Abstract:

Objective To investigate the current situation of the use and management of medical nursing assistants in 44 tertiary hospitals in China，and to provide the guidance for standardizing the management of nursing staff and deepening quality nursing services. Methods From April to August 2021，a self-designed questionnaire was used to investigate the heads of the medical nursing assistants in management departments of 44 tertiary hospitals or the corresponding third party service institutions in 10 provinces，autonomous regions and municipalities. Results Through the investigation of 24 tertiary first-class hospitals and 20 tertiary second-class hospitals，it was found that the current employment management mode of medical nursing assistants was mainly third-party service companies（54.2% of the first-class hospitals，60.0% of the second-class hospitals）. The training was divided into 2 stages，including pre-job and in-job. The Internet + training method was not adopted by most tertiary hospitals. The frequency of receiving in-job training and assessment was low. The in-service evaluation system of medical nursing assistants in tertiary hospitals was mainly carried out by third-party management agencies. The choice of working mode in the general wards and ICU of tertiary hospitals tend to be one-to-one mode. Conclusion At present，the employment and management mode of medical nursing assistants is diverse;the qualification certification needs to be standardized;the training and evaluation mechanism is not fully implemented;the management and evaluation system of work mode needs to be further standardized. It is necessary to strengthen the employment and management of medical nursing assistants，to formulate professional training，to establish a clear and accessible working system and evaluation system，to deepen high-quality nursing services and improve nursing quality.

Key words: Medical Nursing Assistant, Tertiary Hospitals, Cross-Sectional Studies, Nursing Administration Research

摘要：

目的 对国内44所三级医院医疗护理员的使用与管理现状进行调查，为规范护理员行业管理、深化优质护理服务提供指导。 方法 2021年4月—8月，采用便利抽样法，使用自行设计的医院医疗护理员管理现状调查表，对10个省、自治区、直辖市44所三级医院或对应的第三方服务机构医疗护理员管理部门负责人进行调查。 结果 共调查24所三级甲等医院、20所三级乙等医院。当前医疗护理员管理机构主要为第三方服务机构（三级甲等为54.2%、三级乙等为60.0%）;培训分为岗前和岗中2个阶段，“互联网+”的培训方式并未被大多数三级医院采纳;接受岗中培训、考核的频率较低;医疗护理员在三级医院的评价方式主要由第三方管理机构进行;工作模式选择上，三级医院普通病区和ICU都倾向于1对1模式。 结论 当前国内三级医院医疗护理员聘用和管理模式多样、资格认证待规范，培训、考核机制落实不到位，工作模式管理、评价体系有待进一步规范。因此，有必要加强医疗护理员聘用和管理，制订专业化的培训方案，建立清晰可及的工作制度和评价体系，深化优质护理服务，提高护理质量。

关键词: 医疗护理员, 三级医院, 横断面研究, 护理管理研究