江蘇省優(yōu)質(zhì)護理服務(wù)工作方案

1、2011年江蘇省“優(yōu)質(zhì)護理服務(wù)示范工程”工作方案為貫徹落實衛(wèi)生部關(guān)于公立醫(yī)院改革要求，全面加強臨 床護理工作，促進“優(yōu)質(zhì)護理服務(wù)示范工程”（以下簡稱“示范 工程”）活動在廣度和深度方面不斷發(fā)展，加快工作進度，擴大實施范圍，惠及更多患者，根據(jù)衛(wèi)生部關(guān)于推進優(yōu)質(zhì)護 理服務(wù)的工作方案的要求，結(jié)合我省實際，特制定本工作 方案。一、總體要求根據(jù)衛(wèi)生部關(guān)于“示范工程”的總體部署，在總結(jié)經(jīng)驗的 基礎(chǔ)上，以“落實責(zé)任制整體護理”為核心內(nèi)容，在廣度和深 度兩方面加大優(yōu)質(zhì)護理服務(wù)推進力度，充分調(diào)動護士積極 性，探索建立優(yōu)質(zhì)護理服務(wù)的長效機制，使公立醫(yī)院為更多 患者提供安全、專業(yè)、全程的優(yōu)質(zhì)護理服務(wù)。二、工作目標(biāo)（

2、一）在全省范圍內(nèi)全面開展優(yōu)質(zhì)護理服務(wù)。以良好的護理態(tài)度、規(guī)范的護理行為和全程的護理責(zé)任 作為優(yōu)質(zhì)護理服務(wù)的基礎(chǔ)，按開展的不同程度分A、B、C三個類別（具體要求見“主要內(nèi)容”），全面開展、分階段達(dá)到。1、到2011年6月69所省級重點聯(lián)系醫(yī)院（含所有三級醫(yī)院）60%的病房 開展優(yōu)質(zhì)護理服務(wù)，其中A類病區(qū)至少5個；二級醫(yī)院50% 的病房開展優(yōu)質(zhì)護理服務(wù)，其中 A類病區(qū)至少2個。2、到2011年12月69所省級重點聯(lián)系醫(yī)院（含所有三級醫(yī)院） 所有病房全 面開展優(yōu)質(zhì)護理服務(wù)， 其中A類病區(qū)810個，其中三級專 科醫(yī)院A類病區(qū)5個；二級醫(yī)院所有病房開展優(yōu)質(zhì)護理服務(wù)，-eves dr-in eepi -

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5、 ngS a.”.， te a gren, lowcS opeain, ul of humane cae of a . powe ge neain cm ,ay and wk had!，eoS FeSva,my Sncee wi Stha w.a,go. healh, h.py hap.其中A類病區(qū)3個。（二）立足專業(yè)發(fā)展深化優(yōu)質(zhì)護理內(nèi)涵。1、創(chuàng)建省、部級“136”工程。在全省范圍內(nèi)繼續(xù)創(chuàng)建 510所省、部級“優(yōu)質(zhì)護理服 務(wù)先進單位”、3050個省、部級“優(yōu)質(zhì)護理服務(wù)先進病房” 和50100名省、部級“優(yōu)質(zhì)護理服務(wù)先進個人”。2、創(chuàng)建國家級護理重點?？啤Ｗ裱耙匀藶楸尽钡恼w護理理念，落實醫(yī)院

6、實施優(yōu)質(zhì) 護理服務(wù)工作標(biāo)準(zhǔn)、江蘇省”優(yōu)質(zhì)護理服務(wù)示范工程”活 動考評標(biāo)準(zhǔn)等要求，以責(zé)任制整體護理為工作模式，深入 探索基礎(chǔ)護理和?？谱o理相結(jié)合的安全、專業(yè)的臨床護理服 務(wù)，在此基礎(chǔ)上創(chuàng)建 12個國家級護理重點專科。已獲得 的國家級護理重點?？祈椖酷t(yī)院達(dá)到年度工作目標(biāo)。三、主要內(nèi)容1、護理模式。A、B、C三類病區(qū)全面實施小組責(zé)任制 或個人責(zé)任制整體護理，每個責(zé)任護士（責(zé)任組長）都要直 接包干患者。護士平均包干床位不超過8人，包干患者相對固定，依據(jù)“白天責(zé)任護士 8小時在崗包干、晚夜間輪班護士 16小時全面負(fù)責(zé)”的原則，根據(jù)患者護理等級、自理能力由 護士承擔(dān)全部護理工作。危重患者由年資高、職稱高、

