The Action Plan for Further Improving Nursing Services (2023-2025) was issued.
The National Health and Wellness Commission and the State Administration of Traditional Chinese Medicine recently issued the Action Plan for Further Improving Nursing Services (2023-2025), and carried out actions to further improve nursing services with the theme of "strengthening foundation, improving quality and promoting development".
All provinces, autonomous regions, municipalities directly under the central government and the Health and Health Committee of Xinjiang Production and Construction Corps and the Bureau of Traditional Chinese Medicine:
In order to fully implement the spirit of the 20th Congress of the Communist Party of China, carry out in-depth education on the theme of studying and implementing Socialism with Chinese characteristics Thought of the Supreme Leader in the new era, focus on the people’s growing demand for diversified nursing services, further improve nursing services, continuously enhance patients’ medical experience, and effectively promote nursing work to be closer to patients, clinic and society, the National Health and Wellness Commission and the State Administration of Traditional Chinese Medicine decided to carry out further actions to improve nursing services with the theme of "strengthening foundation, improving quality and promoting development". The Action Plan for Further Improving Nursing Services (2023-2025) is hereby printed and distributed to you. Please organize and implement it carefully to ensure effective results.
(2023-2025)
In order to continuously meet the diversified nursing service needs of the people, further improve the nursing service, continuously enhance the patient’s medical experience and promote the high-quality development of nursing work. Formulate this action plan.
I. General requirements
Guided by Socialism with Chinese characteristics Thought of the Supreme Leader in the New Era, we will fully implement the spirit of the 20th Party Congress, focus on the people’s growing demand for diversified nursing services, persist in taking people’s health as the center, focus on solving the urgent nursing problems of the people, and continuously improve the patient’s medical experience. Strive to use three years to carry out the action of further improving nursing service with the theme of "strengthening foundation, improving quality and promoting development" and continuously deepen the concept of "taking patients as the center". Clinical basic nursing has been continuously strengthened, nursing quality has been significantly improved, nursing service has been continuously improved, nursing connotation has been enriched, nursing field has been expanded and extended, service mode has been innovated day by day, and nursing service covering the whole life cycle of the whole population has become more high-quality, efficient and convenient, and nursing work is closer to patients.
Second, strengthen clinical nursing and promote nursing service close to patients.
(a) the implementation of the responsibility system of holistic nursing. Medical institutions should further implement the responsibility system of holistic nursing service. Each nurse in charge is responsible for a certain number of patients, and each patient has a relatively fixed nurse in charge. Nurses should fully perform their nursing duties, and provide patients with holistic physical and mental care services such as medical care, observation of illness, assistance in treatment, health guidance and humanistic care according to their disease characteristics, physiology, psychology and social needs. By 2025, the overall care of all kinds of medical institutions at all levels will cover 100% of the wards in the hospital.
(2) Strengthen basic nursing. Medical institutions should improve the grading nursing system, improve the standard of basic nursing service and strengthen the quality of basic nursing in accordance with the Guiding Principles of Graded Nursing in General Hospitals (Trial), Basic Nursing Service Items for Inpatients and Basic Nursing Service Work Standards. It is necessary to do a good job in basic nursing work such as patients’ oral cavity, provide timely and necessary medical care according to patients’ nursing level, illness and self-care ability, and effectively improve patients’ medical experience.
(3) Pay attention to communication. In the process of providing nursing services for patients, nurses should actively strengthen communication with patients, and the language should be easy to understand, simple and clear, and timely understand and observe patients’ reaction and psychological state, pay attention to patients’ needs and discomfort, and give timely guidance and help. Before the implementation of nursing professional technical operation, it is necessary to explain patiently, ask about concerns during operation, observe in time after operation, and communicate with doctors in time when the patient’s condition changes are found.
(4) Strengthening humanistic care. Medical institutions should deepen the concept of "patient-centered", pay attention to strengthening nursing humanistic construction, refine humanistic care measures, and provide humanized nursing services for patients. Nurses should enhance their awareness of active service and humanistic care, care, love and respect patients, protect patients’ privacy, give careful care, psychological support and humanistic care, enhance the trust between nurses and patients, and harmonize the relationship between doctors and patients.
(5) Do a good job in health guidance. Nurses should provide patients with personalized health education knowledge in terms of diet, nutrition, exercise, rehabilitation, prevention of complications, etc. in written, oral and video ways according to patients’ disease characteristics, individual differences and health needs. Do a good job in the introduction of patients to hospital, discharge guidance, special treatment, examination, perioperative cooperation and matters needing attention.
Third, improve the quality of nursing and promote nursing service close to clinic.
