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Article(id=1322168319986221163, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322168262247432815, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.05.016, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1753027200000, receivedDateStr=2025-07-21, revisedDate=1768579200000, revisedDateStr=2026-01-17, acceptedDate=null, acceptedDateStr=null, onlineDate=1793159092183, onlineDateStr=2026-10-28, pubDate=1773072000000, pubDateStr=2026-03-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793159092183, onlineIssueDateStr=2026-10-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793159092183, creator=13701087609, updateTime=1793159092183, updator=13701087609, issue=Issue{id=1322168262247432815, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='5', pageStart='705', pageEnd='880', issueExtLink='null', onlineDate='null', pubDate='1773072000000', pubDateStr='2026-03-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793159078418, creator='13701087609', updateTime=1793159078418, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=823, endPage=827, ext={EN=ArticleExt(id=1322168320669892717, articleId=1322168319986221163, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Current status of core competencies of nursing staff in hosting hospitals of national regional medical center and its influencing factors, columnId=1220689488284668633, journalTitle=Chinese Nursing Research, columnName=Comprehensive Study, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the current status of core competencies among nursing staff in hosting hospitals of national regional medical center and explore its influencing factors.

Methods

A total of 962 nursing staff from four hosting hospitals of regional medical center in Shanxi province were surveyed using the Chinese Registered Nurse Core Competency Scale,and the influencing factors were analyzed.

Results

The core competency score of nursing staff in the four hosting hospitals of regional medical center in Shanxi province was(138.78±42.05),indicating an above-average level.Among the competencies,ethical and legal practice abilities and professional development scored relatively high,while critical thinking and research abilities,as well as clinical nursing abilities,scored relatively low.Multivariate regression analysis showed that job position and professional rank were influencing factors of the core competencies of nursing staff(P<0.05).

Conclusions

The overall core competencies of nursing staff in hosting hospitals of national regional medical center are at an above-average level.Among these,ethical and legal practice abilities and professional development abilities are relatively strong,while critical thinking and research abilities,as well as clinical nursing abilities,still require improvement.Job position and professional rank are important factors influencing the core competencies of nursing staff.

, authors=Yingying YAN1, Zhaoxia DUAN2, Hong ZHAO2, Ying HAN1, authorsList=Yingying YAN, Zhaoxia DUAN, Hong ZHAO, Ying HAN, authorCompany=null, correspAuthors=Zhaoxia DUAN, authorNote=null, correspAuthorsNote=
DUAN Zhaoxia, E-mail:
, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322168321831714926, articleId=1322168319986221163, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=国家区域医疗中心依托医院护理人员核心能力现状及影响因素, columnId=1220689488938980091, journalTitle=护理研究, columnName=综合研究, runingTitle=null, highlight=null, articleAbstract=
目的

调查国家区域医疗中心依托医院护理人员的核心能力现状，并探讨其影响因素。

方法

采用中国注册护理人员核心能力量表对山西省4所区域医疗中心依托医院的962名护理人员进行调查，并分析其影响因素。

结果

山西省4所区域医疗中心输入医院护理人员的核心能力得分为（138.78±42.05）分，处于中等偏上水平；其中，伦理与法律实践、专业发展得分较高，评判性思维与科研、临床护理得分较低。多因素回归分析显示，职务、岗位层级是护理人员核心能力的影响因素（P<0.05）。

结论

国家区域医疗中心依托医院护理人员的核心能力总体处于中等偏上水平。其中，伦理与法律实践、专业发展能力表现相对突出，而评判性思维与科研、临床护理仍有提升空间。职务与岗位层级是影响护理人员核心能力的重要因素。

, authors=晏莹莹1, 段朝霞2, *, *, 赵宏2, 韩颖1, authorsList=晏莹莹, 段朝霞, 赵宏, 韩颖, authorCompany=null, correspAuthors=段朝霞, authorNote=