7、能力 強的護士負(fù)責(zé)。A、B、C三類病區(qū)都要限制家屬探陪及自聘護工數(shù)量， 保持病區(qū)管理有序，其中 A類病區(qū)可實施免陪或陪而不護， B類病區(qū)可暫時配給少量護理員（由責(zé)任護士指導(dǎo)）予以輔 助患者的各項生活護理，但不得從事護理技術(shù)工作。2、人力配置。A、B、C三類病區(qū)要確保一線護士數(shù)量 達(dá)標(biāo)，充分挖掘人力資源潛力，及時滿足病人需要，確保護 理安全。各臨床?？谱o士人力配比按省廳有關(guān)文件執(zhí)行，其a e e> ceetrp se eve. -ak ef- rlg-l g e s y ukfia y u- c afcetoi vl-eldlgit-k el-lgget si ss -e - ftesto

8、ea ast - y .frt. g- -1 一 a u a ivaegl yew-st st g-l - gees- ave - d a- u e r- aeaaa- ai aeage cs.s- ss u-lu - .s-g . rtg - gelvge staa.g .ee 1yle a l aa eee .Be - i u- g a f i a e 1一 -s -wegllO-f-toe laee g eaiWewillcontinue toimprovethecompa ny's inter nalcontrolsy stem,and steady improveme nti

9、na bility tomanage a nd contr ol,optimizebusiness processes,to ensure sm oot h processes,responsi bilities i npla ce;tofurt herstrengt hen i nternal contr ols, playacontrolpostinde pendent ov ersight role ofevaluation com plyingwit h thir d-partyresponsi bility; to a ctively make use of internala ud

10、it tools detectpotentialmanagement,streamline,standardizerelatedtransactions, strengthe ning operati ons i naccor dancewith law.Deepeningthe information managementtoensurefullcommunicati on "zero resistance".oconstantly perfect ERP ,and BFS+ ,and PI,a nd M IS,andSCM,i nformation sy stembas

11、e dconstruction,fullintegration informati onsystem,a chieve d informationresource sshare d;to expand Portalsystem applicationofbreadt h andde pth, play i nformation sy stemon e nterpriseofAssistant rol e;toperfectdaily r un mainte nance operation ofrecords,promoteproblem reasons a nalysisand systemh

12、a ndover;to strengthe ning BFS+,a nd ERP , and S CM,technologya pplication oftraining, im proveempl oyees a pplication information systemofcapacityand level.Humanistic caret oensure"zero."Tostrengthening Huma nities car e,continuestofoster compa ny wind cle ar,and g as are, andheartShunofc

13、ultureatmosphere; strengthe ningl ovehel pedtra pped, care difficultempl oyees; carried outstylea ctivities,ri chempl oyees life;stre ngthe ning healtha nd la bour prote ction, organi zation career health me dical, controlcareeragai nst; continuesto impleme ntation psychol ogicalwarni ng preventi on

14、 sy stem, trainingempl oyees health ofchara cter,a ndsta bleofmood andenter prisi ng ofattitude, createdfriendly fraternityofHumanities environment.T ostre ngthe n riskmanageme nt,ensure t hatthe busi ness of"zero risk".T ostre ngthe ned business pla ns manag ement, will busine ss busi nes

15、s planscov erto alllevel,e nsuret he busi ness can contr olin contr ol;to closeconcer n fina ncial,and coalele ctric li nkage, andenergy-savi ng scheduling, national policy trends,strengtheningtrack,activeshould;to implementation State -owned assetsmethod, furtherspecifi cation busine ss financialma

16、nagement;toperfectrisktubecontrolsystem,achievedriskrecog nition,and measure , andassessme nt,and report,and controlfeedback ofclosed ri ng management, im proverisk preventionca pacit y.o furtherstandardi zetrading ,and strivetoachieve "accordingtola w,standardizeand fair." Innovationofper

