Study On The Influencing Factors And Countermeasures Of Implicitly Rationed Care On Primary Nurses In Three A-level Hospital In Changchun

Objectives:The aim of this study was to describe the level and influence factor of implicitly rationed care on primary nurses,to explore the relationship between nurseing work environment,to discuss the prevention strategy.All of this would be reference for clinical management further evaluation the level of nurses implicitly rationed care,to provide high quality nursing service,improve the quality of nursing care and patient satisfaction to provide.Methods:A cross-sectional study was undertaken from June 2016 to November 2016,the research was carried out on 410 primary nurses in third-level A-rate hospitals in Changchun.The questionnaire consists of three parts,including General Informention Questionnaire,The Extent of Rationed of Implicitly Nursing Care Questionnaire,Perceived Nursing Work Environment Scale.The data were typed with Epidata3.1,and analysed with SPSS17.0 statistical software,collected data was use descriptive analysis,t test,single factor analysis of variance,Bonferroni pairwise comparition,Pearson coefficient analys,multiple linear regression analysis method.Results:1.The average score of implicitly rationed care(2.16±0.60),in six dimension,the highest score is documentation diemension(2.22±0.69),secondly respectively was activity of daily livings(2.21±0.71),rehabilitation education(2.20±0.69),Monitoring(2.17±0.74),humanistic care(2.15±0.67),the lowest score is safety culture dimision(2.06±0.69).the highest score of item was“You can't close guardianship delirious patients,so have to impose constraints on them or apply sedatives”(2.36±1.03),the lowest score of item was“You will not discuss medical errors,therefore you can't learnform them”(1.89±0.77).2.The average score of perceived nursing work environment was(2.61±0.38),The highest of dimension score was nursing management(2.70±0.59),respectively was professional clinical work system(2.67±0.47),professional practice(2.65±0.50),professional development and participation in decisuin-making(2.59±0.43),medical cooperation(2.48±0.65),the lowest score is manpower and material resources dimenion(2.33±0.68).3.Single factor analysis showed that education background,job title,department,as a primary nurse time,night shift frequency,daily work hours,responsibility to care patients,employment way influence primary nurses implicitly rationed care significantly(P<0.01).4.The implicitly rationed care and nursing work environment has significant negative correlation(r=-0.418),monitoring dimension is most negative correlation to nursing work environment(r=-0.471),activity of daily livings dimension is lowest negative correlation to nursing work environment(r=-0.332).5.Multiple regression analysis showed that education background,as a primary nurse time,night shift frequency,daily work hours,medical cooperation,manpower and material resources entering the model could explain 71.4% of the variance of implicitly rationed care.Conclusions:1.The score of implicitly rationed care on primary nurses in third-level A-rate hospitals in Changchun are in the intermediate level,indicating that there are still space to reduce the level of the primary nurses of implicitly rationed care.2.Age,job title,department,as a primary nurse time,night shift frequency,daily work hours,responsibility to care patients,employment way significantly influence primary nurses implicitly rationed care significantly.3.The more limitedmanpower and material resources,Medical cooperation,the high level of implicitly rationed care on primary nurses.4.education background,as a primary nurse time,night shift frequency,daily work hours,medical cooperation,manpower and material resources significant predictionfactors affecting implicitly rationed care.