THUC TRANG NHAN LUC TAi CAC BENH VIEN DIEU DUONG PHUC HOI CHliC NANG
TOM T A T
D$t van de: Cdc bdnh vidn diiu duong phgc hdi chOc ndng (BVBDPHCN) dWQC thdnh l$p ngdy cdng nhiiu di ddp Ong nhu cau cOa xS hdi- Tuy nhidn. s y thiiu thdn vi nhdn Igc da vd dang inh hw&ng nghidm tnjng din hi$u qui hogt ddng cua cic BVDDPHCN.
Myc tidu: Md ti thgc trgng nhdn Iwc tai cic BVDDPHCN ndm 2009. Phuxmg phdp: Nghien c&u md ti cit ngang kdt hgp djnh luvng vd djnh tinh, triin khaitrdn 35 BVDDPHCN tmng ci nw&c. Kit qua: Hiu hit cdc bdnh vidn (BV) cd thiiu nhdn Igc. ddc bidt li thiiu bic sy chuydn khoa PHCN vi KTV PHCN trinh dd dai hgc. Khuyin nghi: Cdc S& y ti cin hd tra ddo tgo vi bd sung nhdn Igc cho cic BVDDPHCN Cic BVDDPHCN cin cd nhOng chinh sich thu hOt nhdn Igc vd ddi ngd hgrp ly cho nhin vidn.
Tip khda: Bdnh vidn diiu dw&ng phgc hdi chirc ndng, nhdn luc bdnh vidn
SUMMARY
HUMAN RESOURCES IN NURSING AND REHABILITATION HOSPITALS
Background: Nursing and rehabilitation hospitals are being founded at an increasing rate to fully satisfy the social demand. However, the lack of human resoume had affected and is still affecting the functional efficiency of nursing and mhabiiitation hospitals. Objectives- To give descriptions of human resources at nursing and mhabiiitation hospitals in 2009. Methods: Cmss-sectional studies combining with quantitative qualitative methods are Implemented on 35 nursing and mhabiiitation hospital across the nation. Results. Most nursing and rehabilitation hospitals lacked of human resources, especially doctors specialized in nursing and rehabilitation who possess a college education. Conclusion: Health Departments need to aid nursing and rehabilitation hospitals in supplying adequate human msoumes.
Nursing and mhabiiitation hospitals need policies that attract more employee, at the same time enfoming and impmving their employee tmatment policies.
Keywords: Human, nursing and rehabilitation
NGUYEN TH! MINH THCIY, D^i hgc YtS Cdng cdng TRAN QUY TUdNG, B ^ Yte dydi n h i m ndng cao e h i t l y y n g khdm ehda bOnh*
dd gdp p h i n ndng cao c h i t luyng nhdn lye ngdnh y td ndi Chung vd cdc BVDDPHCN d n non tre ndi ridng[1]. Nghj djnh 41/2012/ND-CP v l "Quy i^nh vj tri viOe Idm trong dan vj s y nghiOp cong lap" d y y c ban hdnh Id Ihdch thdc cung Id ea hdi cho d c BVDDPHCN trong viOc xdy dyng ngudn nhdn lyc[2].
Chinh vi vdy, chung tdi tidn hdnh nghlOn edu ndy n h i m ddnh gid thye trgng nhdn lye d c BVDDPHCN, cung d p bdng chdng xdy dyng k l hoach nhdn s y eho tyang lai,
D O I T U ^ N G VA PHU'aNG P H A P NGHIEN CI>U Ddi tyyng nghien edu Id cdn bO lanh dgo bOnh viOn vd cdc khoa eua ede BVDDPHCN; edc ky thudt viOn phyc hdi chdc ndng tryc tiep tham gia cdng tdc phyc hdi chdc ndng tgi edc bOnh viOn,
NghiOn cdu md la d t ngang duyc tien hdnh trOn 35 BVDDPHCN trong ca nydc thdng 10 ndm 2009 d i n h i t thdng 12 ndm 2009. Thye trgng nhdn lyc cda bOnh viOn se d y y c thu thdp qua philu d i l u tra dinh lyyng v l linh hinh nhdn lye eua bOnh vien. Ngodi ra, n h i m bd sung them ede thdng tin eho nghien cdu d{nh luyng, nghien edu dinh tinh eung d y y e thye hiOn thdng qua cdc euOc phdng van sdu vd thao ludn nhdm Idnh dao bgnh vidn, Idnh dao ede khoa n h i m tim h i i u ve thudn lyi, khd khdn eua nhdn lyc trong hogt ddng eua bOnh viOn vd eua edc khoa cung vdi cde bien phdp k h i c phyc.
