Study On The Main Decision-making Of Grading Nursing

Objective To establish the best main decision-making of grading nursing,exploring whether the nurses can participate and the way for nurses to participate in the grading nursing decision-making.SamplingsPartⅠ:Ten head nurses and eight branch directors were interviewed.All of the head nurses interviewed were female,the average age was 41.800±5.051 years old and the average working time was 21.400±5.892 years,four head nurses of them had secondary administrative duties while the others had high administrative duties;Among the branch directors interviewed,six were male and two were female,the average age was 44.500±2.507 years old and the average working time was 21.875±2.800 years,All of the branch directors had high administrative duties.PartⅡ:553 top three hospital nurses working in inpatient department of eight hospitals in Tai Yuan of Shan Xi Province and in Beijing were surveyed,all of the subjectives were female.The numbers of hospitals surveyed in Tai Yuan of Shan Xi Province were five and the nurses surveyed were 453,The numbers of hospitals surveyed in Beijing were there and the nurses surveyed were 100.The age was from 23 years old to 54 years old and the average age was 35.548years old;The working time was from 1 years to 37 years and the average working time was 15.284 years.PartⅢ:10 doctors who had high administrative duties and 13 nurses who were working in nursing academy were chosed to fill in the AHP form.MethodsPartⅠ:The in-depth individual interviews were applied to investigate the ideas of doctors and nurses in hospitals of feasibility and ability of nurses participating in the grading nursing decision-making.The data were analyzed by SPSS 11.5 for Windows software,statistical methods were independent sample t test and Fisher's exact test.PartⅡ:The identification of nurses participating grading nursing decision making and the idea of whether the nurses would like to make the grading nursing decision were surveyed with a questionnaire named "Questionnaire on identification of nurses participating grading nursing decision making" made by the author,and the best main decision-making of grading nursing then could be preliminarily concluded.The data were analyzed by SPSS11.5 for Windows software and the Microsoft Excel database,the statistical method was non-Conditional Logistic regression analysis.PartⅢ:AHP was used to establish the best main decision-making of grading nursing,The data were analyzed by Microsoft Excel database.ResultsPartⅠ:8/10 of the nurses thought that there was something wrong with the grading nursing order ordered by the doctors,however,the doctors believed that the grading nursing order had no doubt.The nurses' ideas on the feasibility of nurses participating in the grading nursing decision-making were half of half,all the interviewed doctors did not object the nurses participating in the grading nursing decision-making but most of the doctors(7/8) doubted the nurses' ability to do so.Majority of the nurses(6/10) believed that they were qualified to participate in the grading nursing decision-making.Both doctors(8/8) and nurses(7/10) were considered cooperating with the doctors as the best way for the nurses to participate in the grading nursing decision-making.PartⅡ:(1) 74.3%of the nurses thought that the nurses should participate in the grading nursing decision-making.There was higher prevalence rate of the undergraduate nurses' first diploma.(2) 96.6%of the nurses thought that nurses should cooperate with the doctors to make the grading nursing decision.There was higher prevalence rate of city surveyed.The OR for nurses in Beijing compared with the nurses in Shan Xi was 0.344.(3) 67.5%of the nurses believed that they had the ability to participate in the grading nursing decision-making.There was higher prevalence rate of jobs types in hospital and administrative duties.The OR for nurses working in nursing management compared with the nurses working in clinic was 1.453;The OR for nurses who had administrative duties compared with the nurses who had no administrative duties was 1.490.(4) 75.0%of nurses were willing to participate in the grading nursing decision-making. There was higher prevalence rate of age and working time.The OR of age was 0.738,the OR of working hours was 0.722.(5) Nurses who had secondary administrative duties were considered to be the suitable candidates who had the ability to make the grading nursing decision,accounting for 61.1 percent.(6) Nurses with secondary education who had worked from 15 years to 20 years were considered to be the suitable candidates making the grading nursing decision,accounting for 80.9 percent;nurses with tertiary qualification who had worked from 10 years to 15 years were considered to be the suitable candidates making the grading nursing decision,accounting for 81.1 percent;nurses with bachelor degrees who had worked from 5 years to 10 years were considered to be the suitable candidates making the grading nursing decision,accounting for 73.6 percent;nurses with master degrees who had worked from 2 years to 5 years were considered to be the suitable candidates making the grading nursing decision,accounting for 50.5 percent.PartⅢ:In nurses group:the weight of nurses independent decision-making(0.61895) was higher than the weight of cooperation decision-making(0.30512) and the weight of medical decision-making(0.07595);In medical doctor group:the weight of cooperation decision-making (0.69668) is higher than the weight of nurses independent decision-making(0.20736) and the weight of medical decision-making(0.09596);In medical doctor and nurses group:the weight of cooperation decision-making(0.56545) was higher than the weight of nurses independent decision-making weight(0.34067) and the weight of medical decision-making(0.09389).Conclusions Most of the nurses believed that nurses should participate in the grading nursing decision-making,Majority of the nurses believed that they had the ability to make the grading nursing decision and were eager to do so.The doctors can not considered to be the best main decision-making of grading nursing.On this question,the nurses'experts thought the nurses could make the grading nursing decision independently,while the doctors' experts thought the nurses should cooperate with the doctors.