(6) Strengthen patrol observation. Medical institutions should strengthen nursing patrol work, and clinical nurses should strengthen patient patrol and condition observation according to the requirements of grading nursing guiding principles. Special care patients should be inspected at any time. Patients with primary care, secondary care and tertiary care should be inspected regularly as required, and their vital signs, conscious state, skin condition, peripheral circulation of limbs, drainage fluid and reaction after surgery/examination/medication should be closely observed, so as to find out the changes of illness and potential complications in time and give effective treatment.
(seven) to ensure the quality and safety of nursing. Advocate medical institutions to carry out joint ward rounds and multidisciplinary cooperation, so that nurses can fully understand the patient’s condition and provide targeted nursing measures. Medical institutions should strictly implement the core systems such as grading nursing, checking and shifting, and standardize the implementation of various clinical nursing technical operations in accordance with the requirements of clinical nursing practice guidelines and technical standards. It is necessary to enhance the ability of early warning and identification of complications, reduce the incidence of medical safety adverse events such as falls of inpatients and new pressure injuries in hospitals, and ensure the quality of nursing and patient safety.
(eight) to improve the level of nursing technology. Medical institutions should strengthen the "three basics and three strictness" as the starting point to consolidate the basic skills of clinical nurses in nursing technology. Combined with the requirements of high-quality development of medical institutions and the construction of clinical specialties, in order to meet the clinical nursing needs of patients, priority should be given to promoting the professional development of clinical nursing and the training of nursing talents in the fields of critical illness, emergency, operating room, obstetrics, blood purification and wound stoma, so as to continuously improve the professional technical level of clinical nursing, enhance the medical effect of patients and promote the high-quality development of nursing.
(nine) to enhance the nursing ability of traditional Chinese medicine. Actively carry out dialectical nursing and specialized nursing with Chinese medicine characteristics, standardize the training of Chinese medicine nursing talents, continuously improve the quality of Chinese medicine nursing service, innovate the service mode of Chinese medicine nursing, give play to the important role of Chinese medicine nursing in disease prevention, treatment and rehabilitation, and promote the further expansion of Chinese medicine nursing to grassroots and families, and extend to the fields of elderly care and chronic disease care.
(10) Effectively reduce the burden on nurses. Medical institutions should take effective measures to effectively relieve the burden on clinical nurses. Combined with the actual clinical nursing work and the post requirements of nurses, online learning, remote guidance and other ways can be used to reasonably arrange nurse training to minimize repetitive assessments and competitions. It is necessary to make full use of information technology to reduce the unnecessary writing burden of clinical nurses, so that nurses can have more time to be close to the clinic and provide direct nursing services for patients.
Fourth, expand the field of nursing and promote nursing service to be close to the society.
(eleven) to carry out continuous nursing services. Third-level hospitals and some qualified second-level hospitals should provide continuous nursing services such as online nursing consultation, nursing follow-up and home nursing guidance for discharged patients with nursing needs by means of information technology and developing mobile APP and nursing service follow-up system, so as to solve the problems of routine nursing, specialist nursing and special disease nursing after discharge. Encourage medical institutions to gradually expand the proportion of wards providing continuous nursing services and reduce the unplanned readmission rate of discharged patients.
(twelve) expand the "internet plus nursing service". Support qualified medical institutions to actively carry out "internet plus Nursing Service" according to laws and regulations, and dispatch qualified registered nurses of this institution to provide professional and convenient on-site nursing services for discharged patients, terminally ill patients or elderly people with limited mobility at home. Further expand the coverage of "internet plus Nursing Service", and gradually increase the number of "internet plus Nursing Service" medical institutions and the number of home care services to benefit more people.
(thirteen) to improve the ability of primary nursing service. With the grid layout of urban medical group and county medical community as the carrier, we will give full play to the sinking and driving role of high-quality nursing resources in large medical institutions, and help grassroots medical institutions in medical associations (county medical community and city medical group) to improve their nursing service capabilities by establishing specialized nursing joint teams, one-on-one mentoring, personnel training and remote nursing consultation. Solve the urgent nursing problems of the masses nearby and improve the professionalism and convenience of nursing services.
(fourteen) to increase the supply of nursing services for the elderly. Support social forces to set up community-based group and chain-like nursing centers, nursing stations and other medical institutions, encourage first-and second-class medical institutions in areas rich in medical resources to transform into nursing homes, and conditional community health service centers actively provide elderly care services through contracting services, rounds and other means, effectively increase the supply of community and home-based elderly care services, and accurately meet the diversified and differentiated nursing service needs of the elderly.
Five, increase support to ensure the effectiveness of the work.
