科研之友
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摘要
Objective: The ABCD patient classification tool was established based on the patients' disease status and nursing needs with the aim of better nursing resource allocation. The objective of this study was to determine the effectiveness of the ABCD classification tool in balancing workload of intensive care unit (ICU) nurses. Methods: A multi-center before-after study including adult and senile patients admitted to the general ICU was conducted. During the before phase between May 20th and June 24th 2012, the nurses for day shifts were allocated by nursing managers according to the standard practice. Subsequently, the nursing managers and relevant nurses received education and training for the ABCD patient classification tool. The after phase included consecutive eligible patients between August 1st and September 4th 2012 that was classified into four-grade groups (A, B, C, D) and the patients in A group needed supreme care. Thereafter, the nurses were matched with patient classification and allocated through the enumeration method. The actual nursing workload for every day shift was evaluated using the mini-version of the Therapeutic Intervention Scoring System (TISS-28). The differences in inter-phase outcome measures including the coefficient of variation, the percent of nurses with normal workload (TISS-28 score, 40-50), and nurses' satisfaction score were compared. A two-level fitting model was further utilized to estimate the influence of ABCD classification tool on the probability of a normal workload. Results: After using the ABCD patient classification tool, the coefficient of variation in nurses' workload decreased from 32.40% to 28.50% and the percent of nurses with normal workload increased from 23.64% to 37.5%. The probability of a normal workload increased by 43% (beta 1=-0.358, P<0.01) when both day shift and nurse staffing based on the ABCD patient classification tool were fitted. No significant inter-phase difference in nurses' satisfaction about workload was found (P=0.486). Conclusion: The ABCD patient classification tool is helpful in balancing nurses' workload in the general ICU.