晏莹莹，硕士研究生

, correspAuthorsNote=
段朝霞，E-mail:
DUAN Zhaoxia, E-mail:
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country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1School of Management, Shanxi Medical University, Shanxi 030604 China), AuthorCompanyExt(id=1322530161313035151, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168319986221163, companyId=1322530161292063629, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1山西医科大学管理学院，山西 030604)]), AuthorCompany(id=1322530161451447184, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168319986221163, xref=2, ext=[AuthorCompanyExt(id=1322530161560499089, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168319986221163, companyId=1322530161451447184, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2Medical Administration Division,Health Commission of Shanxi Province), AuthorCompanyExt(id=1322530161577276306, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168319986221163, companyId=1322530161451447184, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2山西省卫生健康委员会医政处)])], figs=[ArticleFig(id=1322530167252169652, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168319986221163, language=EN, label=Table 1, caption=

Core competency scores of nurses（n=962）

, figureFileSmall=null, figureFileBig=null, tableContent=
维度条目总分得分条目均分
核心能力总分220138.78±42.052.52±0.77
评判性思维与科研3217.84±7.282.23±0.91
临床护理4024.00±9.002.40±0.90
领导能力3622.86±8.282.54±0.92
人际关系3220.16±7.282.52±0.91
伦理与法律实践3222.48±7.522.81±0.94
专业发展2415.48±5.522.58±0.92
教育咨询2414.94±5.582.49±0.93
), ArticleFig(id=1322530167478662069, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168319986221163, language=CN, label=表1, caption=

护理人员核心能力得分情况（n=962）

, figureFileSmall=null, figureFileBig=null, tableContent=
维度条目总分得分条目均分
核心能力总分220138.78±42.052.52±0.77
评判性思维与科研3217.84±7.282.23±0.91
临床护理4024.00±9.002.40±0.90
领导能力3622.86±8.282.54±0.92
人际关系3220.16±7.282.52±0.91
伦理与法律实践3222.48±7.522.81±0.94
专业发展2415.48±5.522.58±0.92
教育咨询2414.94±5.582.49±0.93
), ArticleFig(id=1322530167554159542, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168319986221163, language=EN, label=Table 2, caption=

Univariate analysis of factors influencing core competencies of nursing staff（x±s，n=962）

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类人数得分统计值P
性别男33135.80±40.23t=-0.4330.665
女929138.72±38.00
学历专科及以下29136.55±42.06
本科919138.72±42.12F=5.225<0.001
硕士研究生及以上14148.91±35.80
职称护士52134.56±42.34F=20.480<0.001
护师399137.60±41.37
主管护师442138.63±39.29
副主任护师64139.72±35.37
主任护师5141.42±34.92
职务无829135.47±42.22
组长55137.55±40.06F=11.397<0.001
其他78138.90±42.51
工作年限<5年187135.66±41.94F=18.417<0.001
5~10年255137.70±42.08
>10~20年361138.75±41.99
>20年159140.90±42.21
聘用方式劳务派遣15135.48±41.92
合同聘用793138.64±41.91F=8.223<0.001
在编154139.78±42.05
科室门诊90136.62±41.99F=5.318<0.001
临床837141.70±40.99
消毒供应室29138.81±41.77
行政管理6140.59±41.68
岗位层级N0级44136.82±42.15F=20.741<0.001
N1级221138.66±41.99
N2级366139.99±42.90
N3级303141.70±41.99
N4级28144.00±42.23
), ArticleFig(id=1322530169244464055, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168319986221163, language=CN, label=表2, caption=

