全院床位集中管理模式下临床护士在职培训管理体系的构建与实践

doi:10.3761/j.issn.1672-9234.2026.02.013

中华护理教育 ›› 2026, Vol. 23 ›› Issue (2): 208-214.doi: 10.3761/j.issn.1672-9234.2026.02.013

全院床位集中管理模式下临床护士在职培训管理体系的构建与实践

吴一女¹(), 冯洁惠¹, 殷钰¹, 张露莎², 王华芬¹^,^*()

1.浙江大学医学院附属第一医院护理部杭州市 311100
2.浙江大学医学院附属第一医院入院服务中心杭州市 311100

收稿日期:2025-08-26 出版日期:2026-02-15 发布日期:2026-02-11
通讯作者: * 王华芬，E-mail：2185015@zju.edu.cn
作者简介:吴一女：女，硕士，主管护师，E-mail：hulijy9999@163.com
基金资助:
浙江省卫生健康行业科技计划(2025HY0352)

Construction and practice of an on-the-job training management system for clinical nurses under the “hospital-wide bed-sharing” mode

WU Yinü¹(), FENG Jiehui¹, YIN Yu¹, ZHANG Lusha², WANG Huafen¹^,^*()

1. Department of Nursing，the First Affiliated Hospital of Zhejiang University School of Medicine，Hangzhou 311100，China.
2. Admission Service Center，the First Affiliated Hospital of Zhejiang University School of Medicine，Hangzhou 311100，China

Received:2025-08-26 Online:2026-02-15 Published:2026-02-11
Contact: * WANG Huafen，E-mail：2185015@zju.edu.cn
Supported by:
Zhejiang Provincial Health Industry Science and Technology Program(2025HY0352)

摘要/Abstract

摘要：

目的构建全院床位集中管理模式下临床护士在职培训管理体系，并探讨其实践效果。方法基于前期调研，结合文献研究与专家会议，构建临床护士在职培训管理体系，包括垂直化管理架构、共享化教学资源、差异化人才培养、协同化教学生态4个维度。2025年1月—6月选取浙江省某三级甲等医院中跨科收治患者流动性排名前10位专科的24个护理单元为应用实施范围，共涉及449名护士。运用柯氏模型进行评价，反应层评估护士对培训的满意度与跨科护理自我效能感得分、学习层为客观结构化临床技能考试得分、行为层为护理质量检查得分、结果层为跨科收治患者护理不良事件发生率。结果应用该体系后，对培训管理体系表示非常满意的护士占比93.5%。护士客观结构化临床技能考试得分、护士跨科护理自我效能感得分、护理质量查检评分均高于应用前或同期对照，差异具有统计学意义（P<0.001）。体系应用前后护理不良事件发生率比较，差异无统计学意义（P>0.05）。结论该研究构建的临床护士在职培训管理体系有利于整合护理教学资源，提升护士综合能力与跨科护理自我效能感，提高护理服务质量，为“全院一张床”管理模式的运行提供保障。

关键词: 跨科收治, 4S管理模型, 护士, 在职培训

Abstract:

Objective To construct an on-the-job training management system for clinical nurses under the hospital-wide bed-sharing mode，and to explore its practical effects. Methods Based on preliminary research，combined with literature review and expert meetings，an on-the-job training management system was developed，including vertical management structure，shared teaching resources，differentiated talent cultivation，and fostering a collaborative teaching ecology. From January to June 2025，24 nursing units with 449 nurses from the top 10 specialties with the highest patient mobility for interdisciplinary admissions at a tertiary first-class hospital in Zhejiang Province were selected to apply this system. A quasi-experimental study design was employed，utilizing the Kirkpatrick Training Evaluation Model. The satisfaction and self-efficacy of nurses with the training（Level 1：Reaction），Objective Structured Clinical Examination（OSCE） scores （Level 2：Learning），nursing quality inspection scores（Level 3：Behavior），and the incidence of nursing adverse events in interdisciplinary admissions（Level 4：Results） were compared before and after implementation. Results After applying the system，93.5% of nurses expressed high satisfaction with the training management system. The OSCE assessment scores，nurses’ self-efficacy scores for interdisciplinary nursing，and nursing quality inspection scores were all higher than before implementation or in the concurrent control group，with statistically significant differences（P<0.001）. No statistically significant difference was observed in the incidence of nursing adverse events before and after system application（P>0.05）. Conclusion The implementation of the on-the-job training system for clinical nurses facilitates the integration of specialized nursing training resources，enhances nurses’ skill proficiency and self-efficacy in interdisciplinary care. Furthermore，it improves the quality of nursing services. This system provides high-quality training guarantee for the operation of the “hospital-wide bed-sharing” management mode.

Key words: Interdisciplinary Admissions, 4S Management Model, Nurses, On-the-job Training

吴一女, 冯洁惠, 殷钰, 张露莎, 王华芬. 全院床位集中管理模式下临床护士在职培训管理体系的构建与实践[J]. 中华护理教育, 2026, 23(2): 208-214.

WU Yinü, FENG Jiehui, YIN Yu, ZHANG Lusha, WANG Huafen. Construction and practice of an on-the-job training management system for clinical nurses under the “hospital-wide bed-sharing” mode[J]. Chinese Journal of Nursing Education, 2026, 23(2): 208-214.

