| The National Development and Reform Commission、The Ministry of Health and The State Administration of Traditional Chinese Medicine jointed mandate, announced<The national health service price project specification(2012)> on May4,2012. It firstly increased the "basic human consumption and time-consuming, technical difficulty, the degree of risk" and so on, emphasizes the value of doctors and nurses, and provided the guidance and basis to develop a scientific and reasonable medical service prices for various areas. TCM nursing technical operation is in low charge, some items belong to the free service, leading to the nurses’ labor value was underestimated or ignored, so how to scientifically evaluate has became a problem to be solved.[Objective] To formulate a labor service value evaluation system for nurse in Traditional Chinese Nursing Operation, and assess the nurse value of Traditional Chinese Nursing Operation[Method] Qualitative research was used,9doctors and nurses in hospital of traditional Chinese medicine were interviewed.The recordings were transcribed and analyzed. To stop the interview after information of research saturated, and then combine the result of Literature review to establish the evaluation dimensions and indicators connotation. Convenience sampling was used to choose26experts from6hospital of Traditional Chinese nursing and Traditional Chinese medicine. Importance of the mean and variation coefficient was to screen indicator, and then finish a labor service value evaluation system for nurse in Traditional Chinese Nursing Operation (including weight).At the second part, choose104nurses in6hospitals in Beijing,using the labor service value evaluation system as a tool to survey15Traditional Chinese Nursing Operation. Calculate the mean of each nursing operation, and then multiplied by the weight. The result was added is labor service coefficient.[Results]Experts tend to agree with each other after two rounds, finally built a labor service value evaluation system for Traditional Chinese Nursing Operation (including weight) which contained5first class indexes and11secondary indexes, and the5first index and weight are:the technical difficulty (39.50%), the intensity of labor (19.08%), nursing risk (22.85%), time consumption (9.99%) and technical conditions (8.58%).26experts’authority coefficient is0.87, Experts tend to agree with each other after two rounds of enquiry,26experts’ authority coefficient is0.87, the mean of the two rounds of enquiry range in2.84-4.77,3.67-4.69, the variation coefficient range in0.09-0.44,0.11-0.25, and the the Kendall coefficient is:0.11(X2=63.90, P <0.01),0.28(X2=108.62, P<0.01)、0.81(X2=293.22,P<0.01)。104questionnaires were distributed,93recovered, the recovery rate was89.42%;8invalid questionnaires were excluded, the effective rate was91.40%. Nurses aged at26-35group accounted for65.88%, the majority of has worked5-15years,accounting for64.71%,74.12%nurses are undergraduate,62.35%are senior nurse. Nurses were familiar with13TCM Nursing operation, including Ear point、Acupoint massage、moxa-stick moxibustion and so on. The mean of each13TCM nursing techniques was multiplied by its relative weight. The results show that Ear point (1.7599) is the most difficult; Moving cupping (0.8849) is high intensity of labor; Moving cupping (0.8946) is the most dangerous; Acupoint massage (0.4648) is most time-consuming; Traditional Chinese medicine dressing (0.3511) is the most demanding technical conditions.13operating techniques are arranged in the value of labor from high to low is, Moving cupping、Cupping、 Traditional Chinese medicine dressing、Scraping method、Ear point、Acupoint massage、Moxa-stick moxibustion、Moxa-cone moxibustion、Chinese Herb by Wet Compressing、Chinese herb bath、Herbal compress、Computer mild-frequency electric pulse therapy、Chinese traditional medicine iontophoresis.[Conclusions] The research method used in constructing evaluation system is scientific and expert authority is high, research results have a higher reliability, and the number of indicator are suitable, the structure of the system is reasonable, weight is clear, comprehensive and objective, so it can be used as an effective evaluation of nurse labor service value in TCM operation. The nurses labor service value coefficients of13TCM nursing operation are objective, reliable, and can be used as a reference of nursing manipulation charges. But due to the number and species of TCM nursing operating are different in different departments, not all of nurses are familiar with all TCM nursing operation, so it cannot be measured for all projects, so it can be perfect through improved survey methods research in the future. |
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