Britain is the birthplace of modern nursing. Nightingale was born in Britain. British society generally respects and recognizes nurses. Imperial college London was founded in 1907, specializing in the teaching and research of medicine, science and technology and business. It is one of the most difficult universities in the UK, enjoying a high reputation in the UK. Early July 2017 the author attended to China communist youth league central China guanghua science and technology fund management projects, at imperial college in London to nursing management and health training course of a week of short-term training, during the visit of st. Mary's hospital, charing cross hospital and brooke green community health center hospitals, such as benefit, harvest a lot. Through training and investigation, the author of the status quo of the medical and health care system, nursing status and role, nursing education and continuing education, nursing practice environment, improve nursing quality management has a profound understanding of, the humanized service concept, good professional environment and advanced management experience, is worth learning and using for reference.
英国是现代护理的发源地。夜莺出生在英国。英国社会普遍尊重和认可护士。伦敦帝国理工学院成立于1907年，专门从事医学、科学技术和商业的教学和研究。它是英国最困难的大学之一，在英国享有很高的声誉。2017年7月上旬，笔者在伦敦帝国理工学院参加了中国共产主义青年团华中光华科技基金管理项目的护理管理和健康培训课程，为期一周的短期培训，期间参观了查利圣玛丽医院。吴越医院和布鲁克绿色社区卫生院等医院受益匪浅，收获颇丰。通过培训和调查，笔者对医疗保健体系的现状、护理现状和作用、护理教育和继续教育、护理实践环境、改进护理质量管理有了深刻的认识，对人性化的服务理念有了深刻的认识。良好的职业环境和先进的管理经验，值得学习和借鉴。
The main body of the system is the national health service, which is free for all, supplemented by private hospitals with high treatment costs, and private medical services in the public hospitals of the NHS. The NHS is the most important universal health care system in the British medical system. It was founded in 1948 and is one of the most important parts of the British social welfare system. The NHS system plays a very positive role in improving the health status of British people and is widely welcomed by the society. Britain's national health service is funded through taxation, providing free health services to all citizens based on the needs of patients rather than on their ability to pay.
该系统的主体是国家卫生服务，它是免费的，由私人医院提供高治疗成本的补充，以及在国民保健署的公立医院提供私人医疗服务。国民保健制度是英国医疗体系中最重要的全民保健制度。它成立于1948年，是英国社会福利制度最重要的组成部分之一。国民保健制度对改善英国人民的健康状况起到了非常积极的作用，受到社会的广泛欢迎。英国的国家卫生服务是通过税收来资助的，根据病人的需要而不是他们的支付能力为所有公民提供免费的卫生服务。
The NHS adopts the hierarchical health care system: primary health care is called primary health care, which is the main body of the NHS. Everyone who has income is the target of the primary care team. The PCG is the basic unit that provides health care. A typical PCG provides about 10,000 person-to-person services. Secondary care is provided by hospital trusts, which work independently within the statutory and policy framework of the NHS and are overseen by the NHS executive board. The medical and health system in Britain is a mode of planned adjustment. Community health services are planned and managed by the national health administration department, forming a perfect community health service network. All citizens can enjoy comprehensive health services including general medical treatment, prevention, rehabilitation, health care and community services.
国民保健制度采用分级保健制度：初级保健称为初级保健，是国民保健制度的主体。每个有收入的人都是初级保健团队的目标。PCG是提供医疗保健的基本单位。典型的PCG提供约10000人对人服务。二级护理由医院信托提供，医院信托在NHS的法律和政策框架内独立工作，并由NHS执行委员会监督。英国的医疗卫生体系是一种有计划的调整模式。社区卫生服务由国家卫生行政部门规划管理，形成完善的社区卫生服务网络。全民享有综合医疗、预防、康复、保健、社区服务等综合性卫生服务。
As the cradle of nursing education, Britain has been committed to the development and improvement of nursing education. Nursing has become a truly independent discipline in the UK. The NHS trust system has a good training system for nursing students and nurses. General medical students graduate from high school after the entrance examination, the school system is divided into three years, four years two kinds, after the above degree registration can become a national regular registered nurse. The grade of nurses a-h, gradually increased. After 2 years of regular graduation work, I obtained the required continuing education credits and got the direct D grade, engaged in outpatient triage, venipipture and injection therapy. There is also a class without school training, directly from the non-professional staff to the hospital, through clinical short-term training on the post, nursing staff. After 1 ~ 2 years of work, I passed the examination and graduated from A to B, mainly engaged in basic care of patients, assisting patients who could not take care of themselves in life, accompanying patients to go out for examination, etc. EF above is equivalent to the head nurse, engaged in supervision, guidance work. H is equivalent to deputy director and chief nurse, engaged in nursing management and training of nurses and head nurses. Domestic and foreign nursing consultation, nursing expert outpatient service. Each level of division of labor requirements are very clear, legal protection. As in China, nurses at all levels have detailed refresher training plans and are required to attend various continuing education classes on a regular basis. The assessment of nurses in Britain is mainly based on clinical skills assessment, which is conducive to the improvement of nurses' clinical practice skills as well as the updating of new technologies and new knowledge.
