住院患者直接护理工时的影响因素分析

Factors influencing hospitalized patients′direct nursing work hour

目的探讨住院患者每日所需直接护理工时的影响因素。方法采用随机抽样和目的抽样法对上海市某三甲医院4个病区,进行为期28d的直接护理工时测定。共发放调查表5 120份,其中有效回收4 988份,有效回收率为97.42%。结果经多元逐步回归分析得出,神经内科、消化内科、神经外科术前、普通外科术前患者直接护理工时的主要影响因素为患者护理等级、ADL等级、病情严重程度,神经外科术后患者、普通外科术后患者每日所需直接护理工时的主要影响因素为ADL等级和病情严重程度。而患者的手术类型未被纳入回归方程,不是直接护理工时的主要影响因素。结论患者护理等级、ADL等级、病情严重程度是患者每日所需直接护理工时的主要影响因素,可作为患者分类的指标,进而预测护理人力的需求。

Objective To explore the factors influencing hospitalized patients＇direct nursing work hours.Methods We selected 4 units by random sampling and purposive sampling,and measured the direct nursing work hours for 28 days in a tertiary hospital in Shanghai.Totally,5 120 questionnaires were issued and 4 988 were returned with a response rate of 97.42％.Results By multiple regression analysis,the grades of nursing care,ADL grades,severity of diseases were the major predictors of daily direct nursing work hours in patients hospitalized in department of neurology,digestive internal medicine,as well as in preoperative patients in neurosurgical,or general surgical department.However,only the ADL grades and severity of diseases predicted daily direct nursing work hours in postoperative patients in department of neurosurgery and general surgery.Surgery type was excluded from regression equation,for not being one of the major predictors.Conclusion The grades of nursing care,ADL grades,and severity of diseases are major predictors of daily direct nursing work hours.These indexes could serve to form a patient classification system which could predict nursing manpower demands scientifically.