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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。
Objective To explore a patient grading nursing standard based on the condition and self-care ability. Methods A total of 10 inpatients with general adult wards in a tertiary teaching hospital in Jiangsu Province from May to December in 2015 were investigated. The Barthel index scale and APACHE Ⅱ were used to evaluate the patients Self-care ability and severity of illness, the use of self-designed direct working hours meter records the patient 24 h direct nursing time required, according to the different conditions and self-care ability of patients with 24 h direct nursing time for the classification of care level. Results A total of 570 patients were surveyed and 551 valid questionnaires (96.67%) were obtained. The direct nursing time required by patients with different severity of illness and patient self-care ability was different from that of the other 24 hours. A total of 4 new nursing classes were formed. Conclusion Barthel index rating scale and acute physiology and chronic health assessment system Ⅱ (APACHE Ⅱ) as a grading nursing standards, according to different conditions, self-care ability of patients with direct nursing time differences can be divided into patients grade, a new grading method The method is more objective and convenient than the original nursing grade classification method, which is good for meeting patient’s needs and guiding human resource allocation and cost accounting.