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参考文献 16

[1]	李盈, 金雯, 张正宇. 大型综合医院床位统一调配优化管理实践和成效[J]. 现代医院, 2023, 23(8):1230-1233.
	Li Y, Jin W, Zhang ZY. Practice and effectiveness of unified allocation and optimization management of beds in large com-prehensive hospitals[J]. Mod Hosp, 2023, 23(8):1230-1233.
[2]	Xiong Y, Qin J, Zhou LL, et al. The working experience of medi-cal staff in the hospital-wide bed-sharing mode:a qualitative study[J]. Nurs Open, 2023, 10(10):6885-6895. doi: 10.1002/nop2.v10.10
[3]	李爱群, 蔡益民, 沈周敏, 等. 临床护士跨专业协作能力现状及影响因素分析[J]. 上海护理, 2023, 23(5):30-34.
	Li AQ, Cai YM, Shen ZM, et al. Analysis of status quo and influencing factors of clinical nurses’ transdisciplinary coopera-tion ability[J]. Shanghai Nurs, 2023, 23(5):30-34.
[4]	刘艳, 曾颖, 张莉莉, 等. “全院一张床” 模式下在职护士继续教育培训障碍和促进因素的质性研究[J]. 护理与康复, 2024, 23(9):32-35,42.
	Liu Y, Zeng Y, Zhang LL, et al. Qualitative research on obstacles and promoting factors of continuing education and training of in-service nurses under the bed-sharing model[J]. J Nurs Rehabil, 2024, 23(9):32-35,42.
[5]	Hamele M, Neumayer K, Sweney J, et al. Always ready,always prepared-preparing for the next pandemic[J]. Transl Pediatr, 2018, 7(4):344-355. doi: 10.21037/tp
[6]	许骁玮, 王华芬, 冯洁惠, 等. 新型冠状病毒感染重症患者救护中可转化ICU的组建及应急管理策略[J]. 中华护理杂志, 2023, 58(13):1608-1614. doi: 10.3761/j.issn.0254-1769.2023.13.012
	Xu XW, Wang HF, Feng JH, et al. Establishment and contin-gency management strategies of convertible ICU in severe rescue of COVID-19[J]. Chin J Nurs, 2023, 58(13):1608-1614.
[7]	Anesi GL, Lynch Y, Evans L. A conceptual and adaptable ap-proach to hospital preparedness for acute surge events due to emerging infectious diseases[J]. Crit Care Explor, 2020, 2(4):e0110.
[8]	汪洁, 谢浩芬, 潘赛赛, 等. 基于4S管理模型的加速康复病房管理体系构建与实施[J]. 中华现代护理杂志, 2021, 27(33):4559-4562.
	Wang J, Xie HF, Pan SS, et al. Construction and implementa-tion of ERAS ward management system based on 4S mana-gement model[J]. Chin J Modern Nurs, 2021, 27(33):4559-4562.
[9]	Alomani H, Alanzi F, Alotaibi Y. System, Space, Staff,and Stuff framework in establishing a new pediatric critical care unit(PICU)(4S Framework)[J]. J Pediatr Perinatol Child Health, 2022, 6(4):438-446. doi: 10.26502/jppch.74050129 pmid: 36398116
[10]	Munasinghe NL, O’Reilly G, Cameron P. Establishing the do-mains of a hospital disaster preparedness evaluation tool:a systematic review[J]. Prehosp Disaster Med, 2022, 37(5):674-686. doi: 10.1017/S1049023X22001212
[11]	Huang Y, Mustapha J, Harrison-Williams L, et al. Global oph-thalmic health initiatives in Ebola and emerging infectious disease outbreaks: implications for vision health systems,pro-gram implementation,and disease surveillance[J]. Int Ophthalmol Clin, 2023, 63(1):79-89. doi: 10.1097/IIO.0000000000000443 pmid: 36598835
[12]	Tiwari L, Jayashree M, Jindal A, et al. Practical guideline for setting up a comprehensive pediatric care unit for critical care delivery at district hospitals and medical colleges under ECRP-II[J]. J Pediatr Crit Care, 2023, 10(2):63-71. doi: 10.4103/jpcc.jpcc_12_23
[13]	Baker AH, Lee LK, Sard BE, et al. The 4S’s of disaster management framework:a case study of the 2022 pediatric tripledemic response in a community hospital[J]. Ann Emerg Med, 2024, 83(6):568-575. doi: 10.1016/j.annemergmed.2024.01.020
[14]	Rucks L, Wingate L, López M, et al. Leveraging the Kirkpa-trick four-level model to evaluate evaluation capacity building work[J]. New Drctns Evaluation, 2024, 2024(183):81-94. doi: 10.1002/ev.v2024.183
[15]	Zhang JX, Schwarzer R. Measuring optimistic self-beliefs:a Chinese adaptation of the General Self-efficacy Scale[J]. Psychologia, 1995,38:174-181.
[16]	师曼飞, 钱玉航, 杨淑琪, 等. 知识库与多模型协同驱动的循证护理知识问答智能体的构建与评价研究[J]. 中华护理教育, 2025, 22(9):1036-1042.
	Shi MF, Qian YH, Yang SQ, et al. Construction and evaluation of an evidence-based nursing knowledge question-answering agent driven by knowledge base and multi-model collabora-tion[J]. Chin J Nurs Educ, 2025, 22(9):1036-1042.

全院床位集中管理模式下临床护士在职培训管理体系的构建与实践

Construction and practice of an on-the-job training management system for clinical nurses under the “hospital-wide bed-sharing” mode

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