K £ T QUA
Lanh dgo b f n h viOn vd khoa VLTL-PHCN Bang 1. Thdi gian cdng tdc tmng binh cda Ban GD vd Trudng khoa VLTL-PHCN
DAT VAN D t
Nlidn lyc Id y i u td quan trpng q u y l l djnh chit luyng d|ch vy. Ddng trudc thyc trgng thilu thdn t r i m trpng c i v l sd lyyng vd ehit luyng nhdn lyc cua ngdnh y t l , Bd y t l dd ed nhdng uu tidn trong viOc dau t y ndng d p ca s d ddo tgo d n bO y t l , ndng eao chit lyyng giang dgy n h i m xdy dyng d i y dd vd phdn bd can ddi nhdn lyc y te. NSm 2008. quyit djnh 1816/QD-BYT d y y e BO y t l ban hdnh "Ve viOc phO duyOt d l dn "cd cdn bd chuyOn mdn ludn phien t d bOnh vidn l u y i n tren v l hd try d c bOnh viOn tuyin
Ldnh dao
Gidm ddc Phd GD 1 PhdGD2 Phd GB 3
Trudng khoa VLTL-
PHCN
Sd ndm cdng tdc trong ngdnh Y TB±BLC(n) 27,42 ± 5,76
(35) 23.97 ± 6,78
(32) 17,73 ±5,92
(11) 12(1) 18,32 ±6,83
(35)
Sd ndm cdng tdc trong ngdnh PHCN TB±BLC(n) 10,53 ±6,49
(35) 12,71 ±6,64
(31) 11,82 ±4,9
(11) 12(1) 10,77 ±6,63
(35)
Sd nam tham gia PHCNDVCB TB±DLC(n) 8,54 ± 5,87
(36) 9,73 ± 5,41
(22) 8,14 ± 4,7 (7)
10(1) 7,33 ± 7,4
(35) Cac GD, Phd GD, trudng khoa VLTL-PHCN deu dd trai qua ede d n g tdc khdc trong ngdnh y trydc khi d n g tdc trong ngdnh PHCN; sd ndm cdng tdc tmng binh trong ngdnh PHCN cda cdc cdn bd ndy Id t d 10,5 nSm d i n 12,7 nSm; sd ndm tham gia PHCNDVCB tmng binh t d 7,3 ndm d i n 10 ndm.
Y HO(^HirC HANH (937) - s 6 10/2014
Bang 2. B i n g c i p vd chuyen mdn eua GD BV vd trydng khoa VLTL-PHCN
Chuyen khoa cua oScGD Bdng cdp chuydn
mdn cCia GD B3ng cdp quan ly nhd nu'dc cija GD Chuydn khoa cua tru'dng khoa VLTL-
PHCN BSng cdp chuydn man cua tru'dng khoa VLTL-PHCN
NOi dunq (so BV) PHCN
Khac Dai hpc Sau dai hgc C6 chijnq chi
Khdc Phyc hoi chdc
nSnq Khdc Tmng cap/cao Qknql dgi iioc Sau dai hoc
n 7 28
1 33 19 14 14 21 15 18
Ty 10 % 20 80 2,9 95,7 57,6 42,4 40 60 45,5 54,5 20% GDBV Cd b i n g d p chuyen khoa PHCN, trong dd d i n 95,7% GD ed trinh dd sau dgi hpc. 40%
Imdng khoa VLTL-PHCN ed b i n g d p ve PHCN, 54,5% sd dd cd b i n g d p sau dai hpe. T i t d cdc GD diucd chdng chi hoSc b i n g d p v l quan ly nhd nydc
Nhdn l y v chuyOn mOn
Bang 3. Nhdn lyc ede BV phdn theo chuyen ngdrih PHCN vd chuyen ngdnh khdc
TT 1 2 3 4
Nhan luc PHCN hidn cd
Trdn dai hpc Dai hoc Dudi dai hoc Sd nhan vien/
giudng bdnh
So can bg trung binh/BV Thudc
SYT 3 1 6 0,69
Thupc BYT 9 1 9 0,56
Sd cdn bd trung binh/BV Han g i
9 1 9 0,69
Hang 2 3,2 1 7 0,81
Han qS 2,9 0,8 5 0,64 Bang tren cho thiy. nhdn lye chuyen khoa PHCN it han so vdi cdc chuyOn khoa khdc. cdc BV thude sd y t l ed sd cdn bd trung binh it han so vdi BV thudc Bd Y t l . ddc biOt Id can bd cd trinh dd sau dgi hpc, Cde BV hgng 3 d sd can bd trung binh I h i p han BV hang 2.
