基于聚类分析和判别分析法建立住院患者护理难度等级划分
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摘要
目的:对住院患者护理难度评估结果进行分段划分,确立各分段护理难度得分界值,为医院开展住院患者护理难度等级评估提供参考。方法:调查300名住院患者护理难度现状,应用聚类分析法对300名患者护理难度得分进行分段,用判别分析创建判别函数并确定各分段界值。结果:根据最佳分类数并结合判别分析结果将患者护理难度划分为4个等级,等级越高,护理难度越大;各分段界值分别为≤5分、6?16分、17?25分、≥26分。结论:住院患者护理难度评估需考虑病情严重程度、日常生活自理能力、精神心理状况、社会支持状况、依从性和期望值等方面,采用统计学中的综合评价方法才能更加科学划分护理难度等级;为临床计算护理工作量、统筹人力安排、完善绩效考核提供参考。
Objectives: To segment the results of nursing difficulty evaluation of inpatients, to establish the boundary value of each segment's nursing difficulty scores, and provide reference for hospitals to evaluate the difficulty level of inpatients. Methods: The current status of nursing difficulty of 300 inpatients was investigated. The clustering analysis method was used to segment the nursing difficulty scores of 300 patients. Discriminant analysis was used to establish the discriminant function and determine the segmentation threshold. Results: According to the best classification number combined with the results of discriminant analysis, the patient care difficulty was divided into 4 levels which can be described as ≤5, 6～16, 17～25 and ≥26. The higher the level, the more difficult the nursing; the segmentation thresholds were respectively. Conclusions: The evaluation of the nursing difficulty of hospitalized patients needs to consider the severity of illness, self-care ability of daily life, mental and psychological status, social support status, compliance and expectation value. The comprehensive evaluation method in statistics can be used to more scientifically classify the difficulty level of nursing. It can also provide reference for clinical calculation of nursing workload, coordination of manpower arrangements and improvement of performance appraisal.
Objectives: To segment the results of nursing difficulty evaluation of inpatients, to establish the boundary value of each segment's nursing difficulty scores, and provide reference for hospitals to evaluate the difficulty level of inpatients. Methods: The current status of nursing difficulty of 300 inpatients was investigated. The clustering analysis method was used to segment the nursing difficulty scores of 300 patients. Discriminant analysis was used to establish the discriminant function and determine the segmentation threshold. Results: According to the best classification number combined with the results of discriminant analysis, the patient care difficulty was divided into 4 levels which can be described as ≤5, 6～16, 17～25 and ≥26. The higher the level, the more difficult the nursing; the segmentation thresholds were respectively. Conclusions: The evaluation of the nursing difficulty of hospitalized patients needs to consider the severity of illness, self-care ability of daily life, mental and psychological status, social support status, compliance and expectation value. The comprehensive evaluation method in statistics can be used to more scientifically classify the difficulty level of nursing. It can also provide reference for clinical calculation of nursing workload, coordination of manpower arrangements and improvement of performance appraisal.
引文
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[2]徐军,郭玲玲,王春英,等.护士绩效考核体系的设计与探索[J].中国医院,2016,20(6):49-52.
[3]钟琴,黄芳,柏亚妹,等.加权护理工作量测量工具的研究进展[J].中国护理管理,2017,17(11):1522-1526.
[4]张秀华,吴静,张翠红,等.护理绩效考核中护理技术风险及难度系数的等级设计及应用[J].中国实用护理杂志,2017,33(1):51-57.
[5]宋建林.K-means聚类算法的改进研究[D].合肥:安徽大学,2016.
[6]程祥.基于负荷量测数据的电力负荷聚类方法研究[D].杭州:浙江大学,2017.
[7]胡勇.聚类分析结果评价方法研究[D].包头:内蒙古科技大学, 2014.
[8]陈家伟,胡翠英,马骥,等.荧光光谱法结合Fisher判别分析在西洋参鉴别中的应用[J].光谱学与光谱分析,2017,37(4):1157-1162.
[9]金琳,王伟,李振香,等.《护理分级》卫生行业标准实践现状调查研究[J].中国实用护理杂志,2017,33(13):975-980.
[10]胡晓强,洪丹丹.公立医院绩效考核常见问题及对策分析[J].中国卫生经济,2017,36(4):83-84.
[11]邹艳艳,田萍,李星梅,等.基于因子分析的三级综合医院护理人员能级进阶模型的构建[J].中国实用护理杂志,2017,33(1):66-68.
[12]林玲,娄湘红,陈义璇,等.能级对应护理人力资源管理模式下的绩效考核方案探讨[J].护理学杂志,2016,31(3):64-66.
[13]朱朝晖,吴菁华,罗惠芳,等.老年慢性心力衰竭患者的延续优质护理服务与体会[J].广东医学,2017,38(z1):348-349,351.
[14]王丹丹,柏亚妹,宋玉磊,等.住院患者护理需求与实际服务现状的对比分析[J].中华医院管理杂志,2018,34(2):162-167.
[15]林娜.急性冠脉综合征患者护理难度评价体系的构建与实证研究[D].福州:福建医科大学,2016.
[16]汪紫娟.脑卒中患者护理难度评价体系的构建与实证研究[D].福州:福建医科大学,2016.