在車上，避免護(hù)士因取物等來回走動所消耗的體力和時間，將更多的時間用在對患者的直接護(hù)理上。4、護(hù)理內(nèi)涵。按照綜合醫(yī)院分級護(hù)理指導(dǎo)原則（試行）及相關(guān)文件要求，A、 B、 C 三

20、類病區(qū)責(zé)任護(hù)士全面履行護(hù)理職責(zé)，為患者提供基礎(chǔ)護(hù)理服務(wù)和護(hù)理專業(yè)技術(shù)服務(wù)， 密切觀察患者病情變化，正確實施各項治療、護(hù)理措施，加強(qiáng)護(hù)患溝通、醫(yī)護(hù)配合，提供康復(fù)和健康指導(dǎo)。A類病區(qū)每個?？朴?2個?？铺厣淖o(hù)理，并檢測其成效。護(hù)理措施到位率100% （包括生活、基礎(chǔ)、專科、心理、康復(fù)），住院病人滿意度95% 以上，出院病人滿意度調(diào)查 90% 以上，電話回訪滿意度達(dá)90% 。健康教育指導(dǎo)率達(dá) 100% ，知曉率達(dá)90% ?？祻?fù)護(hù)理指導(dǎo)率100% 。無由于護(hù)理人員工作不到位而致患者意外傷害的發(fā)生。B 類病區(qū)開展多種形式的人性化護(hù)理、全面系統(tǒng)的健康教育。 對自理能力1 級的患者，生活護(hù)理落實率達(dá)到90

21、% 以上。住院病人滿意度達(dá)90% 以上，出院病人滿意度調(diào)查達(dá)laylevels ca dres in enterpri sedevel opme ntin theofback bone backbonerole;to fullstrengtheni ngmembers youthw ork,full playyouth employee s in company developmenti nthe offorcer ole;toimpr ove independent Commission against corr upti on w orklevel,strengt heni ng onen

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23、hanism.o conscienti ouslysum upthe Olympi cse curitycontrol s, pr omoting integratedma nagement to a higher leve l,hig herstandards,a higher levelofdevelopme nt. Employe es,today islunar calendaron Decem ber24,the ox Be llisabouttori ng,atthis timeofyear,weclearlyfeelthepulse oftheXXpowergenerationc

24、ompa nytoflouri sh, t o moreclearly hearXXpower ge neration companie85%以上，電話回訪滿意度達(dá) 85%。健康教育指導(dǎo)率達(dá) 100% ,知曉率達(dá)90%?？祻?fù)護(hù)理指導(dǎo)率 100%。無由于護(hù) 理人員工作不到位而致患者意外傷害的發(fā)生。C類病區(qū)住院病人滿意度達(dá) 90%以上，生院病人滿意度 調(diào)查達(dá)85%以上，電話回訪滿意度達(dá) 85% o健康教育指導(dǎo) 率達(dá)100% ,知曉率達(dá) 90% o康復(fù)護(hù)理指導(dǎo)率 100%。患者 生活護(hù)理落實率達(dá)到100% ,重危病人的生活護(hù)理全部由護(hù) 士承擔(dān)。無由于護(hù)理人員工作不到位而致患者意外傷害的發(fā) 生。5、服

25、務(wù)公示。A、B、C三類病區(qū)實行等級護(hù)理公示制， 根據(jù)綜合醫(yī)院分級護(hù)理指導(dǎo)原則、住院患者基礎(chǔ)護(hù)理服 務(wù)項目（試行）、基礎(chǔ)護(hù)理服務(wù)工作規(guī)范和常用臨床 護(hù)理技術(shù)服務(wù)規(guī)范等規(guī)范，結(jié)合科室情況明確等級護(hù)理服 務(wù)的具體內(nèi)容和標(biāo)準(zhǔn)，并上墻公示。對收取經(jīng)物價部門備案等 級護(hù)理費的病區(qū)，必須做到患者入院時人人簽署知情同意書。A、B類病區(qū)建立“日患者溝通制”，每天由護(hù)士長或臨時 負(fù)責(zé)人員與每位患者交流至少1次，及時了解和發(fā)現(xiàn)患者的護(hù)理工作完成情況和對護(hù)理工作的滿意情況，及時反饋并與 個人滿意度桂鉤。四、全年工作要點1、印發(fā)2011年江蘇省“優(yōu)質(zhì)護(hù)理服務(wù)示范工程”工作 方案、江蘇省醫(yī)院護(hù)理崗位管理的指導(dǎo)意見，部署全

