“医养结合”模式下老年科分级护理服务内容和床护比的研究

Research on the Graded Nursing Service Contents and Patient-to-nurse Ratio of Geriatric Departments in “Treatment-care Combination” Mode

目的:探讨"医养结合"模式下老年护理服务内容及实施者的最低准入资质和适宜的护患比。方法:选取2016年5-7月石河子绿洲医院医养结合老年患者200例为研究对象,通过文献检索、专家咨询和现场测查等方法,测算"医养结合"下老年病房护理时间构成和适宜的护患比。结果:直接护理时间为183.15 min,占护理总时间的85.87%;间接护理时间为30.14 min,占护理总时间的14.13%。实际需要护理人数160例,适宜床护比达到1︰0.42。根据直接护理工时测定护工用时占直接护理工作约38.12%,计算医养结合模式下老年病房护工数为61名,护士数为99名。护工和护士比例为0.6︰1,缺护工23名、护士12名。结论:医养结合老年科患者所需直接护理时间较间接护理时间长,增加直接护理服务时间,减少不必要的间接护理时间,才能及时满足老年患者所需;根据适宜的床护比应及时补充人员。

Objective：To explore the service content of geriatric nursing, the minimum qualifications of operators,and a proper patient-to-nurse ratio in ＂treatment-care combination＂ mode.Method：A total of 200 elderly patients with treatment-care combination in Shihezi Lvzhou Hospital from May to July 2016 were selected as the research objects.The nursing time composition and the appropriate patient-to-nurse ratio in the geriatric ward were calculated by literature retrieval,expert consultation and field survey.Result：The time of direct nursing was 183.15 min,accounting for 85.87% of total nursing time,the time of indirect nursing was 30.14 min,accounting for 14.13% of the total.The actual number of patients in need of nursing was 160 cases,and the proper patient-tonurse ratio reached 1︰0.42.According to the time of direct nursing,the time spent by nursing workers was measured to be about 38.12% of direct nursing,and it was calculated that there were 61 nursing workers and 99 nurses in the geriatric wards in the treatment-care combination mode.The ratio between nursing workers and nurses was 0.6︰1,and another 23 care workers and 12 nurses would be needed.Conclusion：The time of direct nursing needed by patients in geriatric departments is longer than that of indirect nursing in the treatment-care combination mode,increasing direct nursing service time and reducing unnecessary indirect nursing time can meet the needs of the elderly patients in time,and the number of care workers and nurses should be increased according to a proper patient-to-nurse ratio.