加護病房護理人力供求之探討

Staffing Levels and Patient Needs in the Intensive Care Unit

吳鈴珠(Lin-Chu Wu) ； 陳幼梅(Yao-Mei Chen) ； 林盈慧(Yin-Wheuy Lin) ； 潘純媚(Chun-Mei Pan)

《The Kaohsiung Journal of Medical Sciences》 9卷6期 (1993/06) Pp. 361-370

https://doi.org/10.6452/KJMS.199306.0361

摘要

本研究的主要目的是應用病人分類系統，調查本院加護病房護理人員工作時間的分配及病患護理需要分級，進而探討護理人力之供求。本研究採因素型評估系統（factor type），針對本院六個加護病房，設計病患護理需要評估表來分類病人及評估病患護理需要、護理人員工作負荷，並採用瞬間觀察的方式調查護理人員工作時間分配；將兩者相互配合，推估目前人力需求。得知本院加護單位工作時間分配內科系與外科系並無顯著差異；同時計算出各單位病患平均嚴重度之級釋分佈於Ⅰ－Ⅲ級間；工作量指數4.4-11.5；平均每位病人每班接受之護理時數為2.88小時，護理人員應負荷之病人護理時數5.7-5.8小時。並依現況計算各單位三班應上班人數與實安排人數做一比較，發現有二個單位呈現明顯不足、二個單位數量過多；又計算其應有之編置與實際配置人數比較，發現二個單位人力不足均屬外科單位；內科三個單位則全數顯示人力過剩。

並列摘要

The current study sought to utilize a patient classification system to investigate staffing and patient needs along with nursing care distribution in our intensive care units. The study employed a factor type analysis to design a patient need checklist (for our six ICUs) in order to determine staff load and nursing requirements. Snapshot observations were also taken to survey the distribution of nursing care time. The results of the two methods provide an estimate of current staffing needs, they also show that there is no significant difference between our surgical and internal medicine wards. On average, direct care accounts for 40.1% of the time schedule; indirect care, 37.3%; related care, 6.0%; and individual time, 16.6%. The average patient grade lies between Ⅰand Ⅲ; and workload index, between 4.4 and 11.5. The average nursing time per patient per shift is 2.88 hors, and the average workload per person is estimated at 5.7-5.8 hours. By comparing the number of personnel currently employed and the estimated number needed, we discovered that two units are understaffed, and three are overstaffed. The understaffed units are all surgical units; the overstaffed ones, internal medicine units. To conclude the study, we examined the nature and complexity of nursing duties in the hopes of returning non-nursing responsibilities to the proper medical organizations. Our ultimate goal is to realize the full potential and improve the quality of our nursing personnel.

並列關鍵字

patient classification system ； staffing