Institute for Health and Rehabilitation Sciences, Ludwig-Maximilians-Universität, Munich, Germany.
BMC Health Serv Res. 2010 Oct 29;10:295. doi: 10.1186/1472-6963-10-295.
Management decisions regarding quality and quantity of nurse staffing have important consequences for hospital budgets. Furthermore, these management decisions must address the nursing care requirements of the particular patients within an organizational unit. In order to determine optimal nurse staffing needs, the extent of nursing workload must first be known. Nursing workload is largely a function of the composite of the patients' individual health status, particularly with respect to functioning status, individual need for nursing care, and severity of symptoms. The International Classification of Functioning, Disability and Health (ICF) and the derived subsets, the so-called ICF Core Sets, are a standardized approach to describe patients' functioning status. The objectives of this study were to (1) examine the association between patients' functioning, as encoded by categories of the Acute ICF Core Sets, and nursing workload in patients in the acute care situation, (2) compare the variance in nursing workload explained by the ICF Core Set categories and with the Barthel Index, and (3) validate the Acute ICF Core Sets by their ability to predict nursing workload.
Patients' functioning at admission was assessed using the respective Acute ICF Core Set and the Barthel Index, whereas nursing workload data was collected using an established instrument. Associations between dependent and independent variables were modelled using linear regression. Variable selection was carried out using penalized regression.
In patients with neurological and cardiopulmonary conditions, selected ICF categories and the Barthel Index Score explained the same variance in nursing workload (44% in neurological conditions, 35% in cardiopulmonary conditions), whereas ICF was slightly superior to Barthel Index Score for musculoskeletal conditions (20% versus 16%).
A substantial fraction of the variance in nursing workload in patients with rehabilitation needs in the acute hospital could be predicted by selected categories of the Acute ICF Core Sets, or by the Barthel Index score. Incorporating ICF Core Set-based data in nursing management decisions, particularly staffing decisions, may be beneficial.
护士人员配置的质量和数量管理决策对医院预算有重要影响。此外，这些管理决策必须针对特定组织单位内的患者护理需求。为了确定最佳的护士人员配置需求，首先必须了解护理工作量的程度。护理工作量在很大程度上是患者个体健康状况的综合函数，特别是在功能状态、个人护理需求和症状严重程度方面。国际功能、残疾和健康分类（ICF）及其衍生子集，即所谓的 ICF 核心集，是一种用于描述患者功能状态的标准化方法。本研究的目的是：（1）检查患者功能与急性 ICF 核心集类别之间的关联，以及急性护理情况下患者的护理工作量；（2）比较 ICF 核心集类别和 Barthel 指数解释护理工作量的方差；（3）通过预测护理工作量的能力验证急性 ICF 核心集。
使用相应的急性 ICF 核心集和 Barthel 指数评估患者入院时的功能，使用已建立的工具收集护理工作量数据。使用线性回归模型来模拟因变量和自变量之间的关系。使用惩罚回归进行变量选择。
在神经和心肺疾病患者中，选定的 ICF 类别和 Barthel 指数得分解释了护理工作量的相同方差（神经疾病为 44%，心肺疾病为 35%），而 ICF 对于肌肉骨骼疾病略优于 Barthel 指数得分（20%比 16%）。
在急性医院有康复需求的患者中，护理工作量的很大一部分可以通过急性 ICF 核心集的选定类别或 Barthel 指数得分来预测。在护理管理决策中，特别是人员配置决策中，纳入 ICF 核心集数据可能会有所帮助。
