建置以治療性措施為基礎之加護病房病人分類系統

Establishing the TISS-28 Based Patient Classification Informatic System in Intensive Care Units

張麗銀(Li-Yin Chang) ； 尤琇慧(Hsiu-Hui Yu) ； 施素真(Sou-Jen Shih) ； 彭素貞(Su-Chen Pong)

《榮總護理》 30卷3期 (2013/09) Pp. 308-319

https://doi.org/10.6142/VGHN.30.3.308

摘要

本研究之目的為建立以治療性措施為主之資訊化加護病房病人分類系統，及分析加護病房之直接護理時數與護理人力利用率。研究方法分為二階段：第一階段是規劃及開發加護病房病人分類資訊系統，病人分類之內容以「加護病房病人直接護理需要分類表」為主，並結合醫囑系統，能對應項目則依病人之醫囑自動匯入病人分類系統，無法對應項目則可另行點選；第二階段為分析加護病房直接護理時數，以中部某醫學中心之10個加護病房之護理人員及病人為研究對象，運用第一階段建立之加護病房病人分類資訊系統收集病人分類資料作統計分析。研究結果顯示加護病房病人分類資訊系統已於2012年建置完成，平均每日每位病人之護理時數為13.3 ± 2.87小時，大夜之護理人力利用率為126.97%，白班之護理人力利用率為126.91%，小夜之護理人力利用率為121.58%。施行加護病房之病人分類電腦化，可了解人力負荷與人力運用情形，作為人力資源與成本分析之參考。

關鍵字

病人分類系統 ； 直接護理 ； 治療性措施 ； 加護病房

並列摘要

The purpose of this study was to develop TISS-28 based patient classification information system of intensive care unit (ICU), and to analyze ICU direct nursing care hours. The research method was divided into two stages: The first stage was the planning and development of the patient classification information system. The system was based on ”patients” direct care activities of ICU, and with computerized physician order entry (CPOE) system, according to the matching item automatically imported into the patient classification system, the not correspond item being input data by nurses. The second phase was to apply the patients classified information system of ICU to collect data in 10 ICUs. The results showed that the patient classification information system was established. The average daily nursing care hours were 13.3 ± 2.87 hours per-patient. The night shift of nursing manpower utilization was 126.97%; day shift nursing manpower utilization was 126.91%, evening shift nursing manpower utilization was 121.58%. Conclusion: The patient classification information system of ICU provides the information of nursing manpower and workload as evidence-based resources for manpower policy.

並列關鍵字

patient classification information system ； patients' direct care activities ； TISS-28 (therapeutic intervention scoring system) ； intensive care unit

參考文獻

吳鈴珠、陳幼梅、林盈慧、潘純媚(1993)．加 護病房護理人力供求之探討．高雄醫學 雜誌，9 ， 361-370。

邱艷芬(1995)．應用APACHE SCORE 於加護 病房護理行政業務之探討．慈濟醫學， 7 ，187-193。

梁亞文、黃立琪、尹裕君、陳文意、莊家 綾、李卓倫(2010)．護理人力對病患結 果影響之文獻探討．護理雜誌，57 (5)， 77-82。doi: 10.6224/JN.57.5.77

張麗銀、林麗英、盧小玨、王曼溪、張美玉 (2002)．加護病房治療性措施計分系統與 護理人員活動之關係初探．榮總護理， 19 (3)，254-263 。

Cullen, D. J., Civetta, J. M., Briggs, B. A., & Ferrara, L. C. (1974). Therapeutic intervention scoring system: A method for quantitative comparison of patient care. Critical Care Medicine, 2, 57-60. doi: 10.1097/00003246-197403000-00001