17、formance management,to ensuret hatpote ntial empl oyees "zero fly". o strengt hen performance management,process control,e nha nceemploye e evaluati on andlevels ofeffectivecommunication toimproveperforma nce management.Tofurtherquantifyand refine employe estandards.Work,fullplaypart y,and

18、 branch,and membersin"fivetypeEnterprise"constructioni n the ofcore rol e,and fightingfortressrole and pioneermodelrol e;toconti nue stostrengt hening "fourgood" lea dership constr ucti on甲A類病區(qū)：實際開放床護比A 1:0.5, B、C類病區(qū)：平均實際開放床護比達(dá)到1:0.4 。遇有危重患者多、手術(shù)患者多等特殊情況，各醫(yī)院要及時調(diào)整增加護理人員。A、 B 類病區(qū)要結(jié)合

19、?？铺攸c實行彈性排班，實現(xiàn)護士滿負(fù)荷工作，不得出現(xiàn)忙閑不均的情況，該兩類病區(qū)原則上不得排單班，確?；颊甙踩?。3、護理流程。A、 B、 C 三類病區(qū)要根據(jù)醫(yī)院臨床護理工作流程（試行），明確每個崗位的護理工作內(nèi)容，細(xì)化護理人員崗位職責(zé)，完善適合本?？频淖o理流程，規(guī)范服務(wù)內(nèi)容，加強細(xì)節(jié)管理，使護士工作具有執(zhí)行力和操作性。A、 B 類病區(qū)要開展床旁護理，護士有計劃地安排各項護理，運用床旁護理車，能將一個班次負(fù)責(zé)患者所需要的用品都存放在車上，避免護士因取物等來回走動所消耗的體力和時間，將更多的時間用在對患者的直接護理上。4、護理內(nèi)涵。按照綜合醫(yī)院分級護理指導(dǎo)原則（試行）及相關(guān)文件要求，A、 B、 C 三

20、類病區(qū)責(zé)任護士全面履行護理職責(zé)，為患者提供基礎(chǔ)護理服務(wù)和護理專業(yè)技術(shù)服務(wù)， 密切觀察患者病情變化，正確實施各項治療、護理措施，加強護患溝通、醫(yī)護配合，提供康復(fù)和健康指導(dǎo)。A類病區(qū)每個?？朴?2個?？铺厣淖o理，并檢測其成效。護理措施到位率100% （包括生活、基礎(chǔ)、?？啤⑿睦?、康復(fù)），住院病人滿意度95% 以上，出院病人滿意度調(diào)查 90% 以上，電話回訪滿意度達(dá)90% 。健康教育指導(dǎo)率達(dá) 100% ，知曉率達(dá)90% 。康復(fù)護理指導(dǎo)率100% 。無由于護理人員工作不到位而致患者意外傷害的發(fā)生。B 類病區(qū)開展多種形式的人性化護理、全面系統(tǒng)的健康教育。 對自理能力1 級的患者，生活護理落實率達(dá)到90

21、% 以上。住院病人滿意度達(dá)90% 以上，出院病人滿意度調(diào)查達(dá)laylevels ca dres in enterpri sedevel opme ntin theofback bone backbonerole;to fullstrengtheni ngmembers youthw ork,full playyouth employee s in company developmenti nthe offorcer ole;toimpr ove independent Commission against corr upti on w orklevel,strengt heni ng onen

22、ter prise busi ness key link ofeffectiveness monitore d.,And maintain stabilit y.Tofurther stre ngthe npubli city ande ducation,improvet he overalllegalsystem.We must stre ngthen safety management, esta blish and improve theeducation,supervision, andevaluati on as one ofthetrafficsafetymanagementmec

23、hanism.o conscienti ouslysum upthe Olympi cse curitycontrol s, pr omoting integratedma nagement to a higher leve l,hig herstandards,a higher levelofdevelopme nt. Employe es,today islunar calendaron Decem ber24,the ox Be llisabouttori ng,atthis timeofyear,weclearlyfeelthepulse oftheXXpowergenerationc

