Abstract:

Objective To construct an interdisciplinary collaborative care model led by specialty nurses under the hospital-wide bed-sharing model，and to explore its application effects，aiming to improve nursing efficiency and enhance nursing quality. Methods Based on collaborative nursing theory，combined with the healthy work environment framework，an interdisciplinary collaborative care model led by specialty nurses was constructed through literature review and expert meetings，including 6 dimensions：communication，collaboration，decision-making，human resources，value，and leadership. Using purposeful sampling，specialty nurses and interdisciplinary admitted patients from a tertiary general hospital in Zhejiang Province in 2024 were selected as the application subjects. The proportion of interdisciplinary admitted patients，incidence of adverse events，patient satisfaction，average patient hospitalization days，specialty nursing consultation rate，and the collaborative ability and healthy work environment perception level of specialty nurses before（2023） and after（2024） the application of the model were described and compared. Results After implementation of the model，the proportions of interdisciplinary admitted patients，specialty nurses consultation rates，collaborative competence of specialty nurses，and perceived levels of a healthy work environment were significantly higher than those before implementation，with statistically significant differences（P<0.001）. The comparison of adverse event incidence rates before and after the model implementation showed no statistically significant difference（P>0.05）. Patient satisfaction scores were 97.94 points after implementation of the model and 98.48 points before implementation；the average length of hospital stay was 5.00 days post-implementation and 4.87 days pre-implementation. Conclusion The application of the interdisciplinary collaborative care model led by specialty nurses helps to integrate specialty nursing resources，enhances the collaborative ability and healthy work environment perception level of specialty nurses，and can provide a practical pathway for interdisciplinary collaborative care under the hospital-wide bed-sharing model.

Key words: Specialty Nurse, Interdisciplinary Collaborative, Patient-Centered, Healthy Work Environment, Bed-Sharing Model, Nursing Management Research

摘要：

目的 构建全院床位共享模式下专科护士主导的跨学科协作照护模式，并探讨其应用效果，旨在提升护理效率、提高护理质量。方法 以协同护理理论为基础，结合健康工作环境框架，通过文献回顾与专家会议构建专科护士主导的跨学科协作照护模式，包括沟通、合作、决策、人力、价值、领导力6个维度。采用目的抽样法，选取2024年浙江省某三级甲等综合医院的专科护士以及跨学科收治的患者作为应用对象。描述或比较该模式应用后（2024年）与应用前（2023年）的跨学科收治患者占比、不良事件发生率、患者满意度、患者平均住院日、专科护理会诊率、专科护士的协作能力与健康工作环境感知水平。结果 该模式应用后的跨学科收治患者占比、专科护理会诊率、专科护士的协作能力及健康工作环境感知水平均高于模式应用前，差异具有统计学意义（P<0.001）。模式应用前、后不良事件发生率比较，差异无统计学意义（P>0.05）。模式应用后的患者满意度为97.94分、应用前为98.48分；模式应用后的患者平均住院日为5.00 d，应用前为4.87 d。结论 应用专科护士主导的跨学科协作照护模式有助于整合专科护理资源，提升专科护士的协作能力及健康工作环境感知水平，可为全院床位共享模式下的跨学科协作照护提供指导。

关键词: 专科护士, 跨学科协作, 以患者为中心, 健康工作环境, 床位共享模式, 护理管理研究