摘要
目的建立病区护理难度系数,为病区分类研究奠定基础。方法通过Delphi法筛选出6项评价指标(医疗任务完成情况、收治急诊、患者病情、患者生活自理程度、护理风险、护理工作量)并确定权重值(总分100分)。其中医疗任务完成与收治急诊情况依据某三级甲等医院HIS及实地调查结果客观评分,其他4项定性指标通过随机抽取该院20名护理专家进行2轮主观评分。结果专家调查第1轮和第2轮问卷的有效回收率分别为100%和95.0%。61个病区护理难度系数前10位分别为脊柱骨科、儿科、烧伤科、心内1科、神内1科、神外3科、神内2科、新生儿科、创伤骨科及感染科;后10位分别为内分泌科、高干特需4病房、高干特需3病房、皮肤/康复科、高干特需1病房、放疗科、干部内科、整形科、高干特需2病房及高干综合内科。结论病区护理难度系数能够全面反映医院病区的护理难度,奠定了病区分类工作基础,也为医院护理人力资源配置及绩效考核方案的制定提供参考。
Objective To establish the difficulty coefficient of each ward so as to lay the foundation for ward classification. Methods Six evaluation indexes （medical task completion, emergency room visits, patients＇ conditions, self-care ability of patients, nursing risks and nursing workload） were identified through the Delphi method in earlier research, and scoring criteria and weights of the indexes were determined. The indexes of medical task completion and emergency room visits were objectively scored based on data extracted from and hospital information system （HIS） and from field survey by researchers, while the other four indexes were sub- jectively scored twice by 20 nursing experts randomly selected. Results The response rates of two rounds of scoring by the nursing experts were 100% and 95.0% respectively. The top 10 wards having the highest nursing difficulty coefficients were spinal ortho- pedics, pediatrics, burn unit, cardiology ward 1, neurology ward 1, neurosurgery ward 3,neurology ward 2, neonatology, ortho- pedic trauma and infectious diseases; the bottom 10 wards having the lowest nursing difficulty coefficients were endocrinology, senior cadres ward 4, senior cadres ward 3, dermatology/rehabilitation, senior cadres ward 1, radiation oncology, cadres internal medicine, plastic surgery, and senior cadres ward 2 and medical senior cadres. Conclusion Difficulty coefficients of nursing units could comprehensively reflect the difficulty levels of unit nursing service, which lays foundation in ward classification,and provide- basis for nursing human resource allocation and the establishment of performance evaluation scheme.
基金
国家临床重点专科护理建设项目
关键词
护理难度系数
病区分类
人力资源配置
护理工作量
nursing difficulty coefficient
ward classification
human resource allocation
nursing workload
