目的 了解哈尔滨市二三级医院护士专业生活品质现状,探讨护士专业生活品质影响因素,为提升护士专业生活品质提供建议.方法 使用一般资料调查表和专业生活品质量表(ProQOL-V)对黑龙江省4所二级医院、6所三级医院的525名护士进行问卷调查.结果 二三级医院护士专业生活品质总体得分为慈心满意(35.40±7.03)分,工作倦怠(25.32±6.15)分,二次创伤(26.43±5.65)分.二三级医院护士慈心满意、二次创伤得分存在显著差异(P＜0.05),性别、收入、聘用形式、加班次数、婚姻状况、供职科室是护士专业生活品质的影响因素.结论 黑龙江省二三级医院护士专业生活品质总体处于中度水平,建议护士个人、护理管理者、医疗机构等从护士专业生活品质的影响因素入手,共同努力以改善护士专业生活品质.

The theme of patient safety has been extensively studied since the publication of two landmark reports “To Err is Human” and “Crossing the Quality Chasm” in which advocated creating a culture of safety could avoid the adverse events and medical errors. Patient safety culture (PSC) and staff safety behavior may have an impact on hospital safety performance. To date, evidence in establishing the association of PSC and safety performance remains unclear and inconsistence in developing countries. The aim of this study is to evaluate the association of PSC, staff safety behavior and hospital safety performance.

目的 了解二三级公立医院护士职业价值观现状,探讨护士职业价值观的影响因素,为提升护士职业价值观提供建议.方法 利用一般资料调查表和本土化护士职业价值观量表(NPVS-R)对黑龙江省6所三级公立医院和4所二级公立医院的525名护士进行问卷调查.结果 二三级公立医院护士职业价值观总体得分为(96.95±17.34)分,人类尊严维度均分最高为3.90分,行动主义维度均分最低为3.64分;二三级公立医院护士职业价值观得分差异有统计学意义(P＜0.05);多因素分析结果显示,月夜班次数、学历、婚姻状况是护士职业价值观的影响因素.结论 二三级公立医院护士职业价值观总体较为积极;学校和医院应强化职业价值观教育,引导护士树立正确职业价值观;护理管理者要关注个体差异,采取针对性策略提升护士职业价值观水平.

Objective: To establish a proper evaluation system to evaluate the strategic extent of hospital human resource management. Methods: After building index system with two rounds of Delphi method, analytic hierarchy process (AHP) was used to determine the weight of these indicators.Results:The index system consists of 5 first-level indicators, 19 second-level indicators and 85 third-level indicators.And the weights of these indicators were also determined.Conclusion:The index system is reliable, and it' s of great importance to establish and im-prove evaluation system to hospital human resource management.

医院安全文化测评工具对于医疗机构的安全管理至关重要,目前世界范围的医院安全文化测评工具在测评维度和适用条件的差异性还未被深入认知.通过文献法和比较法,系统查阅国内外医院安全文化相关文献,对各主流医院安全文化的测评工具的研发过程、测评内容、应用现状以及优缺点进行深入比较剖析.医院安全文化测评工具在使用前对于维度和条目的修订应在紧密结合本国国情的基础上充分考虑相关领域专家意见,同时,对测评工具的信度和效度进行系统检测,并保证语言翻译的准确性.

Objectives: To discuss the relationship of behavioral intention among nursing job satisfaction, occupational values and patient safety. Methods: The questionnaires are investigated with nursing job satisfaction scale, nursing occupational values scale, nursing patient safety behavior scale. Results: There is a positive correlation among nursing job satisfaction, occupational values and patient safety. Nursing occupational values has a mediating role between job satisfaction and patient safety behavior. Conclusions: Hospital managers should pay attention to the management of nursing personnel’s safety behavior, which is beneficial to improve medical care quality and ensure patient safety.

Objectives:To analyze patient safety influence factors and its mechanism in emergency department to provide reference on preventing medical defaults and protecting patient safety. Methods:With a cross-sectional design, 506 healthcare workers were participated in this study. In depth interview was used as a reference. Factor analysis and SEM were used to evaluate the strength and relationship between factors. Results:In the well simulate equation, the strength of the factors is:Rescue Ability>Safety Management Perception>Career Perception>Medical Error Report System>Knowledge and Skill Training. Conclusion:These five factors could provide scientific evidence to make countermeasures towards medical error and improve patient safety.

