三级医院护理垂直管理模式架构与实践策略集的构建

doi:10.3761/j.issn.0254-1769.2020.11.012

摘要/Abstract

摘要：

目的构建三级医院护理垂直管理模式架构与实践策略集,以推进护理管理改革。方法在文献系统评价和半结构式访谈的基础上拟订初稿,采用德尔菲法对来自全国16个省市三级医院的20名专家进行2轮咨询。结果 2轮专家咨询的权威系数分别为0.93和0.94,肯德尔和谐系数为0.043~0.233。最终确立的三级医院护理垂直管理模式架构与实践策略集包含垂直联合扁平化的管理架构、转换型领导、标准化的护理专业实践、组织授权、创新与实践和支持系统6个维度、17个要素和60个要素特征及其实践策略。结论构建的护理垂直管理模式架构与实践策略集科学、实用、内容较全面,可为国内三级医院护理管理模式改革与实践提供依据。

关键词: 护理管理研究, 垂直管理, 德尔菲技术

Abstract:

Objective To develop a vertical nursing administration model and practice strategies,so as to advance the reform of nursing management model in tertiary hospitals. Methods Based on a literature systematic review and semi-structured interviews,2 rounds of expert consultations with 20 experts in tertiary hospitals from 16 provinces and cities were conducted by Delphi method. Results The authority coefficients of 2 rounds were 0.93 and 0.94. The Kendall’s coefficients of coordination were ranged from 0.043 to 0.233. The vertical nursing administration model and practice strategies were finalized and they consisted of 6 dimensions（including vertical and flat organizational structure,transformational leadership,standardized nursing professional practice,organizational empowerment,innovation and practice,and support system）,17 elements and 60 implementing measures. Conclusion The vertical nursing administration model and practice strategies are scientific,practical and comprehensive,which could provide a guidance for nursing management reform in tertiary hospitals.

Key words: Nursing Administration Research, Vertical Management, Delphi Technique

汤磊雯,杨丽黎,陈香萍,朱陈萍,项伟岚,秦建芬,祁海鸥,潘红英,庄一渝. 三级医院护理垂直管理模式架构与实践策略集的构建[J]. 中华护理杂志, 2020, 55(11): 1673-1679.

TANG Leiwen,YANG Lili,CHEN Xiangping,ZHU Chenping,XIANG Weilan,QIN Jianfen,QI Haiou,PAN Hongying,ZHUANG Yiyu. Development of a vertical nursing administration model and practice strategies in tertiary hospitals[J]. Chinese Journal of Nursing, 2020, 55(11): 1673-1679.

图/表 3

表1 专家意见的协调程度

Table 1 Assessment of concordance among experts with Kendall’s W test

表2 三级医院护理垂直管理模式架构与实践策略集一、二级条目的重要程度及可操作性（第2轮）

Table 2 Importance and feasibility of level 1 and level 2 items of vertical nursing administration model and practice strategies in tertiary hospitals （the second round）

表3 三级医院护理垂直管理模式架构与实践策略集三级条目的重要程度及可操作性（第2轮）

Table 3 Importance and feasibility of level 3 items of vertical nursing administration model and practice strategies in tertiary hospitals（the second round）

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