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首页> 外文期刊>Italian Journal of Medicine >Variables determining clinical complexity in hospitalized Internal Medicine patients: a workload analysis
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Variables determining clinical complexity in hospitalized Internal Medicine patients: a workload analysis

机译：确定住院内科患者临床复杂性的变量：工作量分析

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The clinical complexity of Internal Medicine patients is a daily challenge for clinicians. Although clinical complexity cannot be directly measured, several scores describe the variability of clinical severity and comorbidity. The aim of this study was to analyze staff workload by assessing the nursing and medical complexity of patients admitted to an Internal Medicine ward. We included 40 consecutive inpatients [52.5% females, mean age 71.2 (18.2) years] classified according to the index of clinical complexity (ICC, type A: very high; type B: high; type C: moderate) and the cumulative illness rating scale (CIRS) severity and comorbidity index. Patient outcomes, hospitalization duration, tests performed, number of daily medications and time to perform standard nursing tasks were analysed across groups. Mean duration of hospitalization was 15.6 (10.1) days; in-hospital mortality was 15%. Mean CIRS severity index (SI) was 1.03 (0.31) and median CIRS comorbidity index (CI) was 2 (range 1-5). Significant differences were observed among ICC groups in time spent performing specific tasks [univariate analysis of variance F(2.37)=17.26, P<0.001]. No significant differences were found between the three groups for mean CIRS-SI [F(2.37)=3.033, P=0.060] and median CIRS-CI [Kruskal Wallis test: c 2 (2)= 1.672, P=0.433]. Clinical complexity and caring complexity were not correlated in our sample of Internal Medicine inpatients. Optimal care of Internal Medicine patients must take into account their complexity in both the medical and nursing aspects.
机译：内科患者的临床复杂性是临床医生每天面临的挑战。尽管无法直接测量临床复杂性，但有几个评分描述了临床严重性和合并症的变异性。这项研究的目的是通过评估内科病房患者的护理和医疗复杂性来分析员工的工作量。我们根据临床复杂性指数（ICC，A型：极高; B型：高; C型：中度）和累积疾病等级对40名连续住院的患者（女性为52.5％，平均年龄为71.2（18.2）岁）进行了分类。量表（CIRS）的严重程度和合并症指数。在各组中分析了患者的结局，住院时间，进行的测试，每日用药的数量以及执行标准护理任务的时间。平均住院时间为15.6（10.1）天;住院死亡率为15％。平均CIRS严重程度指数（SI）为1.03（0.31），中位数CIRS合并症指数（CI）为2（范围1-5）。在执行特定任务的时间上，ICC组之间存在显着差异[方差F（2.37）= 17.26的单变量分析，P <0.001]。三组的平均CIRS-SI [F（2.37）= 3.033，P = 0.060]和中位数CIRS-CI [Kruskal Wallis检验：c 2（2）= 1.672，P = 0.433]没有发现显着差异。在我们的内科住院患者样本中，临床复杂性和护理复杂性不相关。内科患者的最佳护理必须在医疗和护理方面都考虑到他们的复杂性。

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