目的 探讨护理人员分级授权式层级管理方法及效果。 方法 通过文献分析、总结各科室护士工作特点、专家函询,构建护理人员分级授权式层级管理方案。包括各层级基本要求及综合评定要求,成立层级管理委员会,授予各层级管理小组相应职权（年度考核、申报认定和申请晋级）。2019年1月,对相关人员进行培训后正式实施该方案。评价实施护理人员分级授权式层级管理方案前后的层级管理工作质量、临床护士及护理管理者满意度。 结果 护理人员分级授权式层级管理方案实施后,层级管理工作质量优于实施前,实施前后的客观资料合格率、综合评定合格率比较,差异有统计学意义（P<0.05）;护理管理者对层级管理方案的满意度得分由（3.24±0.69）分提高至（4.58±0.50）分,临床护士满意度得分由（2.94±0.83）分提升至（4.30±0.79）分,差异均有统计学意义（P<0.001）。结论 在护理人员层级管理中实施分级授权可以有效提高护理管理者工作质量及满意度,提高临床护士满意度,值得推广。

Objective To explore the effects of hierarchical authorization management of nursing staff. Methods Through literature analysis,expert consultation,and summary of the characteristics of nurses in different departments,the hierarchical management scheme was constructed. The scheme included the basic requirements and comprehensive evaluation requirements of all levels,the establishment of hierarchical management committee,and the authorization of corresponding functions and powers（annual assessment,declaration and confirmation and promotion application） of each level group. In January 2019,the program was formally implemented after relevant personnel were trained. The quality and satisfaction of hierarchical management,nurses’ professional identity,participation rate of hierarchical training and qualified rate of hierarchical training were investigated before and after the implementation of hierarchical authorization management. Results The quality of and satisfaction with hierarchical management,participation rate and qualified rate of hierarchical training were significantly higher than those before the intervention（P<0.05）. The total score of nursing managers’ satisfaction level was improved from（3.24±0.69） to（4.58±0.50）,while the satisfaction level of nurses was improved from were（2.94±0.83） to（4.30±0.79）. Conclusion The implementation of hierarchical authorization management of nursing staff can significantly improve the quality and satisfaction of hierarchical management.