Variability of the intra GRD nursing attention related
Abstract
The method of GRD prospective payment, used in Spain and around the European Union, contemplates the nursing attention linked to the main and secondary diagnosis of the patients that motivated its hospitalization. This fact conditions a variability of the nursing practice that guides the activities that nurses carry out toward those derived of the clinical diagnosis, preventing to incorporate the activities required by the patients in function of their characteristics to maintain its autonomy. The GRD pattern is very conditioned by the hospital stay, in occasions it causes different cares in the same patients, not explained by their characteristics, but for the pattern of hospitalization. The cost of the hospitalization for GRD conceals the required attention of nursing services, making invisible the cares in the mark of the GRD pattern; it seems advisable to adapt the pattern with the inclusion of levels of autonomy, related with the nursing practice. Objective: To analyze the variability in the nursing care for the same type of patients, grouped in the GRD 088 COPD (Chronic obstructive pulmonary disease), in two units of hospitalization. Method: A Study of 200 patients with an episode of hospitalization for COPD in the year 2004, in units of Pulmonology with a stay of 6.9 days and short-stay average of 2.8 days. Data Sources: clinical histories and databases of hospital SET between August 1 in 2005 and April 30 2006, collection in questionnaire produced by themselves and analyzed by statistical program SPSS. Results: analyzed 200 episodes of hospitalization. Average age of 74.4 years, hospitalized in conventional units or short stay. 3.2% of the total are women. 97 Episodes are conventional hospitalization, compared to 103 in short stay. Conclusions: There is a variability of the activity nurse not evaluated, for the same type of patients, according to the unity of hospitalization.Downloads
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