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Role of head-nurse of dialysis unit 護理長的任務

Role of head-nurse of dialysis unit 護理長的任務. 翁 淑 滿 Chang Gung Memorial Hospital Oct. 29 , 2011. 透析品質管理經驗分享. 1. Character and prognosis of Dialysis. 基本屬性. 結 果. 病人部份. 1. 透析中急性併發症 2. 透析中意外事件. 1. 年齡層偏高 2. 伴隨其他系統疾病 3. 生活活動能力低. 高罹病率 高死亡率 低生活品質. 1. 免疫功能缺陷

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Role of head-nurse of dialysis unit 護理長的任務

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  1. Role of head-nurse of dialysis unit護理長的任務 翁 淑 滿 Chang Gung Memorial Hospital Oct. 29 , 2011 透析品質管理經驗分享 1

  2. Character and prognosis of Dialysis 基本屬性 結果 病人部份 1.透析中急性併發症 2.透析中意外事件 1.年齡層偏高 2.伴隨其他系統疾病 3.生活活動能力低 高罹病率 高死亡率 低生活品質 1.免疫功能缺陷 2.長期併發症 疾病部份 不穩定過程 2

  3. 設備管理 人員管理 環境維護 安全 及時 公平 有效 效率 資料庫維護 專業知識 維修保養 專業技能 服務態度 汰舊換新 分工 QCC 整合 引進新治療 品質指標監控 實證醫學 專案改善 創意獎勵制度 病人安全 服務創新 品質管理 團隊合作 Management by objectives of Dialysis

  4. Four major missions of head nurse • 責任 / RESPONSIBILITY • 品質 / QUALITY • 創新 / INNOVATION • 關懷 / CARING 4

  5. 責任 / RESPONSIBILITY 5

  6. 護理管理領導模式 Nursing leaders of tomorrow Challenges Demends Expectation Outcome-orientation  Quality of work and outcomes  Innovation  Orientation towards the future Understading nursing Practice  Direct and indirect nursing care  Experitis in nursing  Handyman tasks Accountability activities  Supporting staff  Ensuring staff xompetencies  developing Responsibility activities  communicating  organizing  cooperating Journal of Nursing Management,2008, 16, 525–534. Recognition of underlying premises of one‘s work *Framework of one‘s competence,well-being at work and the basis for one‘s work as nurse manager

  7. Canadian Medical Association Journal, 1993, 148 (4), 501–4. Journal of Nursing Management, 2008, 16, 1012–1020. Nurse Managers (NMs) have an important role in the health care organization and are responsible both for the staffs quality of care and for quality of work life. In Sweden, the NMs have the responsibility for the management of the ward and are responsible for personnel (recruitment, selection of staff, development, work environment), budgets (budgeting, cost control and financial result), nursing practice (introducing and maintaining standards) and the development of the services. The increased responsibility of NMs is supposed to lead to organizational effectiveness and efficiency. 7

  8. 定期評核 腹膜炎 Retraining Time 導管感染 中斷再開始 以病人為中心之照護責任 衛教 照護 追蹤 8

  9. 危機思考/ Critical thinking Reflective Thinking Context/ Situation Intentioned Outcome/Goal Achievement of Goals Patient satisfaction Quality care On budget Satisfaction of Nurse Manager Role Nurse manager retention Nurse manager recruitment Advancement of Practice Evidenced-based practice Antecedents Clinical Knowledge Management Knowledge and Skills Experience Consequences of Empirical Referents NURSING ECONOMIC/March-April ,2009, 27, 2.

  10. 品質 / QUALITY 10

  11. When health care is under pressure to provide quality care at the same time as their economic resources are being reduced, nurses in managerial positions are granted more control over management in the hope of improving cost effectiveness while retaining a focus on the quality of care. 11 Journal of Nursing Management, 2008, 16, 1012–1020.

  12. Peer review • Implies that the nursing care delivered by a group of nurses or an individual nurse is evaluated by individuals of the same rank or standing according to established standards of practice. 12 Journal of Nursing Management,2011, 19, 254–259.

  13. The process by which practicing registered nurses systematically access, monitor, and make judgments about the quality of nursing care provided by peers as measured against professional standards of practice. The development of management peer review will be challenging. The meaningful use of peer review at all levels of nursing will help close the gaps in quality and safety and ensure positive outcomes for patients, families and society. 13 Journal of Nursing Management,2011, 19, 254–259.

  14. 持續不斷的品質改善 掌握住出院動態 人性化空間設計 先進的透析設備 QCC/專案改善 14

  15. 創新 / INNOVATION 15

  16. The National Health Service (NHS) Institute for Innovation and Improvement (2011) state Innovation is about doing things differently or doing different things to achieve large gains in performance. It is a myth that most innovations come from laboratories, policy makers or senior leaders. Most innovations, whether in the public sector or the private sector, come from staff working within those organisations. • Boyd (2011) a recognized authority on IiP makes claims to leaders and managers to see innovation not as a gift, but a skill that everyone in the organization can master. 16 Journal of Nursing Management, 2011, 19, 165–169.

  17. 創新 /Creation case 腹膜透析導管固定帶 血液透析瘻管偵測儀 林口長庚腹膜透析提供 奇美醫院血液透析提供 17

  18. 漸進改善與躍進創新 Innovation P P P D D D A A A C C C Continuous Improvement • Enhance process management/ PDCA • P (Plan): A well organized, detailed plan with solutions and regulations • D (Do): Implementation according to the organized plan, with records for review • C (Check): Regular follow-up /analysis of implementation outcomes, with an improvement plan made subsequently • A (Action): Specific results after implementing the improvement plan Continuous Improvement 18

  19. 關懷 / CARING 19

  20. 20

  21. 激勵 / Motivation 中國醫院管理,2002,22(5),32. 護理雜誌, 2007,54(1) ,83-89. 護理管理者應激勵員工內在的工作動機，產生高度意願及特定行為，以持續性地朝向組織目標前進 。 研究發現:當一個人被激勵後，發揮的能量是激勵前的3~4倍。 剛剛好完美的管理---- <<足感心>> 21

  22. 協調者 / Coordinator 病患/家屬 護理長 外部工作人員 內部工作人員 22

  23. Nurse Managers(NMs) can help fill the need for their employees to feel connected and competent at work. Nurse ManagersNMs can provide recognition for good performance. In the sometimes-thankless world of healthcare, it is the NMs who can show appreciation and praise employees for the hard work they put in each day. 23 JONA, 2009, 39( 2), 60-63

  24. Conclusion 責任 / RESPONSIBILITY 品質 / QUALITY 創新 / INNOVATION 關懷 / CARING 24

  25. 謝謝 參與

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