不同疾病诊断相关分组权重下护理工作量的比较研究  

Comparative study on nursing workload based on the Related Weight of different disease Diagnosis Related Groups

作　　者：杨苏[1] 黄丽华[1] 李盈[2] 王萍[3] 俞玉娣[4] 陈霞[5] YANG Su;HUANG Lihua;LI Ying;WANG Ping;YU Yudi;CHEN Xia(Nursing Department,The First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou,310003,China;不详)

机构地区：[1]浙江大学医学院附属第一医院护理部,杭州市310003 [2]浙江大学医学院附属第一医院病案室,杭州市310003 [3]浙江大学医学院附属第一医院神经外科,杭州市310003 [4]浙江大学医学院附属第一医院呼吸内科,杭州市310003 [5]浙江大学医学院附属第一医院心脏大血管外科,杭州市310003

出　　处：《中国护理管理》2023年第8期1203-1207,共5页Chinese Nursing Management

基　　金：浙江省医药卫生科技计划项目(2019KY387);浙江省医院可持续发展扬子江研究项目(2022ZHA-YZJ205)。

摘　　要：目的:分析比较不同疾病诊断相关分组权重(Related Weight,RW)下的护理工作量差异,旨在帮助护士长积极应对患者快速周转并有效处理不同病区工作量,以便为护理管理者合理配置护理人力资源和科学考核护士绩效提供参考。方法:开展为期1周的代表性住院病区护理工作量的观察性研究。测算纳入研究的住院患者护理总时间,并采用秩和检验分析疾病诊断相关分组(Diagnosis Related Groups,DRG)模式下不同RW分段(RW≤1、1<RW<2、RW≥2)护理工作量的差异。结果:观察期间224例住院患者护理总时间为6.80(3.82,18.05)h,随RW分段增高,住院患者护理总时间递增,不同RW分段间住院患者护理总时间差异有统计学意义(H=47.524,P<0.001)。结论:RW分段与护理工作量存在一定的关联性,护理管理者应综合考虑床护比配置要求和病区住院患者RW分段比例,配备适当数量的病区护士,以帮助护士长积极应对患者周转快、病种复杂、护理工作难度与任务机械化之间的不平衡等挑战。Objective:To analyze and compare the differences in nursing workload under the Related Weight(RW)of different disease Diagnosis Related Groups(DRG),so as to assist nurse managers in proactively addressing the challenges of rapidly rotating patients and effectively managing the workload to different wards.This comparison provides a reference for nurse managers to allocate nursing human resources appropriately and conduct a scientific evaluation of nurse performance.Methods:A one-week observational study of nursing workload in representative inpatient wards was carried out.The total nursing time of hospitalized patients included in the study was measured,and the rank-sum test was used to analyze the difference in nursing workload among different RW segments(RW≤1,1<RW<2,RW≥2)under DRG mode.Results:The median(quartile)of total nursing time of 224 hospitalized patients during the observation period was 6.80(3.82,18.05)h,and there were statistically significant differences between different RW segments(H=47.524,P<0.001).Conclusion:There is a certain correlation between different RW segments and nursing workload.Nursing administrators should consider bedto-nurse ratio requirements and the proportion of RW segments among inpatients in wards to allocate an appropriate number of nurses to the wards.This helps ward nurse leaders proactively address challenges such as rapid patient turnover,complex diseases,and imbalances between nursing work difficulty and task mechanization.

关 键 词：DRG 不同疾病诊断相关分组权重 护理工作量 护理人力配置 护理管理 

分 类 号：R47[医药卫生—护理学] R197[医药卫生—临床医学]