摘要目的 兼顾护理工作数量和质量,建立科学、合理的护理质量综合评价方法.方法 应用SPSS 18.0决策树中卡方自动交互检测法(chi-squared automatic interaction detector,CHAID)分析各病区护理单元平均入院患者数、Ⅰ级护理天数、危重患者数、抢救人次数、手术人次数、静脉输液人次数、肌肉注射人次数、氧气吸入人次数、导尿人次数、胃管置管人次数、灌肠人次数和平均床位周转率等工作数量指标,将各护理单元划分成不同的护理负荷集群,再在同一级护理负荷集群中按12项护理质量考核指标进行综合护理质量的评比.结果 经决策树法分析某月护理质量,对应变量差异无统计学意义的工作数量变量进行合并,最后树伸展为3层:根结为第1层,第2层以首优变量“病危患者数”(P＜0.05)分成节点1、2、3,第3层按变量“Ⅰ级护理天数”(P＜0.05)分成节点4、5、6、7.决策树法能确定各护理工作数量指标的上下层级关系和首优工作数量变量(P＜0.05),并依据首优变量的分布概率建立分层规则,实现按护理负荷将不同护理单元归类划分的作用.结论 决策树方法能为护理质量考核提供同级的护理工作量平台,减少了护理工作数量差异对护理质量评价的影响,提高了护理质量在同级护理负荷单元之间的可比性,是护理质量综合评价的科学方法.

abstractsObjective To establish a reasonable method to evaluate nursing quality with both the quantity and quality of nursing taken into account.Methods Quantity indexes of nursing were analyzed with decision tree method (CHAID)in SPSS18.0,which included the number of patients admitted to wards,first grade' s nursing days,critically ill patients,emergencies,operations,intravenous infusions,intramuscular injections,oxygen inhalations,urinary tract catheterizations,gastric tube catheterizations,enemas and the average turnover rate of beds.After the quantity analysis,the nursing units were divided into different groups according to their workload.Then,we made a comprehensive evaluation of nursing quality with 12 indicators on the same group.Results Decision tree analysis can identify hierarchy relationship of various nursing quantity indicators and high-priority work quantity variables.Furthermore,it can establish the hierarchical rule based on the distribution of high-priority variables,and serve the purpose of classifying nursing units based on nursing workload.Conclusion The decision tree method can provide a same-level nursing workload platform for quality examination.This has minimized the influence of nursing workload discrepancies on nursing quality examination,and made nursing quality more comparable with nursing workload units of the same level,thus a scientific method for comprehensive nursing quality evaluation.