Study Of Policy Model On Management Of Nursing Care Human Resource

Background:The Ministry of Health,"China's development program for nursing," clearly put forward that the nursing care post should be properly arranged according to the development of medical diagnosis and treatment technology requirement of clinic nursing,so as to guarantee the nurses' distribution of the clinical nursing post,and administrate the nurse human resource scientifically.Thereby,it can change the shortage of the first line clinic nurse.And the structure of nurses unit is reasonably regulated according to the work responsibility and the technical standard requirement of the clinical nursing post.The responsibility,the technical standard requirement and the layer-management of nurses should be integrated dynamically,so that the different level nurses fully play their role.Because there are so many problems in the nurse human resource of China,including shortage of nurse,improper establishment structure and arrangement of nurse etc.,the nursing care human resource management mode should be innovated to fully make the use of the existing nursing care resource, finally to improve use efficiency of nursing resourcePart one Investigation on nursing human resource in levelⅢhospital of GuangdongPurpose:To investigate nurses relative data in levelⅢhospital of Guangdong province,and to know the basis nursing human resource management model.Methods:We investigated 65 hospitals at 2006 and 69 hospitals at 2008 by means of spot field investigation,including the number of the nurse staff,the number of the nurse in wards,the ratio of nurses and hospital beds,the ratio of ICU wards and hospital beds,the number of Contract nurses,the proportion of nurses with college education diploma the patients' satisfaction,and so on. Results:Hospital beds and bed occupancy rate increased greatly in 54 hospitals, There is a large proportion of contract nurses in every hospital and a increasing proportion of nurse with college education.Mean ratio of hospital beds and nurses is 1:0.4 There is varying degree resignation of nurses,in every hospitals.The hospitals of nurses resignation ratio more than 10%account for 4.34%of all investigated hospitals,the ones between 5%and 10%account for 27.54%,the ones not more than 5%account for 68.12%.Conclusions:There is a shortage of nursing human resource in levelⅢhospitals of Guangdong province.The nurses' education background varies greatly.The professional educations need to be improved,and a nurse resignation is still exists in variable hospital.It is imperative to explore the efficient nursing human resource management model.Part two Study on policy model of human resource managementSome problems of the present nursing human resource management:1.The content and the complexity of nursing care are increasingly enhancing.2.The operating pattern of clinical nursing is not focus on the patients.But finishing the work tasks.3.The Management of clinical nurses is getting more non-clinical trend because of the homogenization of administration.4.The scheduling way of the nurses has shown the low efficiency of the clinical nurse human resource.Management principles of the policy model:1.Re-planning the Management system of clinical nursing care human resource.2.Establishing a new policy model to manage human resource of nursing care in wards2.1 Refining the quantity,the item and the structure of the human resource of ward nurses,in hospital2.2 Establishing the clinical practice standard of the clinical nurse human resource layer-management.2.3 Establishing the clinical practice standard(policy standard) of the primary nursing.2.4 Establishing the clinical practice standard of the continuous scheduling.2.5 Establishing the working system and operating pattern of nursing care which is focus on layer-management.Part three Analysis on practice state of human resource management model in clinical nursing.Purpose:To investigate the implementation of nursing human resource management model in hospital.(Nursing grade management,continue schedule and primary nursing)Methods:Using the Ward nursing human resources management factors questionnaire,researchers collected data from a sample involved 1125 patients taken at random from 4 hospitals to investigate and analysis the factors of Ward nursing human resources management.Results:Most of the 1125 nurses are young and middle-aged,29.16%of them are 21-25 years old,and 34.76%are 26-30 years,only 0.62%is 46-50 years old.The number of male account for 0.36%,most of them have specialized academic qualification and the professional title of Nurse Practitioner and Nurse-in-charge,but 2.4%are professor of nursing or associate professor of nursing.With the advance of work times,the number of nurses decreases.The work times between 1 and 5 take the most proportion,38.67 of all.Only 1.33%of nurses worked for 26 years or more. Nursing grade management has been applied in the 98.49%clinical department.Conclusion:New nursing human resource management model can promote enthusiasm of nurses because of more explicit the responsibilities.It is a important to achieve the scientific nursing human resources management,optimize the manpower configuration,and provide