目的 编制和修订出适用于我国医疗环境的病人安全文化与安全绩效相关性测评问卷.方法 基于文献法和专家咨询法形成初始问卷,采用问卷调查法对其结果进行信度与效度检验.结果 问卷由15个维度构成,其总体信度Cronbach's α为0.919,各维度Cronbach's α系数为0.531～ 0.949,因子分析结果共提取出15个公因子,累计贡献率为80.164.结论 所编制的病人安全文化与安全绩效相关性问卷信度和效度良好,可以用于病人安全文化与安全绩效的相关性研究.

目的 评估哈尔滨市辖区ICU护士职业价值观现状,提出改善ICU护理人力资源管理的对策和依据.方法 采用Weis护士职业价值观量表修订版(NPVS-R)从哈尔滨市辖区内随机抽取130名ICU护士进行问卷调查.结果 结果显示问卷调查发现哈尔滨市ICU护士职业价值观平均得分99.17,总体对职业价值认同感较好,其中行动主义维度总体得分最高;不同人口学特征的护士对职业价值观的认同情况有显著差异.结论 研究证实目标地区ICU护士职业价值观认同情况较好;提示医院管理者应注重ICU护士的职业价值观,将其视为引导护士改善工作质量,提升工作绩效的有力工具.

Objective:To check out the function of Root Cause Analysis in analyzing the pathological specimen delivery errors in operating room. Methods:An RCA team was set up to analyze the proximate cause and the ultimate cause of error by using the method of RCA, and then the improved measures were proposed and carried out. Results:Before using the method of RCA, the average error rate was 1.03%. After using RCA, the average error rate dropped to 0.26%;Nurse had a positive self-assessment. Conclusion:RCA is a scientiifc method in the management of pathological specimen delivery lfow. RCA method can not only improve the comprehensive ability of nurses ,but also can realize the goal of patient safety in operation room.

目的 通过对Weis“护士职业价值观量表(NPVS)”的编译和本土化修订,开发适用于黑龙江省地区护士职业价值观测评的本土化量表.方法 对Weis英文版护士职业价值观量表进行回译、编译与本土化修订.采用编译与修订后量表对哈尔滨市三级医院130名护理人员开展调查,采用因子分析法对调查结果的信度效度进行验证.结果 通过探索性因子分析将编译后的NPSV-R划分为5个维度(行动主义、社会公正与信任、职业义务、人类尊严、专业精神)、26个条目,问卷总体Cranach'α系数为0.946,各维度系数均大于0.7,经验证问卷总体信效度良好.结论 编译后护士职业价值观量表具有较好的信度效度,其维度设置符合目标地区护士职业价值观的实际情况,适于护士职业价值观的测评.

剖宫产术是目前常见的创伤性手术之一，具有损伤性大和风险性高等特点，手术中任何环节处置不当都会为母婴安全带来严重威胁。本研究以失效模式与效果分析法为理论基础，以术前、术中和术后为划分依据，通过对剖宫产术流程的详细分析，界定剖宫产术的主要风险因素，识别剖宫产术各种风险因素的危害程度，以制定针对性改进策略，规避高危险因素，防范剖宫产术不良事件的发生，保障孕产妇及婴儿生命安全。

Objective To know the needs of specialist training for the nurses of operation room and set a scientific nurse training course in order to find out a training mode for further reference. Methods Using the self-made questionnaire to investigate those who participated in the specialist nursing training of operating room in Heilongjiang Province, and making a Chi-square test and a non-parametric test by the SPSS18.0 for the statistical analysis. Results Nurses of different ages and professional titles wish to obtain a significant difference in training contents(P 0.05). The styles of teaching and assessment tend to diversify mainly in operation of clinical practice. OSCE examination was accepted by the young nurse. The most important of training content to the trainees is the specialized knowledge of operation room in 9 aspects of cognitive appraisal. Conclusion Importance to the nurse grading core should be developed and attached. At the same time, structure diversification of specialist training mode of operation room should be established in order to improve the quality of further specialist nursing training.

