| Objective In order to describe and understand nursing and organizational characteristics of pediatric intensive care units and the current situation of the nursing environment in Grade-A Tertiary hospitals in China.Methods Part 1:Translated and adapted the original questionnaire"nursing and organizational characteristics of pediatric ICU",the questionnaire was evised through the expert group meeting,and content validity was evaluated.Part 2:A cross-sectional survey was employed in this survey.Convenient sampling and cluster sampling were selected.The Chinese version of of nursing and organizational characteristics of pediatric ICU questionnaire were used to survey 26 Grade-A Tertiary hospitals,51 pediatric ICUs and 1414 pediatric ICU nurses,data were analyzed by SPSS20.0.Results 1.The CVI of the Chinese version of of nursing and organizational characteristics of pediatric ICU questionnaire was 0.96.2.Characteristics of nursing organization structure:(1)The 26 hospitals included 15 children's hospitals,5 maternity and children's hospitals,6 general hospitals,51 pediatric ICUs including 26PICUs,16 pediatric CICUs,9 pediatric SICUs,they open 1219 beds with 1910 registered nurses.The percentage of hospitals owned pediatric CICU and SICU in North China,East China and South China was 80%and 53.3%.The percentage of hospitals owned pediatric CICU and SICU in Northwest,Southwest and Northeast was 36.4%and 9.1%.49%pediatric ICUs carry out ECMO and 56.9%develop CRRT.(2)96.1%pediatric ICUs implemented the nurse level management system,54.9%adopted the 8-hour nursing work shift,and 31.4%required the new nurses to be admitted to the ICU to have a bachelor's degree.(3)The average ICU bed to nurse ratio was 1:1.61,the average nurse-to-patient ratio was 1:2.88.48.4%pediatric ICU nurses were senior nurses,60.7%had a bachelor's degree;their ICU working years were mainly 3-5 years,accounting for 30.5%;the professional title,education and working years of nurses were different in different regions(P<0.01).(4)21.5%of pediatric ICU nurses had the international PALS training certification,and 5.5%of pediatric ICU nurses had the international ACLS training certification.19.6%of nurses passed provincial or municipal ICU specialist training,8.8%passed provincial or municipal pediatric nursing specialist training,12.7%passed provincial or municipal advanced life support training.(5)62.7%of pediatric ICUs owned clinical nursing specialist,33.3%of pediatric ICUs were equipped with dietitians,and 11.8%were equipped with respiratory therapists.3.Characteristics of nursing organization process:62.7%pediatric ICUs used electronic nursing records,45.1%used standardized communication,49%used checklists.4.Characteristics of nursing organization results:(1)Patient outcome:the average mortality rate of pediatric ICU patients was 1.88%,the average length of stay in ICU was 7 days.(2)Score of each items of urses'job satisfaction was 3.29±0.49.Hierarchical multiple regression analysis showed that the hospital location and monthly income affected nurses'job satisfaction,the nursing work environment predicted the nurses'job satisfaction(R~2=0.731,P<0.01).5.Nursing work environment:the score of nursing work environment scale was 93.14±15.23,the highest average score of each dimension item was the basis of high quality nursing service(3.12±0.45),and the lowest was sufficient human and material resources(2.83±0.64).Conclusions 1.The Chinese version of nursing and organizational charateristics in pediatric ICU questionnaires in the study was proved to be good validity.2.Nursing organization structure characteristics:(1)The construction of pediatric ICU in Grade-A Tertiary hospitals had been increasingly improved,but the development of domestic regions was unbalanced,the pediatric surgical ICU configuration is not perfect.(2)Nursing human resource was insufficient in pediatric ICUs,bed-nurse ratio and nurse-patient ratiowas insufficient,the majority were young nurses,the proportion of nurses with different educational degree and years of clinical experience was reasonable.(3)Strengthen pediatric and ICU specialist training certification.(4)Pediatric ICU nursing and other medical support positions were diverse.3.Nursing organization process characteristics:the nursing process in most pediatric ICUs was developing scientifically,but there was a considerable gap compared with foreign countries.4.Nursing organizational results:the level of pediatric ICU nurse job satisfaction was medium in Grade-A Tertiary hospitals.The hospital location and monthly income affected the job satisfaction,the nursing work environment was the most important predictive variable.5.Nursing organization environment:nursing working environment in the pediatric ICU of Grade-A Tertiary hospitals was genral,with foundation of high-quality nursing services,but the manpower and material resources were insufficient. |
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