精神科病房實施護理人員月輪班制對護理品質影響之先驅性研究

A Pilot Study of the Effect of Monthly Shift Rotation on Quality of Nursing Care in an Acute Psychiatric Ward

張榮珍(J. C. Chang) ； 李朝雄(C. S. Lee) ； 李引玉(Y. Y. Lee)

《護理雜誌》 45卷5期 (1998/10) Pp. 41-49

https://doi.org/10.6224/JN.45.5.41

摘要

The purposes of this study were (1) to report on a monthly-rotating shiftwork system applied in an acute psychiatric ward, and (2) to compare the effects of monthly-rotating and rapid-rotating shift systems on quality of nursing care. The research data were obtained retrospectively from computerized files related to the work schedules in the psychiatric ward, sociodemographic characteristics of the nursing staff, and records of accidents involving psychiatric inpatients. For an 18-month period of rapid-rotating (N=23) and monthly-rotating (N=18) shift, the demographic characteristics of nurses were similar; the rate of bed occupancy and manpower in the ward were not significantly different. The frequency of rotating shift decreased from 5.8±3.2 to 2.3±2.0 times/month (t=15.0, p＜.001) and the days that the patients were directly cared for by their primary nurses increased from 7.8±1.2 to 14.9±1.6 days/month (t=11.0, p＜.001). There was no marked difference in the rate of accidents between the two rotating periods, but the severity of injuries caused by the accidents was significantly less in the monthly-rotating period (t=2.72, p＜.001). The results were compatible with previous studies. That is, a monthly-rotating shift system, compared to a rapid-rotating system, may be favorable to quality of psychiatric nursing care.

關鍵字

護理品質 ； 連續性照顧 ； 月輪班制 ； 快速輪班制 ； 意外事件

並列摘要

The purposes of this study were (1) to report on a monthly-rotating shiftwork system applied in an acute psychiatric ward, and (2) to compare the effects of monthly-rotating and rapid-rotating shift systems on quality of nursing care. The research data were obtained retrospectively from computerized files related to the work schedules in the psychiatric ward, sociodemographic characteristics of the nursing staff, and records of accidents involving psychiatric inpatients. For an 18-month period of rapid-rotating (N=23) and monthly-rotating (N=18) shift, the demographic characteristics of nurses were similar; the rate of bed occupancy and manpower in the ward were not significantly different. The frequency of rotating shift decreased from 5.8±3.2 to 2.3±2.0 times/month (t=15.0, p＜.001) and the days that the patients were directly cared for by their primary nurses increased from 7.8±1.2 to 14.9±1.6 days/month (t=11.0, p＜.001). There was no marked difference in the rate of accidents between the two rotating periods, but the severity of injuries caused by the accidents was significantly less in the monthly-rotating period (t=2.72, p＜.001). The results were compatible with previous studies. That is, a monthly-rotating shift system, compared to a rapid-rotating system, may be favorable to quality of psychiatric nursing care.

並列關鍵字

quality of nursing ； continuity of care ； monthly-rotating shiftwork system ； rapid-rotating shiftwork system ； accident