护理人员核心能力影响因素的单因素分析（x±s，n=962）

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类人数得分统计值P
性别男33135.80±40.23t=-0.4330.665
女929138.72±38.00
学历专科及以下29136.55±42.06
本科919138.72±42.12F=5.225<0.001
硕士研究生及以上14148.91±35.80
职称护士52134.56±42.34F=20.480<0.001
护师399137.60±41.37
主管护师442138.63±39.29
副主任护师64139.72±35.37
主任护师5141.42±34.92
职务无829135.47±42.22
组长55137.55±40.06F=11.397<0.001
其他78138.90±42.51
工作年限<5年187135.66±41.94F=18.417<0.001
5~10年255137.70±42.08
>10~20年361138.75±41.99
>20年159140.90±42.21
聘用方式劳务派遣15135.48±41.92
合同聘用793138.64±41.91F=8.223<0.001
在编154139.78±42.05
科室门诊90136.62±41.99F=5.318<0.001
临床837141.70±40.99
消毒供应室29138.81±41.77
行政管理6140.59±41.68
岗位层级N0级44136.82±42.15F=20.741<0.001
N1级221138.66±41.99
N2级366139.99±42.90
N3级303141.70±41.99
N4级28144.00±42.23
), ArticleFig(id=1322530169349321656, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168319986221163, language=EN, label=Table 3, caption=

Variable assignment

, figureFileSmall=null, figureFileBig=null, tableContent=
变量赋值方式
学历专科及以下=1，本科=2，硕士研究生及以上=3
职称护士=1，护师=2，主管护师=3，副主任护师及以上=4
职务无=1，组长=2，其他=3
科室门诊（0，0，0），临床（1，0，0），消毒供应室（0，1，0），行政管理（0，0，1）
岗位层级N0级=1,N1级=2,N2级=3,N3级=4,N4级=5
工作年限<5年=1，5~10年=2，>10~20年=3，>20年=4
聘用方式劳务派遣（0,0），合同聘用（1,0），在编（0,1）
), ArticleFig(id=1322530169424819129, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168319986221163, language=CN, label=表3, caption=

变量赋值

, figureFileSmall=null, figureFileBig=null, tableContent=
变量赋值方式
学历专科及以下=1，本科=2，硕士研究生及以上=3
职称护士=1，护师=2，主管护师=3，副主任护师及以上=4
职务无=1，组长=2，其他=3
科室门诊（0，0，0），临床（1，0，0），消毒供应室（0，1，0），行政管理（0，0，1）
岗位层级N0级=1,N1级=2,N2级=3,N3级=4,N4级=5
工作年限<5年=1，5~10年=2，>10~20年=3，>20年=4
聘用方式劳务派遣（0,0），合同聘用（1,0），在编（0,1）
), ArticleFig(id=1322530169496122298, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168319986221163, language=EN, label=Table 4, caption=

Multivariate analysis of factors influencing core competencies of nursing staff in national regional medical center recipient hospitals

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变量回归系数标准误标准化回归系数t值P
常量98.1074.69020.919<0.001
职务8.8202.4290.1223.631<0.001
岗位层级9.4541.5400.2066.139<0.001
), ArticleFig(id=1322530169563231163, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168319986221163, language=CN, label=表4, caption=

国家区域医疗中心依托医院护理人员核心能力影响因素的多因素分析

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变量回归系数标准误标准化回归系数t值P
常量98.1074.69020.919<0.001
职务8.8202.4290.1223.631<0.001
岗位层级9.4541.5400.2066.139<0.001
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国家区域医疗中心依托医院护理人员核心能力现状及影响因素
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晏莹莹 1 , 段朝霞 2, *, * , 赵宏 2 , 韩颖 1
护理研究 | 综合研究 2026,40(5): 823-827
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护理研究 |综合研究 2026 , 40 (5) : 823 -827
国家区域医疗中心依托医院护理人员核心能力现状及影响因素
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晏莹莹1, 段朝霞2, *, * , 赵宏2, 韩颖1
作者信息
  • 1山西医科大学管理学院，山西 030604
  • 2山西省卫生健康委员会医政处
通讯作者:
段朝霞，E-mail:
DUAN Zhaoxia, E-mail:
作者简介:

晏莹莹，硕士研究生

Current status of core competencies of nursing staff in hosting hospitals of national regional medical center and its influencing factors
Yingying YAN1, Zhaoxia DUAN2 , Hong ZHAO2, Ying HAN1
Affiliations
  • 1School of Management, Shanxi Medical University, Shanxi 030604 China
  • 2Medical Administration Division,Health Commission of Shanxi Province
    • Corresponding Author:
    DUAN Zhaoxia, E-mail:
出版时间: 2026-03-10 doi: 10.12102/j.issn.1009-6493.2026.05.016
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摘要
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目的

