精神科护理人员举证责任倒置中举证能力培养及效果研究.docVIP

精神科护理人员举证责任倒置中举证能力培养及效果研究【摘要】目的培养精神科护理人员在举证责任倒置中的证据意识提高其举证能力。方法提高护理人员的医德修养,加强法律知识和业务能力的培训与考核,使各项护理工作规范化、程序化,加强护理证据的过程管理,指导书写护理文书,建立和完善责任签名制度。结果强化培训与管理实施前和实施3年后分别对104名护理人员的相关法律知识和6个病区200份护理文书书写质量、执行签名情况进行检查,统计数据显示差异有统计学意义。结论只有对护理人员的法律知识和业务能力实施强化培训,加强护理文书书写指导和关键环节的管理,才能提高护理人员的举证能力,以应对举证责任倒置,降低医疗纠纷发生率。 【关键词】 精神科护理人员 举证责任倒置举证能力 能力培养 中国分类号:R473.74文献标识号:A 文章编号:1005-0515(2010)10-004-03 【Abstract】objective To improve the pgychiatric nurses ablity to present evidence by training the their awareness of evidence under proof shifting of burden of evidence. Methods The training including: enhancinhg their medical ethics, enhancing training and examination of nurse?s law knowledge and professional knowledge, increseaing the normalization and routinnization in nursing work, enhaning the management of evidence, guiding them to write nursing papers, and bulding and perfecting the signature institutions. Result 104 nurse were examined in view of their law knowledge by random sampling and the quality of nursing records and the signatures were checked in 200 nursing records from 6 wards before and 3 years after the intense training and enhanced management. Statistical analysis showed significant rises of psychiatric nurse?s ability to present evidence under proof shifting of burden of evidence after training. Conclusion By the law knowledge and professional knowledge training, and enhancing the writing of nursing papers and management of key links, the psychiatric nurse?s ability to present evidence under proof shifting of burden of evidence could be increases significantly, and the medical disputes could be decreased. 【Key words】psychiatric nurseshifting of burden of evidenceability to present evidenceadility traing 近年来,医患关系日趋紧张,医疗纠纷发生率居高不下。精神病人多数在认知、情感、意志、行为等方面表现异常,目前多以封闭式强制性管理为主,住院时间较长,无亲人监护,发生意外的机率较高,护理难度相对较大【1】,医疗护理安全是医院生存和发展的基础。护理文书书写在卫生部管理年检查标准中是不可缺少的一部分,尽管医院检查管理体系严密,但都免不了出现这样或那样的问题【2】,,最高人民法院于2002年4月1日起实施的《关于民事诉讼证据的若干规定》作出了医院诉讼举证责任倒置的规定,法律向弱势群体倾斜。这对医务人员提出了新的挑战,特别