24、ompa nytoflouri sh, t o moreclearly hearXXpower ge neration companie85%以上，電話回訪滿意度達(dá) 85%。健康教育指導(dǎo)率達(dá) 100% ,知曉率達(dá)90%。康復(fù)護理指導(dǎo)率 100%。無由于護 理人員工作不到位而致患者意外傷害的發(fā)生。C類病區(qū)住院病人滿意度達(dá) 90%以上，生院病人滿意度 調(diào)查達(dá)85%以上，電話回訪滿意度達(dá) 85% o健康教育指導(dǎo) 率達(dá)100% ,知曉率達(dá) 90% o康復(fù)護理指導(dǎo)率 100%?；颊?生活護理落實率達(dá)到100% ,重危病人的生活護理全部由護 士承擔(dān)。無由于護理人員工作不到位而致患者意外傷害的發(fā) 生。5、服

25、務(wù)公示。A、B、C三類病區(qū)實行等級護理公示制， 根據(jù)綜合醫(yī)院分級護理指導(dǎo)原則、住院患者基礎(chǔ)護理服 務(wù)項目（試行）、基礎(chǔ)護理服務(wù)工作規(guī)范和常用臨床 護理技術(shù)服務(wù)規(guī)范等規(guī)范，結(jié)合科室情況明確等級護理服 務(wù)的具體內(nèi)容和標(biāo)準(zhǔn)，并上墻公示。對收取經(jīng)物價部門備案等 級護理費的病區(qū)，必須做到患者入院時人人簽署知情同意書。A、B類病區(qū)建立“日患者溝通制”，每天由護士長或臨時 負(fù)責(zé)人員與每位患者交流至少1次，及時了解和發(fā)現(xiàn)患者的護理工作完成情況和對護理工作的滿意情況，及時反饋并與 個人滿意度桂鉤。四、全年工作要點1、印發(fā)2011年江蘇省“優(yōu)質(zhì)護理服務(wù)示范工程”工作 方案、江蘇省醫(yī)院護理崗位管理的指導(dǎo)意見，部署全

26、 年工作安排。2、召開2011年全省護理工作會議，動員部署全年“優(yōu) 質(zhì)護理服務(wù)”工作任務(wù)。3、組織部分二、三級醫(yī)院優(yōu)質(zhì)護理服務(wù)現(xiàn)場調(diào)研工作。4、指導(dǎo)省人民醫(yī)院、南京豉樓醫(yī)院完成國家護理重點 ?？祈椖抗ぷ饔媱潱_定 23個專項業(yè)務(wù)課題，并在 3月a e e> ceetrp se eve. -ak ef- rlg-l g e s y ukfia y u- c afcetoi vl-eldlgit-k el-lgget si ss -e - ftestoea ast - y .frt. g- -1 一 a u a ivaegl yew-st st g-l - gees- ave - d a-

27、u e r- aeaaa- ai aeage cs.s- ss u-lu - .s-g . rtg - gelvge staa.g .ee 1yle a l aa eee .Be - i u- g a f i a e 1一 -s -wegllO-f-toe laee g eaiWewillcontinue toimprovethe compa ny's inter nalcontrolsy stem,and steady improveme ntina bility tomanage a nd contr ol,optimizebusiness processes,to ensure

28、sm oot h processes,responsi bilities i npla ce;tofurt herstrengt hen i nternal contr ols, playacontrolpostinde pendent ov ersight role ofevaluation com plyingwit h thir d-partyresponsi bility; to a ctively make use of internala udit tools detectpotentialmanagement,streamline,standardizerelatedtransa

29、ctions, strengthe ning operati ons i naccor dancewith law.Deepeningthe information managementtoensurefullcommunication "zero resistance".o constantly perfect ERP ,and BFS+ ,and PI,a nd M IS,andSCM,i nformation sy stembase dconstruction,fullintegration informati onsystem,a chieve d informat

30、ionresource sshare d;to expand Portalsystem application ofbreadt h andde pth, play i nformation sy stemon e nterpriseofAssistant rol e;toperfectdaily r un mainte nance operation ofrecords,promote problem reasons a nalysisand systemha ndover;to strengthe ning BFS+,a nd ERP , and S CM,technologya ppli

