| 1BackgroundOver the years, the nursing staff performance appraisal has been affected by the planned economy and egalitarian detachment, which is not fully reflect the performance, responsibility, risks, benefits and labor intensity and other factors of nursing work. In the past, the assessment of the nursing work only reflected in a large number of examinations, checks and other surfaces of the work, but not the performance appraisal. Under this distribution system, it is difficult to mobilize the enthusiasm of nurses and also hindered the development of nursing work.With the transformation of the modern medical and hospital management model, the hospital management has gradually shifted from purely medical operations to accommodate the entire discipline of social progress and scientific development. They also began to develop a new mechanism or new method which is focus on exploring a wide range of management and easy to mobilize the enthusiasm of departments and employees, distinguish the scientific differences, ability level, and get reasonable allocation of labor compensation. The Improvement of incentives and performance appraisal mechanism is one of the three priorities service demonstration project."The program of promoting care quality in2012" of the Ministry of Health announced that it is necessary to improve the performance appraisal system. The health care service quality, demanded, quantity, technical risk and patient satisfaction are the keys of performance appraisal of nurses, which is also focus on clinical manifestations and job performance. The performance appraisal relates to income distribution, job promotion, learning education and incentives appraised etc. It is linked to the heavy workload, high technical difficulty of clinical nursing positions, which reflect equal pay, hard work and excellent merit pay.Performance appraisal, also known as performance or achievements evaluation, is a scientific management approach to evaluate the past work performance of employees and its future impacts to achieve the purpose of improvement of production and operation of enterprises.360°feedback assessment, also known as360-degree feedback evaluation of multi-source feedback evaluation, is an assessment method which is completed by many people being around the evaluated person or working together closely. The main function is to evaluate individual career development and performance management. Since the launch of high-quality care demonstration project activities, with the limited human resources, how to mobilize clinical nurses working enthusiasm, ensure quality of care and nurse management has become a problem.The360°feedback assessment were mainly used in the internal management of companies, then were applied to the evaluation of medical education, evaluation of lead teachers and nursing students, pre job training of physician, training of the middle-level cadres in colleges and universities and so on,but this study is the first time to use the360°feedback assessment in nursing performance assessment.Therefore, it becomes a serious problem to carry out reform and innovation for the clinical performance evaluation, so as to adapt to the development of the modern hospital performance management.2ObjectiveIt provides the basis for the development of new nursing assessment model and management system to study the drawbacks of traditional performance appraisal system and bottleneck problems during the nursing career development. We explore the application and effect of the360°feedback evaluation in the ward nurse, clinical nurse performance appraisal and contract nurses equal payment. We will develop a series of specific measures to improve the comprehensive quality and management capabilities, mobilize the enthusiasm of nurses, improve patient satisfaction and reduce the occurrence of c adverse events rates, which is based on the comprehensive analysis of360°feedback assessment and evaluation of the quality of the nurse capability, front-line nurses performance, distribution of wages and equal pay for contract nurses.The study was conduct to:1) Analyze the understanding and implementation of the hospital to the nursing performance appraisal policy;2) Analyze the needs and focus of the performance appraisal frontline clinical care team to a different human relation;3) Analyze the parameters that influce the motivation and satisfaction of the frontline nurses;4) Develop the new performance appraisal approach according to the assessment results.3MethodsWith the guidance of hospital management approaches and the spirit of science and fairness,360°feedback effects in nursing performance appraisal management are evaluated among17nurses,91ward nurses and258contract nurses. The performance determined the coefficients of each indicator from the department director, nurse, colleagues, patients and their families perspective, and from quality, inteligence, deligent, achievements and12index factor, respectively, performing the10months interfering avtivities, evaluzting the materials before and after the360degree feedback system.The data was analized with the SPSS13.0software, and the caculate materials were expressed by the x±S, whicn was analyzed by the t test. The counting data was expressed as the percentage, and analyzed with the x2test. The P value below0.05or0.01was determined as statisticlly significant.4Results1) Through analysis and comparison of different human relations performance appraisal satisfaction clinical care team line drawn: the satisfaction of performance evaluation factors, the nurse job satisfaction, stability and work schedule is100%, which position in nursing and nurse team and their own flight arrangement has a great relationship; their satisfaction appreciate recognition, training, study and work achievements were52.94%,52.94%,70.59%, indicating that in these three aspects of nurse demand strong desire to improve. 2) Satisfaction survey results:different nurses focus on different appraisal needs and human relations performance. The demand for higher performance appraisal matron of the order of personal development, appreciate recognition of achievement; higher demand for performance appraisal ward nurses were to appreciate the recognition, personal development and performance distribution, growth and development among young nurse on demand the highest performance allocation senior nurses appreciated and recognized the need for higher; higher demand for contract nurses were performance appraisal of the performance of distribution, stability, welfare and fairness bonus, they hope to change their status through performance evaluation and equal pay following equal contribute.3) Through360°feedback evaluation of the results of the evaluation factor analysis indicators matron drawn:different evaluators have different views on the nurse’s work, the lower score on the nurse’s superiors and different degrees higher than at the same level (P<0.05), especially in the ability of indicators; higher leeders put lower scores on the head nurse, in the order of ability, diligence, ethics, performance indicators factor, index factor which results in the greatest impact on the evaluation score; factors can be indicators of high qualification nurse communication ability, low capital nurse acceptance of ability.4) The department cohesion, attitude, efficiency, and ability to work were inceased after inplement of the360°feedback evaluation of nurses (P<0.01).5)360°feedback to evaluate the implementation of the quality of care in the ward nurses get continuous improvement, basic care, operating specifications, instrument care, specialist nursing pass rate significantly increased (P<0.01).6)360°feedback to improve the implementation of nurse job satisfaction (P<0.01), increased from83.72%to97.80%before implementation; improved patient satisfaction (P<0.01), increased from88.08%prior to the implementation of the98.51%; reduce the incidence of adverse events in nursing (P<0.05), before the implementation of the3.11%down to0.10%.7) Through360°feedback evaluation in equal pay for contract nurses assessment management, quality of care improved from the95.4±1.36to99.8±1.37; contract nurses satisfaction by the69.0%increase to94.8%; patient satisfaction with the contract nurses degree increased from88.7%to96.8%; contract nurses leaving rate of15.3%is reduced to zero (P<0.01). 5Conclusion and suggestionIn the evaluation process, add the different parameters according to the different levels and different backgrounds in order to make the test scores more objective, which would make benefits to the management of the department and enhance the efficiency of the medical care.In this study, the360°feedback concept was incorporated into the examination so as to satisfy the development requirement of the hospital in the new century and ensure the success of the reformation of the hospital. Meanwhile, the patients were efficaciously cared by the development of the feedback system of the examination. The system was consistent with the services aim of "satisfy the society, satisfy the government and satisfy the patients" in the model project of the fabulous nursing, reflected the requirement of "patient-centered and quality-centered" and the purpose of the medical industry of quality, safety and service.To sum up, this study developed a novel, operable and fair test approach, summarized the management experience and stabilized the nurses and increased the satisfaction rates of the patients so that the aim of the sustainable development of the nursing quality was achieved.Recommendations:conscientiously implement the "nurse ordinance" to protect the legitimate rights and interests of nurses; deepen hospital care management system, establish a scientific and reasonable performance evaluation system; attention frontline clinical nurses, hospitals encourage nurses to participate in policy formulation and evaluation; stable care team, to prevent brain drain. |
PDF Full Text Request