26、 年工作安排。2、召開2011年全省護(hù)理工作會議，動員部署全年“優(yōu) 質(zhì)護(hù)理服務(wù)”工作任務(wù)。3、組織部分二、三級醫(yī)院優(yōu)質(zhì)護(hù)理服務(wù)現(xiàn)場調(diào)研工作。4、指導(dǎo)省人民醫(yī)院、南京豉樓醫(yī)院完成國家護(hù)理重點 專科項目工作計劃，確定 23個專項業(yè)務(wù)課題，并在 3月a e e> ceetrp se eve. -ak ef- rlg-l g e s y ukfia y u- c afcetoi vl-eldlgit-k el-lgget si ss -e - ftestoea ast - y .frt. g- -1 一 a u a ivaegl yew-st st g-l - gees- ave - d a-

27、u e r- aeaaa- ai aeage cs.s- ss u-lu - .s-g . rtg - gelvge staa.g .ee 1yle a l aa eee .Be - i u- g a f i a e 1一 -s -wegllO-f-toe laee g eaiWewillcontinue toimprovethe compa ny's inter nalcontrolsy stem,and steady improveme ntina bility tomanage a nd contr ol,optimizebusiness processes,to ensure

28、sm oot h processes,responsi bilities i npla ce;tofurt herstrengt hen i nternal contr ols, playacontrolpostinde pendent ov ersight role ofevaluation com plyingwit h thir d-partyresponsi bility; to a ctively make use of internala udit tools detectpotentialmanagement,streamline,standardizerelatedtransa

29、ctions, strengthe ning operati ons i naccor dancewith law.Deepeningthe information managementtoensurefullcommunication "zero resistance".o constantly perfect ERP ,and BFS+ ,and PI,a nd M IS,andSCM,i nformation sy stembase dconstruction,fullintegration informati onsystem,a chieve d informat

30、ionresource sshare d;to expand Portalsystem application ofbreadt h andde pth, play i nformation sy stemon e nterpriseofAssistant rol e;toperfectdaily r un mainte nance operation ofrecords,promote problem reasons a nalysisand systemha ndover;to strengthe ning BFS+,a nd ERP , and S CM,technologya ppli

31、cation oftraining, im proveempl oyees a pplication information systemofcapacityand level.Humanistic caret oensure"zero."Tostrengtheni ng Huma nities car e,continuestofoster compa ny wind cle ar,and g as are, andheartShunofcultureatmosphere; strengthe ningl ovehel pedtra pped, care difficul

32、templ oyees; carried outstylea ctivities,ri chempl oyees life;stre ngthe ning healtha nd la bour prote ction, organi zation career health me dical, controlcareeragai nst; continuesto impleme ntation psychol ogicalwarni ng preventi on sy stem, trainingempl oyees health ofchara cter,a ndsta bleofmood

33、andenter prisi ng ofattitude, createdfriendly fraternityofHumanities environment.T ostre ngthe n riskmanageme nt,ensure t hatthe busi ness of"zero risk".T ostre ngthe ned business pla ns manag ement, will busine ss busi ness planscov erto alllevel,e nsuret he busi ness can contr olin contr

