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IMPLEMENTATION OF PATIENT CATEGORIZATION MODEL BASED ON THEIR NEED FOR MEDICAL CARE AS AN INDICATOR OF EFFICIENCY AND EFFECTIVENESS OF NURSING CLINICAL PRACTICE
AMER OVČINA
; Sarajevo University Clinical Center, Sarajevo, Bosnia and Herzegovina
SEBIJA IZETBEGOVIĆ
; Sarajevo University Clinical Center, Sarajevo, Bosnia and Herzegovina
ERNELA EMINOVIĆ
; Sarajevo University Clinical Center, Sarajevo, Bosnia and Herzegovina
Abstract
Introduction: Evaluation and categorization of patients enable us to determine the number of hours required for their medical treatment, to calculate the number of required nursing staff, to monitor and evaluate results, and to determine financing of services. Standardized forms are used for appropriate assessment of patient condition and need for medical care. Categorization of patients contains comprehensive data related to patient condition based on 16 risk factors. Objective of the study: to determine the number of hospitalized patients categorized in the group of patients in high demand for progressive care; to show care evaluation and treatment outcome of highly categorized patients; and to examine the ratio of medical care providers in relation to the number of highly categorized patients. Methods: the study was conducted among patients hospitalized at the Sarajevo University Clinical Center in the period from January 1 to December 31, 2017. The research used standardized nursing documentation, patient categorization forms, monthly evaluation reports and other relevant documentation. The study included 25 organizational units. Analysis of highly categorized patients requiring progressive medical care was conducted in 15 organizational units of the Sarajevo University Clinical Center. In the course of the study, identity and other personal data of patients were protected. This was a retrospective study. Study results and discussion: patients were categorized in one of four categories, in accordance with the methodology described. Most of the total of 28097 patients were category 1 patients where self care sufficed (40.7%), while there were 22.4% of patients in category 4, the majority of them hospitalized at the Department of Neurology (n=1300). Based on the number of patients from different categories and the time required for their treatment, we gave an estimate of the number of nurses required for providing quality medical care. Their number was by 50% lower than their actual number. The percentage of cured patients at the Sarajevo University Clinical Center was 75%. Conclusions: categorization of patients should have its purpose and final objective directed at strategic planning of human resource in the field of nursing, monitoring the course and outcome of health care processes, and analysis of nursing clinical practice efficiency and effectiveness. Study results showed realistic need for medical care providers at different departments where patients were categorized for progressive care. Analysis of the results confirmed that the percentage of cured patients was higher at departments with a higher number of nurses in respect to their estimated number.
Keywords
categorization; patients; nurses; efficiency; effectiveness; outcome
Hrčak ID:
216437
URI
Publication date:
30.1.2019.
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