Practice Research On Long-term Nursing Classification Of Eldly Inpatients Within Treat-care Mode

Objective:The research is on the basis of prophase research[1],to quantitatively understand thenursing time the geriatric patients needs every day, and to explore the relationshipbetween it and their grading nursing, the patients self-care ability of daily life(ADL).Therefor,to provide the reference for the scientific classification standard of carein elderly.To build standard long-term care services Grading，in accordance with thecurrent level and the characteristics of sociology.In order to guide nursing staff targetedto develop geriatric nursing practice under the new situation, and to meet the demand oftreatment，care and pension of elderly patient, improving the quality of aged care andpromoting the development of elderly study.Methods:The clinical research was hold in the geriatric ward within Treat-care Mode in a largegeneral hospital in Anhui province. The first stage: From20August,2012to26August,to use the field recording, the operating content and time in order to satisfy for thepurpose of all232elderly patients with nursing care were measured and recorded for7days, in order to quantitatively understand the average daily nursing time patientsneeded with different level of nursing and ADL scores. SPSS17.0software was usedfor statistical description, single factor ANOVA, χ2test, Pearson correlation analysiswere used for data analysis.The second stage: The method of historical comparison was designed,189hospitalizedpatients before ADL grading implementing were dividing (from April to July,2012) ofas control group,193hospitalized patients after the ADL grading implementing were dividing(from April to July,2012) of as control group as intervention group. The controlgroup was used conventional nursing grading, and provided with conventional nursingcare. According to the results of first study,the patients of intervention group weredivided into9different type of nursing grades IA, IB, IC, IIA, IIB, IIC, IIIA, IIIB, IIIC,and provided with the corresponding long-time nursing service.Patients’satisfaction ofnursing work and geriatric nursing quality were compared between the two groups.Using SPSS17.0software to x2test and t-test, inspection level of alpha was0.05.Results:1、The patient’s ADL scores are relatively independent, which not grown as more severethe grading nursing level was. Even with the same level of care, there were alsodifferent care needs in elderly patients,due to differences of their own care ability.2、With the loss of their own care ability, the dependence on direct care of elderlypatients increased gradually, and far more than the demand for indirect care. degree ofADL-A, B, C degrees daily direct nursing time of elderly patients need renderingpyramid were gradually increased even in the same level,the ratio was about1:2:4, andpercentage increased gradually in total nursing time.3, Security incident rate of intervention group was lower than that of the control group,among them the occurring rate of falling and falling bed had statistical difference (P <0.05), and other security issues such as the incidence of pressure ulcers, burns, lost in theintervention group was0. Nursing quality score and Patients’satisfaction of intervention group issignificantly higher than the control group (all P <0.05).4, The work time of geriatric nurses was416.02min per capita,which is more than theideal working hours. Actual ratio of bed and nurse of geriatric ward was1-0.43, morefar less than1-0.68,which was suitable. The actual number of enrolled nurse was101, 57less than the actual need for158.Conclusion:1, There was a tremendous difference between nursing grading orders and actual careability of elderly patients, and it was difficult for nurses to meet the real needs ofpatients according to grading orders.2, ADL scores can directly reflect the demand for direct care of elderly patients,and alsocan effectively prompt the ability of self-care of elderly patients and the correspondingactual care needs. The lower the ADL scores, the longer it need directly care time whichprovided by nurse.3, It is suggested that doctors to determine grading nursing level I, II, III in elderly,thendivided again to A, B, C degree by nurse with rich clinical experience with theapplication of ADL scale,thus, the elderly patients divided into9types of nursing levelIA, IB, IC, IIA, IIB, IIC, IIIA, IIIB, IIIC.4, The application of ADL scale to raise the level auxiliary that divided elderly patientsinto different nursing grading in the geriatric ward within Treat-care Model,was on thepremise of fully aware of the different demands of elderly patients,, from the Angle ofphysiology, psychology and life ethics at the same time,which to conduct acomprehensive nursing care to patients.And can also effectively guided thedevelopment of geriatric nursing practice,helping realization of better quality care.5, Nursing human resources should be strengthened,to help solving the overload working condition of nurse for a long time.