基于疾病诊断相关分组的普通外科住院患者护理难度分析

Analysis of task difficulty of nurses in general surgery wards based on Diagnosis Related Groups

目的:分析不同疾病诊断相关分组(Diagnosis Related Groups,DRG)的普通外科住院患者护理难度,为普通外科护理人力配置及绩效管理提供依据。方法:采用专家会议法确定普通外科住院患者护理难度评分表,采用系统抽样法抽取20个DRG组共400份病历资料,邀请24名普通外科护理专家对患者进行住院期间的护理难度评分。结果:普通外科消化系统疾病及功能障碍与肝、胆、胰疾病及功能障碍患者的护理难度均明显高于皮肤、皮下组织及乳腺疾病及功能障碍与内分泌、营养、代谢疾病及功能障碍患者的护理难度;普通外科DRG组护理难度评分介于23.10~60.18,不同DRG组的护理难度存在差异,其中HC39(除胆囊切除手术以外的胆道手术组)护理难度最高,JB39(其他乳房手术)护理难度最低。结论:不同DRG的护理难度具有明显差异,普通外科不同亚专科护理人力资源配置及绩效管理应予以考虑。

Objective:To analyze the task difficulty of nursing working in general surgery wards in different Diagnosis Related Groups(DRG),and to provide basis for performance management and manpower allocation in general surgery wards.Methods:The task difficulty scale for nurses in general surgery wards was developed using expert consulting conferences.A total of 400 cases from 20 DRGs were selected by systematic sampling method,and 24 nursing experts specialized in general surgery were invited to evaluate the task difficulty of nursing.Results:The nursing difficulty of patients with MDCG and MDCH is significantly higher than that of patients with MDCJ and MDCK.The total scores of all DRGs in general surgery wards ranged from 23.10-60.18,and statistically differences were observed among different DRGs,of which the task difficulty of HC39(biliary tract surgery except gallbladder resection) was the highest,and that of JB39(other breast surgery)was the lowest.Conclusion:The task difficulty of nursing in different DRGs varies obviously,therefore,nursing performance management and manpower allocation of different subspecialties in general surgery wards should be considered.