31、cation oftraining, im proveempl oyees a pplication information systemofcapacityand level.Humanistic caret oensure"zero."Tostrengtheni ng Huma nities car e,continuestofoster compa ny wind cle ar,and g as are, andheartShunofcultureatmosphere; strengthe ningl ovehel pedtra pped, care difficul

32、templ oyees; carried outstylea ctivities,ri chempl oyees life;stre ngthe ning healtha nd la bour prote ction, organi zation career health me dical, controlcareeragai nst; continuesto impleme ntation psychol ogicalwarni ng preventi on sy stem, trainingempl oyees health ofchara cter,a ndsta bleofmood

33、andenter prisi ng ofattitude, createdfriendly fraternityofHumanities environment.T ostre ngthe n riskmanageme nt,ensure t hatthe busi ness of"zero risk".T ostre ngthe ned business pla ns manag ement, will busine ss busi ness planscov erto alllevel,e nsuret he busi ness can contr olin contr

34、 ol;to closeconcer n fina ncial,and coalele ctric li nkage, andenergy-savi ng scheduling, national policy trends,strengtheningtrack,active should;to implementation State -owned assetsmethod, furtherspecifi cation busine ss financialmanagement;toperfectrisktube controlsystem,achieved riskrecog nition

35、,and measure , andassessme nt,and report,and controlfeedback ofclosed ri ng management, im proverisk preventionca pacit y.o furtherstandardi zetrading ,and strivetoachieve "accordingtolaw,standardizeandfair."Innovationof performance management,to ensuret hatpote ntial empl oyees "zero

36、 fly". o strengt hen performance management,process control,e nha nceemploye e evaluati on andlevels ofeffectivecommunication toimproveperforma nce management.Tofurtherquantifyand refine employe estandards.Work,fullplaypart y,and branch,and membersin "fivetypeEnter prise" construction

37、i n the ofcore rol e,and fightingfortressrole and pioneermodelrol e;toconti nue stostrengt hening "fourgood" lea dership constr ucti on底前按部里要求所有病房全面開展優(yōu)質(zhì)護理服務(wù)。5、委托護理學(xué)會探索建立以省轄市為單位的區(qū)域護士人力資源庫，以南京市為試點。6、繼續(xù)舉辦三級醫(yī)院護士長崗位培訓(xùn)班5 期，二級醫(yī)院護理部主任培訓(xùn)工作一并納入。舉辦三級醫(yī)院護理部主任論壇 2 期。7、繼續(xù)和省物價、醫(yī)保部門溝通協(xié)調(diào)護理收費事項，構(gòu)建科學(xué)合理的護理定價體系

38、。8、 結(jié)合實施“年輕護士素質(zhì)提高行動”， 分專科編寫臨床護理“三基”。印發(fā) 2011 年全省三級醫(yī)院護理人員“三基”抽考方案，重點強化年輕護士臨床操作及護患溝通能力。9、積極推動護理垂直管理，選擇 35所三級綜合醫(yī)院試點實施全面的護士崗位管理，總結(jié)經(jīng)驗，樹立典范，適時召開優(yōu)質(zhì)護理服務(wù)現(xiàn)場推進會，在全省宣傳推廣做法。10 、調(diào)研省級?？谱o士培訓(xùn)基地工作，在原有基礎(chǔ)上創(chuàng)建12新基地。在實施護士崗位管理的試點醫(yī)院中，探索?？谱o士的使用問題。創(chuàng)建國家級護理重點專科 12個。11 、 建立以臨床護士長為主的護理質(zhì)量檢查專家?guī)觳⑦M行系統(tǒng)培訓(xùn)。組織二、 三級醫(yī)院創(chuàng)建“優(yōu)質(zhì)護理服務(wù)示范工程”工作情況中期驗收

