Abstract:

Objective To understand the characteristics and classification of the post tasks of obstetric nursing staff and provide a basis for scientific management of obstetric human resources and standardization of obstetric care responsibilities. Methods A total of 503 midwives and obstetric nurses from Shanghai were recruited to complete a self-designed questionnaire,and the results were analyzed by cluster analysis. Results The post tasks of obstetric clinics are clustered into 2 categories： Class Ⅰ-basic tasks are done by nurses who are characterized by medium degrees,junior professional titles and high working ages;Class Ⅱ-advanced tasks are divided into nurses in charge and obstetricians in charge. The parts of nurses responsibilities are done by the nurses who are characterized by medium-high degrees,junior-intermediate professional titles and high working ages. The post tasks of delivery rooms are clustered into 2 categories： Class Ⅰ is in the charge of midwives,including natural delivery and abnormal delivery,and the midwives who execute the part of abnormal delivery have higher professional titles and working ages. Class Ⅱ is mainly in the charge of obstetricians. The post tasks of postpartum wards are clustered into 5 categories： Class I is the routine nursing content;Class II is the identification of postpartum critical signs,and the third category is personalized counseling including postpartum psychological problem screening. The Class IV and V are neonatal related items. The nurses from different categories have no statistical significance in characteristics. Conclusion The specialty content and personnel classification management of obstetric clinics and postpartum wards need to be strengthened. The obstetric nursing human resources should be managed according to the post content. At the same time,the advanced experience of foreign countries should be used to standardize the division of maternity medical care duties to promote natural childbirth and reduce the trend of over-medicalization of midwifery services.

Key words: Midwives, Obstetric Nursing, Post Tasks, Cluster Analysis, Nursing Administration Research, Health Manpower

摘要：

目的 分析产科护理岗位内容的特征和分类,为科学管理产科人力资源和规范产科医护职责划分标准提供依据。 方法 采用分层抽样法,使用助产士及产科护士岗位内容调查表,对上海市503名助产士或产科护士进行调查,并对调查结果进行系统聚类分析。 结果 产科门诊岗位内容聚为2类：Ⅰ类为基础内容,执行护士呈现中等学历、初级职称和工作年限高的特征;Ⅱ类为进阶内容,又分为护士负责或产科医生负责的内容,执行护士呈现中等偏高学历、初级和中级职称、工作年限高的特征。产房岗位内容聚为2类：Ⅰ类主要由助产士负责,包括初阶—自然分娩和中阶—异常分娩相关内容,其中执行中阶内容的助产士职称和工作年限相对更高;Ⅱ类则主要由产科医生负责。产后母婴同室岗位内容聚为5类：Ⅰ类为产后常规观察项目,Ⅱ类为产后危急征象的识别,Ⅲ类为产后个性化咨询,包括产后心理问题筛查等内容,Ⅳ、Ⅴ类为新生儿相关条目。执行各类岗位内容护士特征未见明显差异。 结论 产科门诊和产后母婴同室的岗位专科特色内容和人员分级管理有待加强,应按照岗位内容分级管理产科护理人力资源;规范产科医护职责划分标准,以促进自然分娩,降低助产服务过度医疗化趋势。

关键词: 助产士, 产科护理, 岗位内容, 聚类分析, 护理管理研究, 卫生人力