心内科疾病诊断相关组权重与护理工作量的相关性研究
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女,本科,主管护师

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浙江省卫生健康委员会(浙江省医药卫生科技计划项目)(2018KY040);浙江中医药大学中青年科研创新基金项目(KC201936)


Association between diagnosis-related groups (DRG) weights and nursing workload in department of cardiology
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    摘要:

    目的 探索疾病诊断相关组(DRG)权重及相关指标运用于心内科护理人力资源管理的可行性。 方法 随机抽取心内科住院患者205例,测定纳入患者住院期间的护理工作量。从电子病历中收集患者意识状态、造影、手术、并发症或合并症、入院第1天护理级别、入院时日常生活活动能力(ADL)等信息,并将患者出院后的住院首页数据上传至浙江省医院质量管理与绩效评价平台获取DRG权重等信息。对所得数据进行相关性分析、多元线性回归分析。 结果 心内科患者住院期间的直接护理时间中位数(四分位数)为337.85(279.44,452.09)min;间接护理时间362.46(229.97,584.15)min;总护理时间702.76(518.55,1 019.64)min。患者DRG权重为0.52~2.57(1.45±0.56)。单因素分析结果显示,直接护理时间、间接护理时间和总护理时间的自然对数值与并发症或合并症、手术、入院第1天护理级别、DRG权重分级有关(P<0.05,P<0.01)。多元线性回归分析结果显示,总护理时间的自然对数值与DRG权重值、入院第1天护理级别、入院ADL评分、并发症或合并症有关(P<0.05,P<0.01),其中DRG 权重值对总护理时间的影响最大。 结论 DRG权重与护理工作量有关,可以利用以DRG权重为主的多因素回归方程来对工作量进行预测,为护理人力资源管理提供参考。

    Abstract:

    Objective To explore the feasibility of applying diagnosis-related groups (DRG) weights and related indicators in human resource management of cardiac nursing. Methods A total of 205 inpatients in the department of cardiology were randomly sampled, and the nursing workload of the included patients during hospitalization was measured.The information of patients′ consciousness state, radiography records, surgery records, complications or comorbidities, level of care on the first day of admission, ADL on admission, etc., were collected from electronic medical records.The data on the first page of patients′ medical chart were uploaded to Zhejiang Provincial Hospital Quality Management and Performance Evaluation Platform after discharge to obtain the weights of DRG and other information.The data were analyzed by Pearson or Spearman correlation analysis, and multiple linear regression. Results The median (P25,P75) time in cardiology patients was 337.85(279.44,452.09) min for direct nursing time during hospitalization, 362.46(229.97,584.15) min for indirect nursing time, and 702.76(518.55,1019.64) min for total nursing time.The DRG weights of patients ranged from 0.52 to 2.57(1.45±0.56).Univariate analysis showed that the natural logarithm values of direct nursing time, indirect nursing time and total nursing time were associated with complications or comorbidities, surgery, level of care on the first day of admission, and weights grading of DRG(P<0.05,P<0.01).The results of multiple linear regression analysis showed that the total nursing time was associated with DRG weights, level of care on the first day of admission, ADL values on admission, and complications or comorbidities (P<0.05,P<0.01), with DRG weights exerting the most sizable effect. Conclusion DRG weight is associated with nursing workload.DRG weight-included multivariate linear regression analysis can be used to predict nursing workload.This method provides a new perspective for nursing human resource management.

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蔡晓芳,胡斌春,戴丽琳,缪建华,骆晓琳,吴丽,王齐齐.心内科疾病诊断相关组权重与护理工作量的相关性研究[J].护理学杂志,2021,36(11):56-59

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  • 收稿日期:2021-01-03
  • 最后修改日期:2021-03-18
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  • 在线发布日期: 2022-12-12