34、 ol;to closeconcer n fina ncial,and coalele ctric li nkage, andenergy-savi ng scheduling, national policy trends,strengtheningtrack,active should;to implementation State -owned assetsmethod, furtherspecifi cation busine ss financialmanagement;toperfectrisktube controlsystem,achieved riskrecog nition

35、,and measure , andassessme nt,and report,and controlfeedback ofclosed ri ng management, im proverisk preventionca pacit y.o furtherstandardi zetrading ,and strivetoachieve "accordingtolaw,standardizeandfair."Innovationof performance management,to ensuret hatpote ntial empl oyees "zero

36、 fly". o strengt hen performance management,process control,e nha nceemploye e evaluati on andlevels ofeffectivecommunication toimproveperforma nce management.Tofurtherquantifyand refine employe estandards.Work,fullplaypart y,and branch,and membersin "fivetypeEnter prise" construction

37、i n the ofcore rol e,and fightingfortressrole and pioneermodelrol e;toconti nue stostrengt hening "fourgood" lea dership constr ucti on底前按部里要求所有病房全面開展優(yōu)質(zhì)護(hù)理服務(wù)。5、委托護(hù)理學(xué)會探索建立以省轄市為單位的區(qū)域護(hù)士人力資源庫，以南京市為試點。6、繼續(xù)舉辦三級醫(yī)院護(hù)士長崗位培訓(xùn)班5 期，二級醫(yī)院護(hù)理部主任培訓(xùn)工作一并納入。舉辦三級醫(yī)院護(hù)理部主任論壇 2 期。7、繼續(xù)和省物價、醫(yī)保部門溝通協(xié)調(diào)護(hù)理收費事項，構(gòu)建科學(xué)合理的護(hù)理定價體系

38、。8、 結(jié)合實施“年輕護(hù)士素質(zhì)提高行動”， 分?？凭帉懪R床護(hù)理“三基”。印發(fā) 2011 年全省三級醫(yī)院護(hù)理人員“三基”抽考方案，重點強(qiáng)化年輕護(hù)士臨床操作及護(hù)患溝通能力。9、積極推動護(hù)理垂直管理，選擇 35所三級綜合醫(yī)院試點實施全面的護(hù)士崗位管理，總結(jié)經(jīng)驗，樹立典范，適時召開優(yōu)質(zhì)護(hù)理服務(wù)現(xiàn)場推進(jìn)會，在全省宣傳推廣做法。10 、調(diào)研省級專科護(hù)士培訓(xùn)基地工作，在原有基礎(chǔ)上創(chuàng)建12新基地。在實施護(hù)士崗位管理的試點醫(yī)院中，探索專科護(hù)士的使用問題。創(chuàng)建國家級護(hù)理重點專科 12個。11 、 建立以臨床護(hù)士長為主的護(hù)理質(zhì)量檢查專家?guī)觳⑦M(jìn)行系統(tǒng)培訓(xùn)。組織二、 三級醫(yī)院創(chuàng)建“優(yōu)質(zhì)護(hù)理服務(wù)示范工程”工作情況中期驗收

39、工作并進(jìn)行情況通報。12 、評選表彰2011 年“優(yōu)質(zhì)護(hù)理服務(wù)”先進(jìn)單位、先進(jìn)病房及先進(jìn)個人若干，總結(jié)全年工作。五、保障措施1 、建立信息通報制度。自 2011 年 2 月起， 完善原有信息通報制度，及時掌握69 所省級重點聯(lián)系醫(yī)院工作情況，立足進(jìn)度和實效兩方面，定期通報工作進(jìn)展，對工作不力的衛(wèi)生行政部門和醫(yī)院進(jìn)行通報批評。2、加大對醫(yī)院考核力度。各級衛(wèi)生行政部門要高度重laylevels ca dres in enterpri sedevel opme ntin theofback bone backbonerole;to fullstrengtheni ngmembers youthw o