目的：观察社区康复路径在脑卒中患者家庭康复中的应用效果，探讨脑卒中患者家庭康复的规范化护理模式。方法将60例社区脑卒中患者随机分为对照组和实验组，对照组采用传统康复治疗及护理方法，实验组采用社区康复路径护理模式。分别在干预1个月后及3个月后采用Brunnstrom、FMA、BI、照顾者的照顾能力等量表，对患者康复情况进行康复效果评价。结果两组患者及家庭照顾者各项评分无显著性差异（P＞0．05），1个月后及3个月后各项评分有显著差异（P＜0．05）。结论按临床护理路径脑卒中病人家庭实施康复护理，可以提高脑卒中患者的疗效，促进患者家庭健康。

Objective To analyze ICU nursing job information in 3A comprehensive hospital,to clarify ICU nursing personnel qualification requirements,and to provide reference and basis for scientific management of ICU nurses.Method Using O*NET work context,skill and ability questionnaires to conduct a questionnaire survey on 125 nurses in ICU.Result The score of each dimension of work context,skill and ability questionnaires were all higher than 3 points,among them,interpersonal relationships,basic skills and cognitive abilities are the highest dimensions.Conclusion Job descriptions should be established to meet the ICU nursing job characteristics,to ensure that the ICU nursing personnel selection according to the post requirements,and to improve the hospital and patients' safety.

面对日趋严峻的医疗风险问题,如何识别和应对风险已经成为整个医疗行业共同面对的议题.以失效模式与效应分析法在医疗风险管理中的应用为研究对象,探讨失效模式与效应分析法的具体实施方法和目前在国内外医疗行业的应用现状,并对失效模式与效应分析法在未来医疗风险管理中的应用予以展望.

Employee Assistance Plan is the effective way of improving the working staffs' working and life qualyty,and of lightening staffs' psychological pressure.It has been widely used in enterprise hurman resource management at home and abroad,and has achieved good effect.The application of comprehensive discussion ofEmployee Assistance Planin nursing human resources management is explored to help nursing staffs to reduce pressure of working and life,to improve physical and mental health level of nursing staffs,to make them have a better state to investment in work,and to provide higher quality medical and health service to patients.

<正>1关于卫生人员的职业生涯管理对卫生人员的职业生涯管理目前尚无明确的定义。基于企业的职业生涯管理的定义,可将卫生人员的职业生涯管理定义为卫生组织和个人针对卫生人员的从业生涯进行设计、规划、执行、评估和反馈的一个综合性过程,通过组织和个人的通力合作,使员工的职业生涯目标与组织的发展目标相

Objective To analyze the clinicopathologic data and operative parameters of 209 elderly co-lon cancer patients treated by radical resection between January 2002 and December 2011 ,and to investigate the factors related to recurrence and metastasis after colon cancer radical resection in elderly patients .Methods We used univariate and multivariate analysis of Cox regression ,including 14 variables:age,gender,disease duration, hospitalization duration,surgeon experience,operation duration,laparoscopicsurgery,tumor location,tumor size, gross morphology ,differentiate degree ,depth of bowel wall invasion ,lymph node involvement and obstruction .The survival curve was obtained by Kaplan -Meier method.Results Univariate analysis showed that tumor size (RR=2.658,P<0.0001),gross morphology(Infiltrating type,RR=3.407,P=0.0054),degree of differentiation (RR=0.32,P<0.0001) were associated with tumor relapse and metastasis .Multivariate analysis showed that gender(RR=0.585,P=0.0359),tumor size(RR=2.364,P<0.0001),degree of differentiation (Infiltrating type,RR=0.246,P=0.0437),gross morphology(RR=0.31,P<0.0001)were the significant factors.Conclu-sion Gender,tumor size,degree of differentiation,gross morphology were the independent factors of recurrence and metastasis of colon cancer after radical resection in elderly patients .Targeted follow -up for high -risk groups will improve patients′life quality and prolong their survival time .

Objective:To understand the prevalence and related risk factors of depression in pregnant women during the third trimester of pregnancy,and explore the correlation between spousal intimate relationship and depression in pregnant women during the third trimester of pregnancy.Methods:Intimate bond measure(IBM),self-rating depression scale(SDS),and general questionnaire were used to survey 326 pregnant women during 28-36 gestational weeks.Results:Among 326 respondents,the incidences of depression was 32.5%.There was a negative correlation between care score of IBM and score of depression,but there was a positive correlation between control score of IBM and score of depression(P<0.05).There was a statistically significant difference in the types of spousal intimate relationship between depression group and non-depression group(P<0.05)." Moderate care-low control" accounted for the largest proportion in depression group and non-depression group.In depression group,the proportions of " low care-low control"," high care-high control"," moderate care-high control",and " low care-high control" were statistically significantly higher than those in non-depression group.While in non-depression group,the proportions of " high care-low control" and " moderate care-low control" were statistically significantly higher than those in depression group.Conclusion:Depression exists in pregnant women during the third trimester of pregnancy universally,spousal intimate relationship is closely correlated with depression during pregnancy,more attention should be paid to reducing unhealthy emotions of pregnant women during pregnancy by improving spousal relationship.