内科

目的探索构建护理绩效垂直管理结合护士分层绩效考核体系，并分析其应用效果。方法参考国内多家三甲综合医院研究结果并结合本医院运行实际，构建护理绩效垂直管理与护士分层绩效结合考核体系，并于2020年1月正式实施。分别于该方案实施前（2019年1月至12月）、实施后（2022年1月至12月）选取本院251名、291名护士，比较实施前后护士绩效满意度、患者护理满意度、护理质量评分，护士专业素养水平、护士内生动力等。结果该体系实施后，护士绩效满意度增加，患者护理满意度上升，护理质量评分、护士“三基”理论知识考试和技术操作考核得分均较实施前增加（均P<0.05），护士的离职率从实施前的3.8%降至实施后的1.1%（P<0.05）。结论构建护理绩效垂直管理结合护士分层绩效考核体系科学可行，其应用规范了护士绩效管理，有利于护士队伍的稳定和学科的发展，可促进护理质量和护、患满意度的提高。

Objective To explore the construction of an integrated system for vertical nursing performance management and stratified nurse performance appraisal and analyze its application effects. Methods Based on frameworks from multiple Grade A tertiary hospitals in China and tailored to the operational context of our hospital, an integrated system for vertical nursing performance management and stratified nurse performance appraisal was developed and officially implemented in January 2020. A total of 251 and 291 nurses were selected before (January to December 2019) and after (January to December 2022) implementation, respectively, nurses' satisfaction with performance, patients' satisfaction with nursing care, nursing quality scores, levels of nursing professionalism, and intrinsic motivation of nurses were compared before and after implementation. Results After the implementation of the system, nurses' satisfaction with performance increased, patients' satisfaction with nursing care improved, and nursing quality scores, as well as scores on theoretical knowledge exams and technical operation assessments ("three basics") for nurses, were higher than those before implementation (all P<0.05); the nurses' turnover rate decreased from 3.8% before implementation to 1.1% after implementation(P<0.05). Conclusions The development of an integrated system for vertical nursing performance management and stratified nurse performance appraisal is scientifically sound and feasible. Its implementation standardizes performance management, enhances the stability of the nursing workforce, fosters disciplinary development, and ultimately improves nursing quality and satisfaction among both nurses and patients.

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