急診室護理人力需求探討

A Study of Nurse Staffing Requirements in the Emergency Departments

張元玫(Yuan-May Chang) ； 李秋霞(Chiu-Hsia Li)

《健康與建築雜誌》 1卷4期 (2014/10) Pp. 75-80

https://doi.org/10.6299/JHA.2014.1.4.R8.75

摘要

背景：我國急診室護理人力以病人總數為設置標準的計算方式近20年來未有調整，近年來全球護理呈現有關人力不足現象，臨床經常性加班被用來填補護士空缺，導致護士身心疲累，醫療疏失增加，影響病人安全的主要原因。因此現有之人力設置標準是否仍能符合當前醫療市場發展的需要及達到病人安全照護需求實值得進一步探討。目的：探討急診室護理人員數現況與醫院評鑑護理人力設置標準及實際作業所需人力之差異。方法：以資料庫分析台北市5所區域級某醫院，自97年1月1日至97年12月31日止之急診室病人就診資料及護理人員延遲下班時間紀錄。結果：（1）依醫院評鑑標準，有3個院區的急診室護理人力配置不足數為1.9~3.2人，（2）以護理人員延遲下班時間推估，各院區護理人力配置不足數為0.7~2.2人，（3）依病人護理時數，各院區護理人力配置不足數為2.5~12.6人。結論與運用：急診室護理人員數現況與醫院評鑑護理人力設置標準及實際人力需求是不足的，管理者應依急診病人來診特性、護理人員事、病及分娩假和年休的需求及護理品管稽核等所需人力，適時調整護理人力，以提升病人安全。

關鍵字

急診室 ； 護理人力 ； 延遲下班

並列摘要

Background: Our nursing manpower of the emergency department had set the standard for the total number of patients around the past 20 years. In recent years, a global shortage of nurses' phenomena related to clinical nurses overtime which are used to fill the vacancy resulting nurses burnout, medical errors increase, the main impact of patient safety. So whether the standards of nurse manpower setting still meet the needs of the current medical market needs further study. Purpose: The purpose is to compare differences from the number of nurse staffing in the actual situation with the hospital accreditation in emergency department. Method: This study was collected the number of patient visit Emergency Department (ED) and staff nurses' working hours from five regional hospitals and also got IRB approval from January 1st, to December 31, 2008. Results: (1) According to appraisal standard of hospital, it had a shortage of nurse staffing in ED in the three regional hospitals, it showed short of nurse staffing 1.9 to 3.2 persons. (2) According to nurses overtime, it had a shortage of nurse staffing in ED in the five regional hospitals, it showed short of nurse staffing 0.7 to 2.2 persons. (3) According to patient hours, it had a shortage of nurse staffing in ED in the five regional hospitals, it showed short of nurse staffing 2.5 to 12.6 persons. Conclusions/ Implication for Practice: Short of nurse staffing in the actual situation with the hospital accreditation in emergency department to adjust nurse staffing based on patient conditions, promotes the patient safety. The nurse quantity have to considered maintain nursing quality of unit, and demand of staff nurse vacancies from sick leave, maternity leave and vacations, promotes nurses' of satisfaction.

並列關鍵字

Emergency department ； nurse staffing ； overtime