Hayman Brenda, Wilkes Lesley, Cioffi Jane
Clinical Nursing Research Unit, University of Western Sydney, Sydney, Australia.
J Nurs Manag. 2008 Apr;16(3):257-65. doi: 10.1111/j.1365-2834.2007.00774.x.
This paper reports a case study of nursing practice model redesign in a surgical ward at a large metropolitan acute care hospital in Sydney, Australia.
Literature suggests that factors such as financial restraints and shortage of nurses necessitate redesign of nursing care.
A descriptive case study design was used. The nursing practice model was changed from a patient allocation model to a team-nursing model and a new role of Clinical Activities Coordinator was introduced.
This study has confirmed that people need to be able to empower themselves to ensure an effective change process. It was also apparent in the case study that the staff were resistant to the redesign.
Change is a difficult process, which needs to involve all stakeholders. The planning process needs to consider the characteristics of the context such as workload and skill required, and the measures such as patient and staff satisfaction and health outcomes.
本文报告了澳大利亚悉尼一家大型都市急症医院外科病房护理实践模式重新设计的案例研究。
文献表明，诸如资金限制和护士短缺等因素使得重新设计护理工作成为必要。
采用描述性案例研究设计。护理实践模式从患者分配模式转变为团队护理模式，并引入了临床活动协调员这一新角色。
本研究证实，人们需要能够自我赋权以确保变革过程有效。在该案例研究中还明显看出，工作人员抵制重新设计。
变革是一个艰难的过程，需要所有利益相关者参与。规划过程需要考虑诸如工作量和所需技能等背景特征，以及诸如患者和工作人员满意度及健康结果等指标。