调查国家区域医疗中心依托医院护理人员的核心能力现状，并探讨其影响因素。

方法

采用中国注册护理人员核心能力量表对山西省4所区域医疗中心依托医院的962名护理人员进行调查，并分析其影响因素。

结果

山西省4所区域医疗中心输入医院护理人员的核心能力得分为（138.78±42.05）分，处于中等偏上水平；其中，伦理与法律实践、专业发展得分较高，评判性思维与科研、临床护理得分较低。多因素回归分析显示，职务、岗位层级是护理人员核心能力的影响因素（P<0.05）。

结论

国家区域医疗中心依托医院护理人员的核心能力总体处于中等偏上水平。其中，伦理与法律实践、专业发展能力表现相对突出，而评判性思维与科研、临床护理仍有提升空间。职务与岗位层级是影响护理人员核心能力的重要因素。

国家区域医疗中心  /  护理人员  /  核心能力  /  影响因素  /  调查研究
Objective

To investigate the current status of core competencies among nursing staff in hosting hospitals of national regional medical center and explore its influencing factors.

Methods

A total of 962 nursing staff from four hosting hospitals of regional medical center in Shanxi province were surveyed using the Chinese Registered Nurse Core Competency Scale,and the influencing factors were analyzed.

Results

The core competency score of nursing staff in the four hosting hospitals of regional medical center in Shanxi province was(138.78±42.05),indicating an above-average level.Among the competencies,ethical and legal practice abilities and professional development scored relatively high,while critical thinking and research abilities,as well as clinical nursing abilities,scored relatively low.Multivariate regression analysis showed that job position and professional rank were influencing factors of the core competencies of nursing staff(P<0.05).

Conclusions

The overall core competencies of nursing staff in hosting hospitals of national regional medical center are at an above-average level.Among these,ethical and legal practice abilities and professional development abilities are relatively strong,while critical thinking and research abilities,as well as clinical nursing abilities,still require improvement.Job position and professional rank are important factors influencing the core competencies of nursing staff.