英国作为护理教育的摇篮，一直致力于护理教育的发展和完善。护理已成为英国真正独立的学科。国民健康保险信托制度对护生和护士有良好的培训体系。普通医学生高中毕业后，经入学考试，学校制度分为三年、四年两种，经过上述学位注册后，可成为国家普通注册护士。护士的A-H等级逐渐提高。经过2年的正规毕业工作，我获得了所需的继续教育学分，获得了直接D级，从事门诊分流、静脉穿刺和注射治疗。还有一个班没有经过学校培训，直接从非专业人员到医院，通过临床短期培训岗位上的护理人员。经过1~2年的工作，我通过了考试，从A到B毕业，主要从事病人的基本护理，协助生活中不能照顾自己的病人，陪同病人外出检查等。以上的ef相当于护士长，从事高级护理工作。愿景、指导工作。H相当于副主任和护士长，从事护士管理和护士长和护士长的培训工作。国内外护理咨询、护理专家门诊服务。各级劳动分工要求十分明确，受到法律保护。与中国一样，各级护士都有详细的进修培训计划，并要求定期参加各种继续教育课程。英国护士的评估主要以临床技能评估为基础，有利于提高护士的临床实践技能，更新新技术、新知识。
Community nursing in the UK has been well developed. There are district nurses, occupational health nurses, learning disabilities nurses, family health nurses, community mental health nurses, health visitors, community children nurses, general practice nurses, school nurses and so on. And gradually in the development of senior and specialist nurse, some professional areas of senior nurse and specialist nurse prescription right has been recognized by the law. At the present stage, most of the community nursing work in China continues the basic nursing of general hospitals, but community nurses are no longer the traditional disease nurses, but the integration of educators, consultants, managers and other roles. China's community nursing started late, there are deficiencies in government funding, management mechanism, nursing manpower allocation and other aspects, there is still a lot of room for learning and progress, there are still problems and deficiencies in the development. We will carry out and promote a variety of community care services, and improve the pricing system of community care services in accordance with policies. Carry out various forms of services, such as home visits, family care, community health education activities, lectures on chronic disease care, physical examination, etc. Improve the community nursing service system, make community nursing become an important part of community health service. Make our community nursing work more convenient, fast, better for the people's health service.
Occupational health and infection control of hospital staff is also one of the important tasks of nursing. Britain has a good occupational environment, harmonious nurse-patient relationship and high social recognition. Nurse-patient relationship, friendly, patient, responsible, to patients to do their best to provide services. Occupational health concerns include staff to take care of, restore jobs guidance, the hospital managers pay attention to psychological problems, they think that 70% people associated with mental illness, they were concerned about the worker's health, undertake to the worker regularly hearing, vision, lung, alcohol, drugs, testing, distribution of health report, at the same time try to work for high strength relief. Just like our country, the UK also pays great attention to hand hygiene in the prevention and control of nosocomial infection, and agrees that maintaining hand hygiene is the simplest, most effective and most economical method to reduce nosocomial infection. Therefore, the monitoring of hand hygiene implementation rate and compliance is also an important part.
Throughout the development history of the NHS for more than 60 years, there are also some structural problems in the NHS, such as rigid system, efficiency needs to be improved, adverse incentives for hospitals, excessive concentration of administrative power, leading by the medical supplier, imperfect accountability mechanism and long waiting time for customers. Therefore, the NHS has also carried out a series of reforms in terms of health organization structure, service delivery mode and service management to provide economical, convenient and high-quality health services. They linked administrative records from hospital incidents between 2003 and 2012 to immigration data from the British Labour survey and found that immigration reduced waiting times for outpatient referrals and had no significant impact on waiting times for accident and emergency departments and selective care. Reduced outpatient waiting times can be explained by the fact that migrants increase internal mobility and tend to be healthier than those who move to different areas. In addition, the UK hospital administration's assessment of reform measures is not only economic, quality and safety, which is a small improvement. Nursing to develop a series of quality improvement project research, such as "right nurse, right skill" nurse training and safety case report activities; Introducing artificial intelligence and data systems; Nurse qualification training and management, education and practice standard setting, etc.
The NHS medical system in Britain can be used for reference in China's medical reform. However, China is faced with a series of complex problems such as large population and shortage of funds, which cannot be copied from foreign experience. Therefore, it is necessary to cross the river by feeling the stones to realize the medical and health undertakings of the whole country. Nursing management personnel to adapt to the new situation, establish forward-looking management thinking, improve the level of nursing management. Facing the general trend of international nursing development and many favorable policies of the government, nursing management should move from basic management to service-oriented management and talent cultivation management. For nursing managers, they need to learn from the UK to develop and improve the nursing discipline step by step. Pragmatic quality improvement and pursuit, international cooperation vision, training of young people with higher education. Create conditions for the growth of nursing staff, further innovate the talent training mechanism, conduct precise training, precise positioning and accurate evaluation of expert talents, technical talents and compound talents, and cultivate an important force in the medical care career in the new era.
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