| ObjectiveTo establish a nursing personnel classification system conform to the pediatrics nurses’ growth cycle, including hierarchical frame-work, access standards, job responsibilities, specific nursing project. To compile the patient mark sheet adapt to the characteristic of the pediatrics patients. To calculate the nursing work hours of the different levels of the patients that there were different points, so as to establish a simple, effective and feasible mathematical model of hierarchical allocation of nursing staff’s in the pediatrics.Methods1. Established the classification system of pediatrics nurses and rating scale of the pediatrics patients with Delphi method. The survey project was analysed using the descriptive statistical analysis, the variation coefficient and the content validity. Made the research through the expert forum law and investigation of the questionnaire, at the same time, calculated the expert coordination coefficient and expert authority coefficient of the survey project. Analysed the reliability coefficients of the classification system of pediatrics nursing staff and the rating scale of the pediatrics patients by the pre-surveys. Analysed the project relateddegree of the patient rating scale with the correlation coefficient method. Scored the same patients in the pre-surveys with Ross Madiccus scale. Analysed the related degree of the two scales with Pearson correlation analysis. Analysed the difference between the two scales by paired t test.2. Calculated work hours of nursing staff in the 3 wards of pediatrics system,which included general pediatrics, neonatology, PICU(Pediatric Intensive Care Unit). First of all, estimated the single operating time of 101 direct nursing projects of pediatrics with the observation method and recording method. Made the analysis of variance and LSD using SPSS18.0. Tracked and recorded indirect nursing time for a week, then scored the hospitalized patients in the pediatrics with the patient score sheet. Extracted 150 patients at all levels by stratified random sampling method, recorded the frequency of direct nursing operation of the samples.Calculated the nursing work hours of all levels nurses of the patients that there were different points corresponding to the grading system of nursing staff of pediatrics.3. Got the linear regression equation of the different patients’ score and the different level nures’ working time through linear regression analysis, then established the mathematical model of the hierarchical nurses allocation in the three pediatric wards.Results1. The classification system of pediatrics nursing staff was composed of four dimensions. The first dimension was the nurse level, it included six items, they were N0(assistant nurse), N1(registered nurse A), N2(registered nurse B), N3(registered nurse C), N4(professional nurse)and N5(clinical nurse specialist); The second dimension was the access standards, it included six items, they were education background, working years, professional title, dissertation, theory and operation level,scientific research; The third dimension was the responsibility of the position, it included 70 items; The fourth dimension was the specific work projects, it included 150 items. The results of the survey showed that expert authority coefficient(Cr) was 0.88, the Cronbach’s a was 0.82, the Retest reliability was 0.81, the CVI was 0.86, respectively.2. The rating scale of the pediatrics patients included 3 dimensions and 48 items. The measure classification score table was scored by likert’5 point scoring method. The results of the survey showed that the Cronbach’ a was 0.81, the CVI was 0.89, the correlation coefficient of the all items with the total score were above 0.6, the correlation coefficient was o.89 between the rating scale of the pediatric patients and the Ross Madiccus scale. There were not statistically significant differences between the rating scale of the pediatric patients and the Ross Madiccus scale by paired t test.(P > 0.05). Both of them had a positive correlation(r = 0.89), it indicated that correlations of both of scales were high.3. There were not statistically significant differences in the mean direct nursing time among the nursing staffs with different education.(P > 0.05); there were statistical significant differences in the mean direct nursing time among the nurses with the different titles and working years, if it’s difficult coefficient and risk coefficient is high, or it needs strong communication ability and the strain capacity(P < 0.05).4. There were not statistically significant differences in the mean indirect nursing time in three pediatric wards.(P > 0.05).5. The scores of the pediatrics patients as independent variables, the nursing hours of the different levels as the dependent variables, the scatter shown that there is a linear relationship between the two variables, obtained the regression equation by the statistical analysis.=0?Y 50.953+6.346 X, =1?Y-227.831+27.332 X, =2?Y-114.339+10.095 X, =3?Y-116.853+11.567 X, =4?Y-2.165+0.589 X, =5?Y-6.436+0.509 X, then calculated the total nursing work hours and the number of the nurses of different levels.Conclusions1. The grading system of the pediatrics nurses and the rating scale of the pediatrics patients can be used to score the patients and configurate the nurses of different levels in general pediatrics, PICU and neonatology department.2. The mathematical model of hierarchical allocation of nursing staff’s in the pediatrics can be used to calculate the nursing working time and the number of the nurses of different levels operably. |
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