PV sdu d c GD BV thay ndi bdt tinh trgng thieu nhdn lyc tgi cdc BV, dac bidt Id thieu bdc s? chuyen khoa PHCN vd KTV PHCN cd trinh dd dgi hpc. mdt gidm ddc ndi: "BV tdi ehl cd 1 Ihae sy chuyOn ngdnh, 3 bdc sy djnh hydng PHCN. 4 KTV vd cdn bd ky thudt nhyng h i u nhu phdi hpc thOm de ndng eao vl tay n g h l cQng han hep. Ngdnh PHCN Id dmh biOn
t h i p nhit trong hO chung, chi cd 0,8, tuy nhidn BV tdi mdi cd 0.7 edn bd/giudng bdnh" - PV GDLS.
BAN LUAN
Lanh dgo b f n h vidn va khoa VLTL-PHCN T i t ca cde gidm dde BV d i u dd d u y c ddo tao v l quan ly nhd nyde gdp p h i n hd try cdng tdc quan ly BV duyc tdt han, Lanh dao BV, khoa VLTL-PHCN deu cd nhieu kinh nghigm trong ngdnh y, tuy nhidn, chi ed duy nhat 1 phd GD tham gia cOng tdc PHCN ngay khi vdo ngdnh. D i l u ndy cQng d l h i i u khi PHCN mdi ehi d y y c quan tam khoang 10 nSm g i n ddy vd lye lyyng ehuyOn -mdn cdn dang Irong qud trinh ddo tao vd tich luy kinh nghigm.
Nhdn l y c chuyen m d n
Nhdn lye chuyen mdn eua hau h i t edc BV d i u cdn thieu ca ve sd luyng Idn chat lyyng. Phin Idn nhdn vien duac ddo tao ede ehuyOn ngdnh khdc tnj'dc khi nhan ddo tao PHCN, D i l u ndy cd till do nhu c i u nhdn lyc PHCN Id c i p thiet trong khi ddo tao chuyOn mdn khdng the ddp dng trong thdi gian ngin. Giii phdp tinh t h i la bdi dydng, ddo tgo bd sung nhdn lyc y t i sin cd, Theo nghiOn cdu cua Pham Ngpe TuyOn (2012) tai BOnh viOn Da khoa D i k Lak binii qudn sd bdc sy/
giudng I^Onh cda benh vidn ed xu hydng gidm qua cdc nSm: 0.3 ndm 2009; 0,29 nam 2010; 0,26 ndm 2011 [3]. D i l u ndy c6 the do che dp ddi ngd chua hyp ly khdng gid chdn d y y c nhdn vien.
K^T LUAN VA KHUYEN NGHj
Tinh trgng thieu bien che xay ra a h l u nhu l i t cd cdc BV khi so sdnh vdi quy dinh cua Thdng t u lien tjch sd 08/2q07/TTLT/BYT-BNV. Cde s d y l l d n c6 biOn phdp hd try ddo tgo nhdn s y cdng nhu thu hiit ngudn nhdn lyc chuyOn mdn eho BV
TAI LIEU THAM K H A O
1. Bp Y t l pOOB). Quyit djnh 1816/QD-BYT, V l viOc phe duygt de dn "Cd can bp chuyen mdn ludn phien td bOnh vien tuyen trdn ve hd try cdc bgnh vign tuyen dydi nham ndng eao ehit lyyng khdm ehda bOnh'
2. Chinh phu (2012), Nghi djnh 41/2012/ND-CP,
"Quy djnh vj tri vigc Idm trong dan vj sy nghiOp cdng lap"
3. Phgm Ngpc Tuyen (2012), T h a n tich tinh hinh tai chinh eiia Bgnh viOn Da khoa tinh Dak Lak trong giai dogn 2009-2011", lugn van thac sy, Trydng dgi hpc Y t l Cdng d n g .
DANH GIA TiNH TRANG SEO BONG SAU MO CAT BE AP MITOMYCIN C DIEU TRI GLOCOM TAI PHAT
TRAN THANH THUY - Benh vl$n Hiru Nghi N G U Y I N T H I HOANG THAO - Benh vien Mit Trurig inwig TOM T A T
.4p Mitomycin C trong phlu thuit cSt bi cung glic m^c c6 tSc dung ngSn ngira KO h6a s^o bong. ChOng toi dOng thang phSn io^i Indiana Bleb Appearance Grading Scale (IBAGS) va Visante OCT dinh gii seo bQng sau phSu thuit e l f be ip MMC diiu tii giocbm tiiphit. Muc tiiu nghien cOv: Dinh gii tinh trang seo
bong sau md cit be ip MMC, mdi lien quan giCra nhan ip vi tinh trang bgng thSm. D6i tur^ng va phuryng phip nghiin cCru: Nghiin cihi md ti lim s^ng, tidn c(eu khdng doi chimg trin 30 mat gdm 12 mat (40%) gdc mi> nguydn phit, 18 mat (60%) gdc ddng nguyin phitds PT cat bi cdng glic m^c 1 lin, nhan ip l<hdng dieu chinh (> 21 mmHg do bang NA
Y HOC THUC HANH (937) - s 6 10/2014