national regional medical centers  /  nurses  /  core competencies  /  influencing factors  /  investigation
晏莹莹, 段朝霞, 赵宏, 韩颖. 国家区域医疗中心依托医院护理人员核心能力现状及影响因素. 护理研究, 2026 , 40 (5) : 823 -827 . DOI: 10.12102/j.issn.1009-6493.2026.05.016
Yingying YAN, Zhaoxia DUAN, Hong ZHAO, Ying HAN. Current status of core competencies of nursing staff in hosting hospitals of national regional medical center and its influencing factors[J]. Chinese Nursing Research, 2026 , 40 (5) : 823 -827 . DOI: 10.12102/j.issn.1009-6493.2026.05.016
正文
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推进区域医疗中心建设是国家促进优质医疗资源扩容下沉与区域均衡发展的重要举措，旨在有效降低群众跨区域异地就医比例，更好满足病人对优质医疗资源的需求[1]。国家发展改革委已分5批批复125个区域医疗中心建设项目[2]。2023年3月，山西省政府印发《山西省支持国家区域医疗中心建设工作方案》，从资金、用地及配套设施、人才引育、医疗技术、医保政策、医教研协同创新等6个方面提出36条细化推进措施，为区域医疗中心建设蓄势赋能、保驾护航。山西省4个国家区域医疗中心充分发挥长短板优势，形成各有侧重、特色鲜明、错位发展、同向发力的良好发展态势。国家区域医疗中心建设作为国家优化医疗资源配置、提升区域医疗服务能力的核心战略，对护理人员的能力素质提出了系统性、高阶化的新要求[3-7]。护理人员核心能力是指护理人员履行整体责任制护理所需的综合能力，是工作态度、护理技能与相关知识的集中体现[8]。护理人员核心能力反映了临床护理人员外在的综合能力，受年龄、学历、职称、岗位层级及工作年限等多种因素影响。本研究对山西省4所区域医疗中心医院护理人员核心能力进行现状调查，为后续制定精准干预措施奠定基础，从而提升护理队伍整体素质并优化其结构。
1　对象与方法
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1.1　研究对象
采取整群抽样法，选取山西省4所区域医疗中心的962名护理人员作为调查对象。纳入标准：持有护理人员资格证书；工作时间超过1年；知情同意参与本研究。排除标准：休假或进修等原因暂不在岗者。本研究数据使用通过山西省卫生健康委伦理审查委员会批准，且所有受访者均签署知情同意书。
1.2　研究工具
1.2.1　一般资料调查表
本研究通过阅读国内文献并咨询专家设计一般资料调查表，内容包括护理人员年龄、学历、职称、职务、岗位层级、科室、工作年限、聘用方式。
1.2.2　中国注册护理人员核心能力量表
该量表由刘明等[9-10]编制，共包括7个维度、55个条目，分别为评判性思维和科研（8个条目）、临床护理（10个条目）、领导能力（9个条目）、人际关系（8个条目）、伦理与法律实践（8个条目）、专业发展（6个条目）、教育咨询（6个条目）。量表总体Cronbach's α系数为0.99，各维度Cronbach's α系数为0.785~0.981，KMO值为0.989，近似χ2值83 411.36，P<0.001。量表采用Liker 5级评分法，“没有能力”计0分，“有一点能力”计1分，“有一些能力”计2分，“有足够能力”计3分，“很有能力”计4分，量表总分220分，分数越高代表核心能力越强。
1.3　调查方法
本研究采用问卷星线上发放问卷进行匿名调查，由山西省卫生健康委下发给4所医院，采用统一的指导语向其详细阐述此次调查目的、填写问卷的方法、注意事项和伦理原则。问卷星上题目设置为必答题，同时限制每个微信号只能填写1次。调查问卷的个人信息和问卷内容绝对保密。采用统一指导语向调查对象详细说明调查目的、内容、方法以及填写注意事项，同时调查对象知情同意并自愿参与。本次发放问卷1 223份，剔除各条目选项一致、填写时间<120 s和>1 800 s的无效问卷后剩余962份，问卷有效回收率为78.66%。
1.4　统计学方法
将收集的数据建立数据库，核对无误后，采用SPSS 26.0软件进行统计分析。定性资料采用人数、百分比（%）描述；满足正态分布的定量资料采用均数±标准差（x±s）描述，组间比较采用独立样本t检验及方差分析。采用多因素回归分析进行影响因素分析。以P<0.05为差异有统计学意义。