(15) Increase support and guarantee. Medical institutions should establish a special working mechanism for improving nursing service in their own units, mainly responsible comrades should personally grasp it, form a multi-department linkage mechanism such as personnel, finance and logistics, and increase the guarantee for improving nursing service from many aspects such as people, finance and materials. Improve the logistics support system, increase the number of auxiliary service personnel responsible for sending samples, drugs and patients to accompany the inspection, etc., to ensure that the equipment and facilities needed for clinical nursing work are in place and maintained in time. Departments such as intravenous drug dispensing center, disinfection supply center, etc. accept and deliver drugs to ward, reduce nurses’ non-nursing work, and let nurses devote themselves to clinical nursing services to the maximum extent.
(sixteen) to strengthen the manpower of nurses. Medical institutions should scientifically and reasonably allocate a sufficient number of clinical nurses according to functional orientation, service radius, bed size, clinical nursing workload and technical risk factors. The ratio of nurses in the ward of the second-class hospital and above to the actual open beds is not less than 0.5: 1. Priority should be given to ensuring that nurses in clinical nursing posts are in place, and the number of clinical frontline nurses should not be reduced. In principle, the number of nurses in clinical nursing posts accounts for no less than 95% of the total number of nurses in the hospital. We should strengthen the manpower allocation of nurses in primary medical institutions and increase the supply of primary nursing services according to the needs of clinical nursing and home care services for residents in the jurisdiction.
(seventeen) fully mobilize the enthusiasm of nurses. Medical institutions should protect nurses’ legitimate rights and interests such as salary, welfare, social insurance, health protection and practice safety according to laws and regulations. It is necessary to make overall consideration of the internal and external personnel in the aspects of nurse post setting, income distribution, professional title evaluation and employment, management and use. It is necessary to improve the incentive mechanism of nurses, and tilt towards clinical frontline nurses in terms of performance distribution, professional title promotion, education and training, so as to get more for more work and excellent performance and reward.
(eighteen) to strengthen the support of information technology. Through the construction of smart hospitals, smart wards and electronic medical records, medical institutions strengthen the development of nursing informatization, make full use of new generation information technologies such as artificial intelligence, 5G and Internet of Things, improve and optimize nursing service processes, improve nursing work efficiency and reduce the workload of clinical frontline nurses. Actively innovate the nursing service mode, and extend the in-hospital nursing to the outside of the hospital through "internet plus" and other ways.
(nineteen) to strengthen the standardized management of medical care workers. According to the patient’s condition, self-care ability and nursing level, medical institutions can employ a suitable number of qualified medical nurses in the ward scientifically and reasonably. Medical nursing staff shall, under the guidance and supervision of medical personnel, assist in providing life care services such as cleaning, diet and excretion according to the condition and self-care ability of hospitalized patients. It is forbidden for medical nurses to take the place of medical staff to engage in discharge guidance and medical nursing professional and technical work.
VI. Organizing implementation
(twenty) to strengthen organizational leadership. Health administrative departments at all levels (including the competent department of traditional Chinese medicine, the same below) and medical institutions should fully understand the significance of improving nursing services to promote the high-quality development of medical institutions, improve and protect people’s livelihood, and the main responsible comrades should personally grasp them, make overall arrangements and seriously organize their implementation. Health administrative departments should guide and urge medical institutions to continuously improve nursing services and implement various tasks and measures. Medical institutions should be in accordance with the unified deployment, combined with the actual clear objectives and tasks of improving nursing services and effectively implement them.
(twenty-one) timely tracking and evaluation. The provincial health administrative departments should formulate specific plans to improve nursing services in combination with the actual situation in the region and report them to the National Health and Health Commission for the record, and at the same time do a good job in dynamic monitoring and evaluation of the implementation of specific plans in the region. The National Health and Wellness Committee will conduct regular follow-up evaluation on the implementation of actions to improve nursing services in various places every year, and timely summarize and report the progress in various places.
(22) create favorable conditions. Health administrative departments should take the initiative to strengthen inter-departmental communication and coordination, and create favorable policy conditions for the implementation of the action plan to improve nursing services. Actively coordinate and implement the relevant policy requirements of nursing service price adjustment, gradually straighten out the price comparison relationship of nursing service, and reflect the technical labor value of nurses. Continue to deepen the reform of the salary system in public hospitals, establish a dynamic adjustment mechanism, and reasonably determine the salary level of nurses.
(twenty-three) increase publicity and guidance. Health administrative departments and medical institutions should make full use of radio, television, newspapers, the Internet and other news media forms, and do a good job in interpreting policies and guiding public opinion to improve nursing services. Fully explore and publicize the typical experience of improving nursing service, give play to the role of advanced driving and demonstration, and create a good social atmosphere to promote the development of work.