| 摘要: |
| 目的 探索一种基于病情和自理能力的病人分级护理标准。方法 调查2015年5—12月江苏省某三级教学医院内科、外科共10个普通成人病房的住院病人，采用Barthel指数评定量表和急性生理功能和慢性健康状况评估系统Ⅱ（APACHEⅡ）评价病人自理能力及疾病严重程度，采用自行设计的直接护理工时测量表记录病人24 h所需直接护理时间，根据不同病情及自理能力病人24 h直接护理时间的不同进行护理等级的划分。结果 共调查病人570例，有效问卷551份（96.67%），不同疾病严重度和病人自理能力病人24 h所需直接护理时间不同，共形成4个新的护理等级。结论 以Barthel指数评定量表和急性生理功能和慢性健康状况评估系统Ⅱ（APACHEⅡ）作为分级护理标准，依据不同病情、自理能力病人所需直接护理时间的差异可将病人划分等级，新的分级方法较原有护理等级划分方法更加客观、方便，有利于满足病人需求，指导人力资源配备和成本核算。 |
| 关键词: 分级护理 标准 护理工时 |
| DOI： |
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| Exploratory Study on the Nursing Care Classification System in Public Hospitals |
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| Abstract: |
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Objective
To explore the method for nursing care classification standard based on different conditions and activities of daily living (ADL). Methods Investigating inpatients from 10 common adult wards in Department of Internal Medicine and Department of Surgery in a tertiary teaching hospital in Jiangsu Province from May to December, 2015. The Barthel index and acute physiology and chronic health evaluations Ⅱ(APACHE II) were used to evaluate their ADL and severity of illness, and the self-designed direct nursing hour scale was applied to record the direct nursing time needed by patients in 24h. Nursing class was defined according to different conditions and ADL and to the difference of patients’ need of direct nursing time in 24h. Results 570 patients were investigated in total, and 551 effective questionnaires were collected with an effective return rate of 96.67%. 4 new nursing classes were formed according to severity of different diseases. Patients’ ADL and the difference of patients’ needed direct nursing time in 24h. Conclusion Patients can be classified into different conditions and ADL by the direct nursing time they need. Such a new method is more objective and convenient than usual nursing grading used previously, and is helpful for guiding human resources allocation and cost accounting. |
| Key words: nursing grading system, standard, nursing hour |
