| Objective:1 In this study,the nursing operation project framework of the hepatobiliary surgery ward was constructed to provide a scientific and effective tool for the investigation and measurement of the nursing workload of the hepatobiliary surgery,and the clinical nursing hours were measured by the constructed nursing operation project measurement scale.2 To explore the correlation between case portfolio index(Case Mix Index,CMI)and nursing hours,establish a nursing human resource allocation model with CMI as the core index,realize the dynamic prediction of nursing workload in the department of hepatobiliary surgery,and provide reference for scientific and reasonable allocation of nursing human resources.Methods:1 By referring to relevant literature,clinical Nursing Practice Guide(2018 edition)and nursing sensitivity indicators,combined with clinical nursing practice,make follow-up and on-site observation records in the ward,and preliminarily develop nursing project framework and nursing hours measurement scale.Ten nursing experts were selected to determine the formal nursing project framework and nursing hours scale through two rounds of Delphi expert consultation.2 In-service nursing staff with different professional titles in the department of hepatobiliary Surgery were selected to operate and time the items in the framework of nursing project one by one.Each operation was measured at least 30 times,and the average value was taken as the length of each nursing operation.Nursing operations received by 257 patients admitted between February 1,2021 and April 30,2021 were recorded in the form of attendants,and the nursing workload was obtained.CMI of patients were collected through the management platform system of information research Center.The mean±standard deviation and constituent ratio were used for statistical description,one-way anova,S-N-K test and two independent samples T test were used for statistical inference,and Pearson correlation analysis and simple linear regression analysis were used to establish the mathematical model between CMI and nursing hours.Results:1 Construction of nursing project framework of hepatobiliary surgery:10 experts 2 rounds of Delphi expert consultation,expert positive degree was 100%,the expert authority coefficient is 0.93,final 79 nursing operation projects directly,indirectly 30 nursing operating projects,and design the direct nursing project operator inventory,indirect nursing project operator meter.2 Nursing manpower allocation in the department of hepatobiliary Surgery:At present,there are 103 beds and 42 nursing staff in the department of hepatobiliary surgery,and the ratio of bed to nurse is 1:0.41.Among them,the nursing staff aged 30 to 40 years old account for more than half,up to 53.8%.There are half of nursing staff with junior college and bachelor’s degree,only one with master’s degree,and the professional title is mainly junior professional title,accounting for 64.28%.The nursing team as a whole presents the characteristics of young,lacking of senior professional titles,experienced,highly educated personnel.At the same time,there is a vacancy in male nurses.A total of 257 patients were investigated in this study.The CMI less than 2,2～4,and the average length of hospital stay for patients greater than 4 were(12.14±4.75)days,(16.03±5.54)days,and(16.52±6.34)days,respectively.There were statistical differences between different CMI and the length of hospital stay of patients(P<0.05).The average resident age of patients with CMI less than 2,2-4 and above 4 were(53.61±13.52)years old,(56.03±13.60)years old and(53.47±10.57)years old,respectively.There was no statistical significance between different CMI and the average age of patients(P>0.05).Patients with different CMI had different average length of hospital stay,CMI were less than 2,2～4,and average working hours of patients with CMI greater than 4 were(101.20±16.00)days,(123.03±19.64)days,(123.03±17.66)days,respectively.There was statistical difference in nursing time required by patients with different CMI(P<0.05).Pearson correlation analysis results showed that CMI was positively correlated with the average daily total nursing hours(r=0.786,P<0.05),and the mathematical model between CMI and the number of nursing human resource allocation was as follows:Number of nurses required=∑(16.579*CMI+82.021)/285.71.Conclusion:1 With the development of society and the change of medical model,improve quality of nursing service,nursing operation constantly update and specialization development,so it is necessary to more accurate,has the property department nurse solution,and this research specialist in liver and gallbladder surgery,for example to project framework characteristics significantly,expert evaluation,It can provide specialized reference for the follow-up human resources allocation.2 There is a positive correlation between CMI value and nursing hours.The nursing human resource allocation model constructed based on CMI can quickly and accurately measure the number of nurses needed,which is beneficial for managers to dynamically allocate nursing staff. |
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