以生活能力状况测定综合医院成年住院患者护理时间分配的研究

Study of nursing time assignment based on the activities of daily living among adult inpatients in general hospital

目的通过评估和测量综合医院成年住院患者自理能力,24h所需的直接、间接护理时间,了解患者直接、间接护理时间与自理能力的相关关系,以及24h不同生活能力(ADL)等级的患者所需间接与直接护理时间的相关关系及比例。方法便利取样的方法抽取226例成年住院患者,用ADL量表及自行设计的患者基本直接护理需求量表来评估样本的自理能力和未来24h直接护理需求,观察法测量这些需求完全被满足时所需的直接、间接护理时间。结果(1)患者24h所需直接、间接护理时间与患者的自理能力呈负相关关系;(2)不同自理能力的患者24h所需间接与直接护理时间呈正相关,不同自理能力的患者24h所需间接与直接护理时间比例不同:ADL为1、2级的患者的间接与直接护理时间之比约为1∶2,ADL为3、4级的患者的间接与直接护理时间之比约为1∶4。结论(1)只需测得患者24h所需直接护理时间,根据间接与直接护理时间的比例,即可获知24h患者全部所需的护理时间;(2)根据患者ADL等级的不同计算护理时数,更能客观反映护理工作量。

Objective The purpose of this research was to find out time distribution in general hospital based on the patient＇ s capability of self care. Methods In this study, 226 inpatients of medical and surgical units in general hospital were chosen conveniently. Self designed nursing work load form and Barthel index of inpatients were used to assess the patients＇ capabilities of self care and their needs of direct care in the future 24 hours. The factual direct and indirect care time was assessed by researcher＇s observation. Results Average direct and indirect care time of the inpatients was negatively related to their capabilities of self care. The direct care time was positively related to the indirect care time in the inpatients with different self care capabilities, and the proportion of direct and indirect care time was different. Conclusions Nursing time can impersonally reflect the working load of the nurses, we can get it based on the direct and indirect care time.