2　结果
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2.1　护理人员核心能力评分情况
山西省4所区域医疗中心医院962名护理人员核心能力得分为（138.78±42.05）分，各条目均分为（2.52±0.77）分；各维度条目均分由高到低依次为伦理与法律实践能力、专业发展能力、领导能力、人际关系能力、教育与咨询能力、临床护理能力、评判性思维与科研能力。具体见表1。
2.2　护理人员核心能力影响因素的单因素分析
结果显示，不同学历、职称、职务、岗位层级、科室、工作年限、聘用方式的护理人员核心能力得分比较差异有统计学意义（P<0.05）。见表2。
2.3　国家区域医疗中心依托医院护理人员核心能力影响因素的多因素分析
以护理人员核心能力总分为因变量，单因素分析中差异有统计学意义的变量为自变量进行多因素回归分析，变量赋值见表3。多因素分析显示，学历、职务、岗位层级为国家区域医疗中心依托医院护理人员核心能力的影响因素（P<0.05),见表4。
3　讨论
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3.1　国家区域医疗中心依托医院护理人员核心能力现状
调查结果显示，山西省4所区域医疗中心医院护理人员核心能力处于中等偏上水平，与相关研究结果[11-13]一致。护理人员在伦理与法律实践能力维度得分较高，表明区域医疗中心医院在制度层面为护理人员提供了明确的法律操作指引，医院成功将“以病人为中心”的理念转化为具体实践能力，护理人员伦理与法律实践能力提升，有利于构建和谐的医患关系[14]。区域医疗中心依托医院对这一能力的重视，体现在对护理人员培养上的全面性方面，不仅关注临床操作技能，更注重职业精神和合规意识等软实力的提升，为护理人员的长期发展夯实基础。专业发展能力得分次之，结合区域医疗中心的定位承担区域内疑难重症救治、人才培养等任务，护理人员的专业发展能力得分较高，说明4所区域医疗中心依托医院可能建立了完善的护理人员职业晋升通道和继续教育体系。护理人员对自身专业成长有明确的目标，医院在资源投入方面也相对充足，推动了整体队伍的成长。领导能力、人际关系能力和教育与咨询能力均处于中等水平。领导能力得分较高，可能与区域医疗中心护理人员队伍中存在较多的护士长、护理组长等管理岗位有关，其日常管理积累了一定的组织协调能力和问题解决能力[15]。人际关系能力良好，则反映护理人员在跨科室协作、医患沟通中表现较好，这既是区域医疗中心作为“区域医疗枢纽”对团队协作的基本要求，又与护理人员职业特性相关。但这两个维度能力的“高”更多只体现在基础执行层，并没有进行护理模式改革等方面的创新。区域医疗中心护理人员承担对下级医院护理人员的带教、病人及家属的健康宣教等任务，而教育与咨询能力得分低于其他4个维度，说明能力可能停滞在单向输出方面，这与区域医疗中心的技术辐射高要求存在差距。作为护理人员的核心职能，临床护理能力得分偏低是需要关注的问题。这可能与护理人员人力配置不足导致重执行、轻质量，专科化培训针对性不足，实践考核标准宽松，缺乏对临床实效的深度评估有关。评判性思维与科研能力得分最低，评判性思维缺乏，表明护理人员可能习惯一味执行医嘱和流程，而对临床上出现的异常情况缺乏独立判断与反馈能力；科研能力薄弱，则表明护理队伍很难将临床经验转化为循证护理证据，无法为区域护理质量提升提供理论支撑，也制约了护理人员向专家型人才转型。因此，山西省4所区域医疗中心医院护理人员队伍在制度遵守、职业发展支持等保障性能力方面表现较好，体现了医院管理的规范性和对护理人员的重视；在团队协作、基础管理等协调性能力基本达标，能满足日常运营需求。但在核心临床技能和创新驱动能力方面相对滞后，暴露了护理人员存在重合规、轻实效，重执行、轻突破的问题，这与区域医疗中心引领区域医疗发展、解决疑难危重诊治的定位存在一定的落差。
3.2　国家区域医疗中心依托医院护理人员核心能力的影响因素
3.2.1　职务
本研究显示，职务是国家区域医疗中心依托医院护理人员核心能力的影响因素。不同职务的职责决定核心能力的方向与深度。普通护理人员的核心任务是完成临床基础护理，日常工作主要围绕具体病人和医嘱，较少有管理、科研或复杂决策的职责，核心能力主要集中在临床护理基础技能和基础沟通能力方面。因此，建议强化其临床护理能力，通过一对一带教和轮岗历练增加重症、专科护理经验来弥补临床能力短板。专科护理人员作为特定专科的技术骨干，需要处理复杂病例、执行专科操作，并承担带教新护理人员、指导病人康复的任务；医院也会为其提供专科培训、进修的机会，提高临床护理能力和教育咨询能力。因此，建议对其拓展科研与教育能力，鼓励参与多中心研究、承担院内专科培训课程，促进技术骨干向专科导师转型。护士长及承担管理职责的护理人员涵盖了团队管理、质量控制、跨科室协调等方面，需频繁应对流程优化、纠纷处理、政策落实等复杂问题，领导能力、人际关系能力、伦理与法律实践能力得到强化，而临床护理能力可能因脱离一线操作而有所弱化。因此，建议护理管理人员定期回归临床一线，避免临床护理能力退化；同时加强科研思维培训，提升批判性思维能力[16-17]。