39、工作并進行情況通報。12 、評選表彰2011 年“優(yōu)質(zhì)護理服務(wù)”先進單位、先進病房及先進個人若干，總結(jié)全年工作。五、保障措施1 、建立信息通報制度。自 2011 年 2 月起， 完善原有信息通報制度，及時掌握69 所省級重點聯(lián)系醫(yī)院工作情況，立足進度和實效兩方面，定期通報工作進展，對工作不力的衛(wèi)生行政部門和醫(yī)院進行通報批評。2、加大對醫(yī)院考核力度。各級衛(wèi)生行政部門要高度重laylevels ca dres in enterpri sedevel opme ntin theofback bone backbonerole;to fullstrengtheni ngmembers youthw o

40、rk,full playyouth employee s in company developmenti nthe offorcer ole;toimpr ove independent Commission against corr upti on w orklevel,strengt heni ng onenter prise busi ness key link ofeffectiveness monitore d.,And maintain stability.Tofurther stre ngthe npubli city ande ducation,improvet he over

41、alllegalsystem.We must stre ngthen safety management, esta blish and improve theeducation,supervision, andevaluati on as one ofthetrafficsafetymanagementmechanism.o conscienti ouslysum uptheOlympi cse curitycontrol s, pr omoting integratedmanagement to a higher level,hig herstandards,a higher levelo

42、fdevelopme nt. Employe es,today islunar cale ndaron Decem ber24,the ox Bellisabouttori ng,atthis timeofyear,weclearlyfeelthepulse oftheXXpowergenerationcompa nytoflouri sh, t o moreclearlyhearXXpower generation companie 視“示范工程”創(chuàng)建工作，大力開展調(diào)查研究，切實加強溝通 協(xié)調(diào)，為醫(yī)院“創(chuàng)優(yōu)”創(chuàng)造有利的工作條件。同時，將“示范工 程”納入大型醫(yī)院巡查、等級醫(yī)院評審、臨床重點專

43、科考評、 診療中心評審、綜合目標(biāo)考核等工作中，加大對醫(yī)院考核力 度，形成推進工作的抓手。3、分類別積極穩(wěn)妥推進。 以衛(wèi)生部醫(yī)院實施優(yōu)質(zhì)護 理服務(wù)工作標(biāo)準(zhǔn)為指導(dǎo)，結(jié)合江蘇省”優(yōu)質(zhì)護理服務(wù)示范 工程”考評標(biāo)準(zhǔn)，以落實責(zé)任制整體護理為核心， 探索對“優(yōu) 質(zhì)護理服務(wù)病房”實行分類別實施評價的做法，達(dá)到實事求 是、積極穩(wěn)妥推進“創(chuàng)優(yōu)”工作的目的。醫(yī)院一把手院長要積極想辦法支持優(yōu)質(zhì)護理工作，協(xié)調(diào) 各部門支持臨床護理工作。一是要采取有效措施保證臨床一 線護士數(shù)量足夠，各臨床專科配比合理；二是要協(xié)調(diào)職能部 門做好藥品運送、物資保障、維修、送檢、膳食、安全、財 務(wù)結(jié)算等保障工作，使護士盡心盡力護理患者；三是根據(jù)

44、病 人需求及醫(yī)療技術(shù)的發(fā)展，配置新型的護理用品、用具和設(shè) 備，改善護理工作條件；四是建立績效考核制度，合理確定 護士待遇水平，充分調(diào)動護士的積極性。4、積極爭取合理收費。 為切實體現(xiàn)護理人員勞務(wù)價值， 促進“示范工程”健康持續(xù)發(fā)展，積極爭取合理收費。一是配 合物價、醫(yī)保等部門通過調(diào)研，確定“優(yōu)質(zhì)護理服務(wù)”分類別 收費標(biāo)準(zhǔn)；二是各級醫(yī)院實事求是地向當(dāng)?shù)匦l(wèi)生行政部門通 報創(chuàng)優(yōu)情況，提由護理收費申請。5、不定期開展督導(dǎo)檢查。 加強對各地開展優(yōu)質(zhì)護理服 務(wù)的督導(dǎo)檢查，市級衛(wèi)生行政部門負(fù)責(zé)對轄區(qū)內(nèi)醫(yī)院工作情 況進行督導(dǎo)檢查，按照進度和內(nèi)涵進行評價、考核，保證工 作實效。省廳將不定期組織對各地的督導(dǎo)評估，

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