40、rk,full playyouth employee s in company developmenti nthe offorcer ole;toimpr ove independent Commission against corr upti on w orklevel,strengt heni ng onenter prise busi ness key link ofeffectiveness monitore d.,And maintain stability.Tofurther stre ngthe npubli city ande ducation,improvet he over

41、alllegalsystem.We must stre ngthen safety management, esta blish and improve theeducation,supervision, andevaluati on as one ofthetrafficsafetymanagementmechanism.o conscienti ouslysum uptheOlympi cse curitycontrol s, pr omoting integratedmanagement to a higher level,hig herstandards,a higher levelo

42、fdevelopme nt. Employe es,today islunar cale ndaron Decem ber24,the ox Bellisabouttori ng,atthis timeofyear,weclearlyfeelthepulse oftheXXpowergenerationcompa nytoflouri sh, t o moreclearlyhearXXpower generation companie 視“示范工程”創(chuàng)建工作，大力開展調(diào)查研究，切實加強(qiáng)溝通 協(xié)調(diào)，為醫(yī)院“創(chuàng)優(yōu)”創(chuàng)造有利的工作條件。同時，將“示范工 程”納入大型醫(yī)院巡查、等級醫(yī)院評審、臨床重點專

43、科考評、 診療中心評審、綜合目標(biāo)考核等工作中，加大對醫(yī)院考核力 度，形成推進(jìn)工作的抓手。3、分類別積極穩(wěn)妥推進(jìn)。 以衛(wèi)生部醫(yī)院實施優(yōu)質(zhì)護(hù) 理服務(wù)工作標(biāo)準(zhǔn)為指導(dǎo)，結(jié)合江蘇省”優(yōu)質(zhì)護(hù)理服務(wù)示范 工程”考評標(biāo)準(zhǔn)，以落實責(zé)任制整體護(hù)理為核心， 探索對“優(yōu) 質(zhì)護(hù)理服務(wù)病房”實行分類別實施評價的做法，達(dá)到實事求 是、積極穩(wěn)妥推進(jìn)“創(chuàng)優(yōu)”工作的目的。醫(yī)院一把手院長要積極想辦法支持優(yōu)質(zhì)護(hù)理工作，協(xié)調(diào) 各部門支持臨床護(hù)理工作。一是要采取有效措施保證臨床一 線護(hù)士數(shù)量足夠，各臨床專科配比合理；二是要協(xié)調(diào)職能部 門做好藥品運送、物資保障、維修、送檢、膳食、安全、財 務(wù)結(jié)算等保障工作，使護(hù)士盡心盡力護(hù)理患者；三是根據(jù)

44、病 人需求及醫(yī)療技術(shù)的發(fā)展，配置新型的護(hù)理用品、用具和設(shè) 備，改善護(hù)理工作條件；四是建立績效考核制度，合理確定 護(hù)士待遇水平，充分調(diào)動護(hù)士的積極性。4、積極爭取合理收費。 為切實體現(xiàn)護(hù)理人員勞務(wù)價值， 促進(jìn)“示范工程”健康持續(xù)發(fā)展，積極爭取合理收費。一是配 合物價、醫(yī)保等部門通過調(diào)研，確定“優(yōu)質(zhì)護(hù)理服務(wù)”分類別 收費標(biāo)準(zhǔn)；二是各級醫(yī)院實事求是地向當(dāng)?shù)匦l(wèi)生行政部門通 報創(chuàng)優(yōu)情況，提由護(hù)理收費申請。5、不定期開展督導(dǎo)檢查。 加強(qiáng)對各地開展優(yōu)質(zhì)護(hù)理服 務(wù)的督導(dǎo)檢查，市級衛(wèi)生行政部門負(fù)責(zé)對轄區(qū)內(nèi)醫(yī)院工作情 況進(jìn)行督導(dǎo)檢查，按照進(jìn)度和內(nèi)涵進(jìn)行評價、考核，保證工 作實效。省廳將不定期組織對各地的督導(dǎo)評估，

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