Research On The Classification Standard Of Graded Nursing In Public Hospitals

[Objective]Taking objective condition and self-care assessment scale as the basis for grading of grading nursing by measuring direct nursing hours to quantify nursing time patients to explore a suitable adult ward nursing grading standards,and then build a new level of grading nursing in public hospitals,and provide reference for clinical nursing work and government classification nursing reform.[Method]?Through literature review and investigation to put forward the research hypothesis of grading nursing level construction of public hospitals,and establish the research plan,including determining the condition and self-care ability assessment scale,and determine the scale of data collection and field survey program for nursing hours.? Using convenience sampling survey in Jiangsu province 2 three grade A hospitals,each hospital in internal medicine,surgical classification number,which includes the Department of respiration,Department of Gastroenterology,Department of Neurology,Department of Endocrinology,Department of Cardiology,Department of Nephrology,Department of general surgery,Department of thoracic surgery,Department of orthopedics,including cardiac surgery,anorectal surgery and Department of Urology,and selected 6 sections according to random sampling from internal medicine and surgery,then investigate the normal adult inpatients from May 2016 to December 2016 with a cluster sampling method.? Field investigation:Firstly,the person in charge of the project selected the patient then the assessors evaluate patients with the SCS and Barthel index scale determining the level of the patient according to the scale of the scale,at last observers measure 24 hours nursing time of the patients and collected research data.? A new graded nursing level was formed by comparing the differences of 24h direct nursing hours between patients with different condition and self-care ability.were analyzed by SPSS 20 statistical software,measurement data using(standard deviation),the distribution of different nursing grades were compared with chi square test,different levels of 24h nursing.Analysis of variance was used to compare between the 22 groups was compared with SNK method.The difference was statistically significant in P<0.05.[Result]?The existing problems of grading nursing grades:from doctor nursing degree distribution,the level of care and nursing care of patients with a high proportion of two,respectively 58.24%and 40.29%,and three grade nursing proportion was only 0.97%;the difference from the doctor nursing grade standard of care and grade distribution,there was a significant difference between the two groups(P<0.05).? Barthel index rating scale and simple clinical score assessment results:ADL level of the number of patients with more uniform distribution,and different levels of ADL in patients with 24h direct nursing time there were statistical differences between the groups(P<0.05),the comparison between each grade differences were statistically significant(P<0.05);different levels of SCS in patients with 24h directly nursing time comparison had statistical significance(P<0.05).The comparison between every two groups showed statistically significant difference between each level(P<0.05);statistical significance with 24h direct nursing time difference between the combined application of ADL and SCS 16 level of care scale formation in the presence(P<0.05).? The formation of new nursing grades:Based on the comparison of different ADL and SCS with 24 hours of direct nursing time,Merge groups which have no statistically significant differences between every two groups,a total of 6 classifications of patients were formed:?ID;?IB,IC;?IVD,IIID,IID;?IIA,IA,IIB,InC;?IVC,IIIC;?IVA,IVB,IIIA,IIIB,the24hdirect nursing time of 6 classifications of patients were 5.49h,4.46h,3.69h,h,2.80h,2.26h,1.83h.?Verification of new nursing grades:From the difference between different orders of nursing grade,grade 24h standard nursing direct nursing time,no statistically significant difference between grade two and grade three nursing care of direct nursing time(P>0.05);different grades of nursing patients with new 24h direct nursing time comparison was statistically significant(P<0.001).The comparison between every two groups showed that six a grade of direct care workers the difference was statistically significant(P<0.05).?6 classifications of patients with the existing classification form of grading nursing four grades for the matching and refine the formation of sub grade,the final formation of the new nursing grades:special nursing care(ID),one A nursing grade(IC,IB);one B nursing grade(IID,IIID,IVD),two A nursing grade(IIC,IIB,IIA,IA),two B nursing grade(IIIC,IVC),three nursing grade(IIIA,IIIB,IVA,IVB).[Conclusion]? There are many shortcomings in the current grading nursing classification,which brings many problems for clinical nursing work.We need to explore an objective,specific and quantifiable grading standard of nursing classification.? disease severity and self-care ability are two elements of grading standard.Combined application of Barthel index rating scale and simple clinical score to evaluate and classify patients is more objective.? we classify patients according to the difference of 24 hours of direct nursing time needed by patients with different condition and self-care ability.The new nursing grade was special nursing care,one A nursing grade,one B nursing grade,two A nursing grade,two B nursing grade,three nursing grade.? The new nursing grade has the characteristics that the grading standard is objective,specific and quantifiable,and more accurately reflects the workload of clinical nursing,reflects the actual needs of patients,and increases the objectivity and scientificity of patients' grading.It is easy to operate and perform,which can promote the fine management level of nursing.