3.2.2　岗位层级
本研究显示，岗位层级是国家区域医疗中心依托医院护理人员核心能力的关键影响因素。区域医疗中心依托医院内岗位层级越高的护理人员核心能力越高，护理人员岗位层级越高，在专业知识、技能、经验等方面的综合能力越强，能胜任复杂的护理工作。初级护理人员处于职业生涯初期，工作以辅助性任务为主，接触病例复杂度低，培训集中在基础技能和医院规章制度方面，核心能力局限于临床基础护理、合规性认知。因此，培训时除基础培训外，需增加病例讨论和模拟应急演练，培养其临床问题分析能力。中层级的主管护师具备一定经验后，承担复杂病例的护理、带教、参与质量改进等任务，同时医院也提供更多的培训，推动临床综合能力、教育咨询能力、专业发展能力的提升，积累基础领导与协调能力。因此，应赋予其小范围管理职责，积累领导与协调经验[18-19]。高层级的主任护师和副主任护师作为学科带头人，需处理疑难病例、牵头科研项目、制定护理规范，医院也会倾斜资源支持其参与科研、管理培训，强化评判性思维能力与科研能力、领导能力、专业发展能力，成为学科发展推动者。因此，医院应对其“压担子”和“给资源”，鼓励其牵头护理创新项目，强化科研与领导能力。
3.2.3　职务与岗位层级的相互影响
国家区域医疗中心依托医院中，职务与岗位层级往往存在关联，二者通过“资源分配机制”进一步放大核心能力差异。医院对高职务、高层级护理人员在培训资源、实践机会和激励机制方面更加倾斜。因此，首先应打破资源倾斜固化，为低职务、低层级护理人员提供能力晋升通道，如选拔优秀、年轻的护理人员参与科研项目、选派骨干普通护理人员参与专科进修[20-21]。其次，应调整考核指标，对所有的护理人员平衡执行性指标与发展性指标，尤其对高层级护理人员，增加临床护理能力的考核权重，避免出现“重管理，轻临床”的情况。建立“能力达标与职务晋升挂钩”机制，避免仅因资历或管理能力突出而忽视其他核心能力。最后，针对临床护理能力、评判性思维与科研能力得分较低的问题，应强化普通护理人员和低层级护理人员的重症、专科护理培训，同时要求护士长参与临床质量督查，通过管理倒逼临床能力提升和鼓励中层级及以上护理人员牵头进行临床护理问题研究，医院提供科研方法和数据支持，将实践经验转化为科研成果。
4　小结
收起
本次调查显示，山西省区域医疗中心4所依托医院护理人员的整体核心能力处于中等偏上水平，这可能与山西省近年来严格贯彻实施国家《新入职护理人员培训大纲》，在省级层面系统推进了规范化培训项目、临床实践与骨干引领、科研能力强化与政策支持有关。山西省4所区域医疗中心医院的护理队伍制度规范与职业支持体系较为成熟，管理与协作能力总体能满足日常需求，但仍有提升空间，尤其是创新能力，制约发展上限；与区域医疗中心“引领区域医疗发展、解决疑难杂症问题”的定位存在明显的落差，若不能有效改善，在医疗技术迭代、病人需求升级的背景下，其核心竞争力可能会面临风险[22]。本研究虽揭示了职务、岗位层级与核心能力的关系，但医院文化、个人职业动机等关键变量没有被纳入[23-24]，可能掩盖其真实的影响机制。未来研究可着力于多中心追踪研究、动态机制挖掘和政策干预实验等研究方向，深入剖析其影响机制。

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doi: 10.12102/j.issn.1009-6493.2026.05.016
  • 接收时间：2025-07-21
  • 首发时间：2026-10-28
  • 出版时间：2026-03-10
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  • 收稿日期：2025-07-21
  • 修回日期：2026-01-17
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    1山西医科大学管理学院，山西 030604
    2山西省卫生健康委员会医政处

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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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