ABSTRACT
Establishing a scientific and sustainable grading nursing care evaluation system is the key to realizing the rational distribution of medical and nursing resources in the combined medical and nursing care services. This study establishes a grading nursing care index system for medical and nursing institutions from both medical and nursing aspects, and proposes a grading nursing care evaluation model based on a combination of interval-valued intuitionistic fuzzy entropy and a two- stage gray synthetic clustering model for interval gray number under a social network context. Through case analysis, the proposed method can directly classify the elderly into corresponding grading nursing care grades and realize the precise allocation of medical and nursing resources, which proves the feasibility of the method.
Subject(s)
Fuzzy Logic , Health Facilities , Aged , Cluster Analysis , Humans , Social Environment , Social NetworkingABSTRACT
Objective To construct a grading nursing care system at public hospitals based on the severity of illness and activities of daily living ( ADL). Methods Multi-center stratified random sampling was used to investigate the general adult patients hospitalized in 12 wards of six tertiary-level hospitals in the eastern, central and western parts of China from January to December of 2016. The Barthel index and simple clinical score ( SCS) were used to evaluate their ADL and severity of illness, while a customized direct nursing hour scale was applied to record the direct nursing time needed by patients in 24 hours. Nursing grades were defined according to different conditions and ADL and to the difference of patient needs of 24 h direct nursing hours. Results 7 200 patients were investigated in total, and 7 073 effective questionnaires were collected (98. 24% ). Seven new grades of nursing care were defined based on patients′ severity of illness, ADL and different 24 h direct nursing time. These grades match the existing four grading nursing care levels to become refined sub-levels. Conclusions Patients can be graded according to their conditions, ADL and the 24 h direct nursing time needed. Such a new method is more objective, specific and quantitative than before, conducive to upgrading fine management level of nursing.
ABSTRACT
Objective Skin tears are one of the skin adverse events in hospitalized patients which increased the length of stay and cost.How to intervene effectively is one of the global research priorities.The article aimed to study effective treatment for skin laceration by analyzing the characteristic and classification and applying grading nursing care for skin laceration.Methods From the first visit of 26 patients,the wound care center assessed the site,cause,severity classification and duration of skin laceration and managed wounds with individualized grading nursing care and overall intervention.Measurement was done on the area reduction once a week with dynamic adjusting interventions until healing.Results 26 patients with skin laceration were mainly grade 3,accounting for 76.92％ (20/26).Extremities were the main injured sites,accounting for 84.62％ (22/26).All wounds healed within 60 days and the average healing time was (22.38-±13.56)days.Median healing time was 20 days.No significance was found in the reduction rate of wounding site in 3 weeks and healing time for different severity grades,different durations and different sites of skin laceration (P＞0.05).Conclusion Individualized grading nursing care can efficiently treat skin tears with different severity,durations and sites.
