Abstract:

Objective To investigate the current working situation of specialist nurses（SN） in secondary and tertiary hospitals in mainland China,so as to provide references for usage and administration of SN.Methods Two hundred and twenty-six hospitals in 24 provinces （cities or autonomous regions） were investigated using a self-designed questionnaire developed by Department of Continuing Education of Chinese Nursing Association（CNA）.Results Three thousand and eighty SNs worked on clinical nursing positions,accounting for 75.2% of all SNs in the investigated hospitals trained by CNA. SNs in 72.6% of the hospitals worked throughout the hospital,and in 41.1% of the hospitals SNs worked outside the hospital. In the aspect of working content,SNs in over 80% of the hospitals had participated in making care plans for critical patients,discussion of intractable cases,nursing consultation,teaching and researching. Besides,SNs in 59.3% of the hospitals had worked in nursing outpatient clinics. However,only 17.3% of the SNs undertook scientific research tasks as project leaders. Compared with secondary hospitals,more tertiary hospitals provided chances for SNs to work outside the hospital,in nursing outpatient clinics,make care plans for critical patients,undertake nursing teaching and scientific research tasks as project leaders（P<0.05）.Conclusion SNs worked mainly on clinical practice position. The workplace of SNs had been expanded. The working abilities of SNs had been improved. However,SNs’ scientific research ability needs to be enhanced. Compared to those in secondary hospitals,nurses in tertiary hospitals worked in more workplaces,and have been better used.

Key words: Specialist Nurse, Cross-sectional Studies, Root Cause Analysis, Nursing Administration Research

摘要：

目的 了解全国二级、三级医院专科护士的使用现状,为加强专科护士使用和管理提供参考依据。方法 采用中华护理学会继续教育部设计的全国专科护士使用效果调查问卷,应用问卷星对全国24个省、自治区、直辖市226所医院的护理部主任或教学主管人员进行问卷调查。结果 75.2%的专科护士工作岗位为临床护理岗;在72.6%的医院中,专科护士工作地点已延伸至全院,在41.2%的医院中,专科护士工作地点已延伸至院外;在70%以上的医院中,专科护士参与制订危重患者护理计划、疑难病例讨论、护理会诊、护理教学与科研工作,59.3%的医院还安排专科护士参与专科护理门诊工作;在科研能力方面,仅17.3%的专科护士作为课题负责人承担科研课题。与二级医院相比,三级医院专科护士在院外开展工作的比例较高（P<0.05）;较多的三级医院专科护士参与制订危重患者护理计划、专科护理门诊、教学科研工作（P<0.05）;三级医院的专科护士较二级医院的专科护士承担的科研课题更多（P<0.05）。结论 专科护士角色重在临床实践,工作地点得到拓展,专科能力得到提升,但科研能力有待提高。三级医院专科护士工作地点更为广泛,对专科护士的使用更为充分。

关键词: 专科护士, 横断面研究, 影响因素分析, 护理管理研究