目的 构建外科护理单元绩效薪酬分配方案，探讨不同方案优势、劣势，为丰富考核体系提供参考。方法 通过专家函询，构建以工作量为基础的外科系统护理项目与相对价值单位(relative value unit，RVU)绩效点值，分别形成以疾病及诊断相关分组(diagnosis related groups，DRGs)、RVU、DRGs和RVU为绩效点数调整参数的三类外科护理单元绩效薪酬分配方案。结果 22个外科护理单元护理疾病可分入820个DRG病组，37。27组/护理单元;心脏外科重症病房、神经外科重症监护病房、小儿外科RVU均数最高，美容整形外科、颌面外科、产科RVU均数最低。以DRGs、RVU、DRGs和RVU为测算方案得到的绩效点数分别是1 180。36、1 856。28、1 510。58。结论 DRG突出护理难度差异，但不适用于周转患者护理绩效评价;RVU适合对护理流程复杂的护理单元绩效进行评价，但不利于成本控制;RVU和DRG突出了护理难度与技术价值，可以此为导向，建立护理绩效分配新秩序。
Research on Optimization of Performance Salary Distribution Scheme in Surgical Nursing Unit of Public Hospital
Objective To construct the performance salary distribution scheme of surgical nursing unit,to explore the advantages and disadvantages of different schemes,and to provide reference for enriching the assessment sys-tem.Methods Through expert correspondence,the performance point value of surgical system nursing items and relative value unit(RVU)based on workload was constructed,and three types of surgical nursing unit performance compensation allocation schemes were formed with disease and diagnosis-related groups(DRGs),RVU,DRGs and RVU as performance point adjustment parameters.Results The nursing diseases of 22 surgical nursing units can be divided into 820 DRG disease groups,37.27 groups/nursing unit;The average number of RVUs in cardiac surgery intensive care unit,neurosurgery intensive care unit and pediatric surgery was the highest,while the average number of RVUs in cosmetic plastic surgery,maxillofacial surgery and obstetrics was the lowest.With DRGs,RVU,DRGs and RVU as the measurement scheme,the performance points obtained were 1 180.36,1 856.28 and 1 510.58 re-spectively.Conclusion DRG highlights the difference in nursing difficulty,but is not applicable to the evaluation of nursing performance of turnover patients;RVU is suitable for evaluating the performance of nursing units with com-plex nursing processes,but it is not conducive to cost control;RVU and DRG highlight the difficulty and technical value of nursing,which can be used as a guide to establish a new order of nursing performance distribution.
Public hospitalSurgical nursing unitPerformance plan
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