perfect seamless patient care.Part four:Assessment on nurses' job satisfaction with human resource management model in clinical nursing.Objective:Compared nurses' job satisfaction with ordinary scheduling to the continuity scheduling,discusses the related factors which influence job satisfaction after continuity scheduling.Methods:In Zhujiang hospital,142 nurses who working on ordinary scheduling and 396 nurses who working on continuous scheduling take part in survey;A total of 1125 nurses which respectively come from the People's Hospital of Dongguan City,First People's Hospital of Foshan,Hospital of Shenzhen Longgang District,Zhujiang Hospital working on continuous scheduling take part in survey.Self-made and MMSS questionnaire were adopted.Self-made questionnaire mainly contain age,gender, marriage,educational history,working lifetime et al.MMSS have eight factors,31 items.Eight factors are welfare treatment,scheduling,balance of family and work, colleague relationship,social or professional exchanges,interaction opportunities, professional development opportunities,and support and decision-making opportunities on work,praise and recognition.Items were rated using a 5-point scale ranging from 1(very dissatisfied) to 5(very satisfied).1 to 5 represent very dissatisfied,moderate dissatisfied,neutrality,moderate satisfied,very satisfied respectively.Results:After continuous scheduling,total satisfaction,welfare treatment,scheduling, balance of family and work,colleague relationship,social or professional exchanges, interaction opportunities,professional development opportunities,support and decision-making opportunities on work,praise and recognition were all increased.It's significantly different with ordinary scheduling.After continuous scheduling,job satisfaction was related with age,marriage,educational history,grade,working lifetime.Conclusion:The continuous scheduling is superior to ordinary scheduling,and improved job satisfaction of nurses.Job satisfaction of continuous scheduling was related to factors as age,marriage,educational history,grade,working lifetime.Part five:Assessment on nurses' recognition in patient safety culture of human resource management model in clinical nursing.Purpose:To investigate the recognition of patient safety in nurses after the implementation of APN shift arrangement and to make a comparison between APN and traditional shift arrangement in the patients' knowledge of safety culture.Objective:and methods:A cluster sampling was applied to select nurses of Guangdong province from four different departments of hospitals in different areas, To assess the recognition of patient safety in nurses after the implementation of APN shift arrangement,it was measured with "Hospital Survey on Patient Safety Culture" which designed by American Healthy Care Study and Quality Administration.Of this total,three rounds of questionnaires were performed in Zhujiang Hospital including before,initial stage and late stage of APN shift arrangement.Multivariate regression analysis is applied to the statistics of the results.Results:The total valid questionnaires are 192,which regained from Zhujiang Hospital before the implementation of APN shift arrangement,while 254 in the initial stage.The number that comes from the late stage in four hospitals is 1125.The Statistics analysis showed that there was no statistical significance between APN and traditional shift arrangement in the patients' knowledge of safety culture.(P＞0.05) After the implementation of APN shift arrangement,the higher consent rate among nurses were in "Organizational learning-Continuous improvement","Teamwork within units","Feedback & communication about error","Supervisor/manager expectations & actions promoting safety",while the lower consent rate were in "Personnel Configuration","No punitive response to error","Frequency of events reported".The professional title can be a statistical significant factor influencing the total score of patients' safety culture.Conclusion:The implementation of APN shift arrangement seemed to have no negative effect on patient safety and would improve the safety recognition among nurses in China.Part six:Assessment on patients' satisfaction of human resource management model in clinical nursingObjective:To explore the inpatients' satisfaction with the medical service in the hospitals,and administrate the nursing care human resources by the new policy model in ward.Methods:The questionnaire of inpatients' satisfaction with the medical service (IPSQⅢA),including the procedure of admission to hospital,nursing care,hospital environment and facilities,the right to know etc.,is finished by 825 inpatients in Zhujiang Hospital,the First People's hospital of Foshan,the People's hospital of Doguan city and Hospital of Shenzhen Longgang District.Results:In the study of the 4 hospitals,most inpatients are satisfied with the medical services and have highest level of satisfaction with doctor service(83.78) and nursing care(82.04).But most of them have lowest level of satisfaction with the food supply (64.93) and the cost(71.38).Conclusion:Reasonable nursing human resources management is very important to improve nursing care quality and patient satisfaction in hospital.