护士主导 -医疗护理员协同模式对骨科免陪照护服务质量的影响 [中文引用][英文引用]

目的  探讨护士主导 - 医疗护理员协同模式对骨科免陪照护服务质量的影响。方法  本院骨科中心 2024 年11 月开展免陪照护服务病房试点工作，本研究选取本院骨科中心的护士及医疗护理员作为研究对象，原 18 名护工经规范化培训转为医疗护理员，再增加 8 名护理员，与 62 名护士组成免陪照护团队，试点工作开展后 8 个月（2024 年 11 月— 2025 年 6 月）期间应用护士主导 - 医疗护理员协同模式，并与实施前 8 个月（2024 年 3 月—10 月）的传统模式进行比较。比较实施前后护士、护理员关爱能力、职业认同感、团队协作质量、患者对照护服务满意度和护理不良事件发生率。结果  实施后护士、医疗护理员关爱能力水平、职业认同感、团队协作质量、患者对照护服务满意度高于实施前，护理不良事件发生率低于实施前，前后比较，差异具有统计学意义（均 P<0.05）。结论  护士主导 - 医疗护理员协同模式可提高免陪照护团队的专业素养及照护质量、协作水平、降低护理风险，为实现护理服务高质量发展提供有力支持。

Objective To evaluate the effect of a nurse-led and medical nursing assistant-assisted collaborative model on unaccompanied orthopaedic care services. Methods The Orthopaedic Centre of Zhujiang Hospital，Southern Medical University， established a pilot ward（this study selected nurses and caregivers from the orthopedic center of our hospital as the research subjects. Eighteen caregivers were converted into formal caregivers after standardized training，and an additional eight formal caregivers were added. Together with 62 nurses，they formed a no-companion care team for unaccompanied care services in November 2024）. From November 2024 to June 2025，the nurse-led and caregiver-assisted collaborative model was adapted to unaccompanied care services. The effects of implementation were compared with those yielded by the traditional nursing model during March 2024 to October 2024. The outcome measures included caring ability，professional identity，teamwork quality of nurses and caregivers，patient satisfaction with care services，and the incidence of nursing adverse events. Results After implementation of the nurse-led and medical nursing assistant-assisted collaborative model，the caring ability，professional identity，teamwork competence of nurses and caregivers，and patient satisfaction with care services were all higher than those before the implementation，while the incidence of nursing adverse events was lower than that before implementation. All differences were statistically significant（P<0.01）. Conclusion The nurse-led and medical nursing assistant-assisted collaborative model can improve the professional competence，care quality，and collaboration of the unaccompanied care team，reduce nursing risks and strongly support high quality development of nursing services.