Research On The Content Of Graded Nursing Service In Public Third Class Hospital

[Objective]according to the needs of patients and the grading nursing service implementation status of the investigation,through consulting experts Delphy,formation of a new system of nursing service classification,further complement and determined under different levels of grading nursing services,implementation and execution frequency of qualified personnel,and ultimately service the hierarchical management of nurses.[Methods]the domestic and foreign literature,the self-made patient care demand questionnaire and the status quo questionnaire of nursing service were reviewed.A multi center stratified random sampling method,in the East,central and western of the selected 2 public hospital,then randomly from internal medicine and surgery were selected from 6 adult patients with ordinary department,by the method of cluster sampling survey were selected from January 2016 to December 2016 Department of hospital,a total of 7200 cases.On the basis of the results of investigating the nursing needs of patients and the status of implementation,literature review,interviews with experts,from the "nursing classification"(NIC)standard nursing project,making the initial questionnaire,after two rounds of expert consultation,and ultimately determine the different level service projects,specific implementation of the minimum frequency and executive personnel qualification.[results]? Investigation of patient care needs:there were 28 items,24 items,17 items and 8 items for patients with special,first,two and three nursing inpatients'demands for grading nursing service more than 50%;there was no statistically significant difference in demand for basic grading nursing service content between medical and surgical patients(P>0.05);there was statistically significant difference in nursing needs among different grades of patients(P<0.05).? Investigation of the status of patient care service implementation:there was no statistically significant difference in nurse level between different levels of patients(P>0.05);The special care,primary care,two grade care and three grade care of hospitalized patients with more than 50%of grading nursing needs of the project were 46,36,22 and 11;the specific implementation of the frequency and clinical executive under different levels of grading nursing service items without qualification there is a difference.? Comparison and analysis of the present situation and nursing needs of patients,the difference was statistically significant between the nursing needs of patients and the status of implementation of basic needs,basic treatment,observation of three dimensions(P<0.05);patients,soft target such as the "observation" satified them;there is a difference between the nurses and the nurses on their cognition because nurses tend to neglect health education such as "measuring blood pressure,turning over their back".?This study adopts Delphy expert inquiry method for the 2 round of questionnaire inquiry of 30 experts,the effective rate of the questionnaire was 100%,the authority coefficient is 0.89.The final determined the grading nursing service system including three level indicators:basic needs,basic treatment and observation;to determine the number of items of special care,primary care,two grade care and three grade care respectively contain 54,44,29 and 12,but also a clear service the project under different levels of the specific implementation and execution frequency of qualified personnel.[Conclusion]? Conclusion of patient care needs:the needs of different grades of nursing care are different,and the content system of graded nursing service is generally adapted to internal medicine and surgery.? Conclusion of the status of patient care service implementation:at present,the clinical practice is still unable to meet the requirements of the implementation of graded nursing:different grades of patients are equipped with different levels of nurses;the current classified nursing service is extensive,the lowest executive frequency and the lowest executive qualification are not clear,compared with the actual need in clinical practice:the project needs to be increased,the operability needs to be strengthened,and the practicability needs to be improved.? The comparative analysis of patients' nursing needs and implementation status showed that the demand of hospitalized patients was higher than the actual nursing services provided by hospitals,clinical nurses attach importance to hard targets and the cognitive gap between nurses and patients is large.? Delphy after consultation and determined the grading nursing service system,compared with the original service content,the new system has stronger practicability,higher maneuverability and better standardization.It also made clear the specific implementation frequency and executive qualification of service items under different levels,providing a good reference for clinical nursing staff to implement hierarchical training.