摘要目的 探讨护理夜查房中指令性管理的效果与作用.方法 护理部动态监控护理夜查房的质量,实行查房内容、查房科室及被查频次指令性管理.在夜查房实施前后1年,对住院患者护理质量、护理文件书写、压疮、意外拨管发生数及患者满意度进行调查.结果 实施夜查房指令性管理后,护理质控综合得分(97.79±1.85)分、患者满意度(97.6％)均高于实施前[(92.14±2.54)分；90.6％],实施前后比较,差异有统计学意义(t=-7.16,x2=4.74；P＜0.05)；意外脱管、压疮护理并发症(2例),投诉发生数(1例)低于实施前的(11,8例),实施前后比较,差异均有统计学意义(x2分别为4.99,4.05;P＜0.05).结论 夜查房中实施指令性管理,查房内容突出,有利于提高夜间护理工作质量,保证患者安全.同时可进一步提高护士长管理能力及专业内涵,促进其成长.

abstractsObjective To explore the effect of mandatory management in night clinical rounds.Methods Quality of night clinical rounds was dynamically monitored by the nursing administrative department,and mandatory management was implemented on the content of rounds,round departments and check frequency.Results The comprehensive score of nursing quality control was ( 97.79±1.85 ),and the degree of the patients' satisfaction was 97.6％ after the implementation of mandatory management in night clinical rounds,both of which were higher than before (92.14±2.54 ;90.6％ ),and the differences were statistically significant (t=-7.16,x2=4.74,respectively; P＜0.05).Two cases had accidentally detachment of tube,and there was one complaint after the implementation of mandatory management in night clinical rounds,better than before (11 cases and 8 complaints),and the differences were statistically significant (x2=4.99,4.05,respectively;P＜0.05 ).Conclusions Implementation of mandatory management in night clinical rounds can help to enhance the nursing quality and ensure patients' safety at night.It also can further improve nurse leaders' management ability and professional knowledge.