降低一般內科病房白班護理人員逾時下班率之專案

Project for Reducing the Day-shift Nurse' Amount of Overtime in General Medical Ward

劉淑慧(Shu-Hui Liu) ； 吳鳳美(Feng-Mei Wu) ； 陳靜儀(Ching-Yi Chen) ； 施淑君(Shu-Chun Shih) ； 李雅文(Ya-Wen Lee) ； 康宜靜(I-Ching Kang)

《若瑟醫護雜誌》 13卷1期 (2019/06) Pp. 38-50

摘要

護理人員常逾時下班，易導致身心疲乏、工作滿意度下降，進而影響照護品質。本單位護理人員因護理照護工作繁雜等因素延遲下班，統計2014年6月至8月白班逾時下班率高達83.7%，引發進行本專案動機。經分析主因為書寫護理記錄過程效率差、換藥及困難傷口病人多、非專業性護理照護工作繁重、血液採檢病人及項目多、交班效率不佳，故本專案目的在改善白班護理人員逾時下班率。經由採用電腦資訊簡化護理記錄書寫、專科護理師協助換藥、部份檢體由抽血小組協助、護理助理師人力運用、運用ISBAR模式簡化交班等對策方案介入；白班護理人員逾時下班率降至42.1%。故工作流程再檢視與簡化、輔助人力運用，對改善護理人員逾時下班有顯著幫助。

關鍵字

一般內科病房 ； 護理人員 ； 逾時下班

並列摘要

Nursing staff often work overtime, which commonly leads to fatigue and increased dissatisfaction with their work, thereby influencing the quality of their work. In the unit under study, nurses were delayed from leaving work by the complexity of their work and other factors. From June to August 2014, the frequency of overtime work was as high as 83.7%. This statistic motivated the development of this project. According to our analysis, the main reasons behind the high frequency of overtime work involved poor bookkeeping efficiency, the high number of patients requiring more complex care and dressing changes, the significant amount of non-specialized work, the necessity of acquiring blood and other samples from patients, and inefficient handovers. Therefore, this project aimed to reduce the overtime hours of daytime nursing staff. By using computers to simplify bookkeeping, having specialist nurses to help with dressing changes, having the workers who drew blood also collect other samples, using nursing assistants, using the ISBAR system to facilitate handovers, and applying other countermeasures, we decreased the frequency of daytime nursing staff's overtime work to 42.1%. This result showed that the re-examination and simplification of the workflow and the use of assistant staff have significantly improved the situation.me.

並列關鍵字

general medical ward ； nursing staff ； overtime

參考文獻

黃薇萱 2012。護理人員超時工作與疲勞之相關性分析(碩士論文)。取自華藝線上圖書館。

Geiger-Brown J, Trinkoff A, Rogers VE: The impact of work schedules, home, and work demands on self-reported sleep in registered nurses. Journal of Occupational & Environmental Medicine 2011; 53: 303-307.

劉曉君、黃于芳、鍾淑媛、張月娟：護理人員逾時下班改善專案。志為護理 2011；10：74-82。

Bae SH, Fabry D: Assessing the relationships between nurse work hours/overtime andnurse and patient outcomes: Systematic literature review. Nursing Outlook 2014; 62: 138-156.

馮容莊、林碧珠：探討護理人員延遲下班之相關因素。榮總護理2010；27: 10-19。