基層護理人員時間分配之探討模式－以宜蘭縣之星鄕為例

宜蘭縣三星鄉衛生所同時擁有兩項基層醫療保健的新嘗試：群體醫療執業中心與綜合地段健康管理，醫療與保健的相互配合因而成為其首要工作。本研究挑選1987年7月，每個工作日諳六位地段護士作以分鐘為單位之「自我實地觀察記錄」將工作分為六類，再由研究人員統計每人從事各類工作時間之百分比，及六位地段護士之平均值。結果六位地段護士平均之「家訪」佔全部工作時間的30.08%，「門診」佔全部工作時間的35.82%，「資料處理及抄寫」佔全部工作時間的20.29%，「衛教」佔全部工作時間的0.41%，「預防注射」佔全部工作時間的4.56%，「其他」則佔9.00%。此結果若與省公共衛生研究所綜合地段健康管理的標準相比較，則可發現基層護理人員花在「門診」及「資料處理及抄寫」的時間百分比偏高，花在「家訪」等保健工作上的時間則相對減少。因此本文建議減少報表，實施保健工作電腦化，並加強門診醫療中的保健工作，鼓勵醫師參與社區衛教等保健業務，以使醫療與保健相輔相成。

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並列摘要

The San-shing Health Station of Ilan County was chosen to conduct two newly innovated primary health care trials-the group practice center and the comprehensive district health care projects. Therefore, maximizing limited resources and providing medical care and public health services of good quality became important issues. In July 1987, a self-recording method was used by six district nurses and their head nurse to record in six major categories each nurse's time allocation in minutes. After one month of data collection, the percentages by category for each nurse and the averages (means) of the six district nurses were calculated. For the six nurses, the time allocation percentages were as follows: 1) home visits, 30.80%; 2) outpatient department (OPD), 35.85%; 3) data processing and paperwork, 20.29%; 4) health education, 0.41%; 5) vaccinations, 4.56%; and 6) other, 9.00%. In comparison with the criteria set forth by the Provincial Institute of Public Health, the district nurses took more time on OPD and data processing and paperwork, and less time on public health activeities such as home visits. Based on these results, the authors suggest reducing the paperwork load of district nurses, computerizing health care activities and records, increasing public health activities in OPD, and encouraging physicians to join in public health work in the commumity.

並列關鍵字

Delivery of Health Care ； Time Allocation ； Nursing Program Evaluation

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基層護理人員時間分配之探討模式－以宜蘭縣之星鄕為例

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