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  • 學位論文

護理人員輪班最佳化模式之研究-以某醫學中心病房為例

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指導教授 : 顏上堯
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摘要


近年來,因為經濟發展快速,大眾生活水平逐漸提升,但伴隨而來的是各種文明病及癌症問題,使民眾非常仰賴醫療體制,在醫院的編制中,護理人員是醫院單位編列人力資源最多單位,但隨著長時間輪班及睡眠品質不良,多數人不願從事護理工作,導致醫療單位嚴重缺乏護理人員的問題。除了改善護理人員勞動工作問題是人力管理最重要的議題外,護理人員多寡將是影響醫療品質的主要因素之ㄧ。現今護理人員輪班以三班制輪值為多數,加上醫院工作特性具備每日24小時及全年無休形態,以往人力指派,大多由各單位護理長依經驗判斷,採人工排班方式,容易有個人主觀意識及人員喜好而影響班別公平性、未經科學方法客觀判斷性、且人力排班需花費較多時間。 本研究針對以上問題以中部某醫院病房為範例,建構以最佳化與數學模型,運用LINGO-12套裝軟體以0-1整數規劃模式求解護理人員最平均工數與人力指派最佳化,更加入勞基法對於護理人員工作期間懷孕及哺乳限制要求。經研究後發現本模式較人工經驗指派方法為優,其成果顯示本研究指派模式之效益佳且公平性,可做為醫療單位對於護理人員人力指派實務上之參考。

並列摘要


In recent years, raid economic development and gradually promotion of public life level may be come along with various civil diseases and cancer problems, causing that people rely lots on medical care system. Nursing personnel is in a unit with most cost budgeting for human resources in the organization of hospital unit. However, the relevant personnel is unwilling to engage in nursing working as long time shift and poor sleep quality, resulting in serious shortage of nursing personnel. In addition to the most significant issue of manpower management for improving the labor work problem of nursing personnel, the number of nursing personnel is the main factor that may influence on healthcare quality. Today’s nursing personnel on three-shift rotation basis is the majority, combined with the hospital operating characteristics of 24 hours per work day and the whole day through. In the past, manpower assignment is mostly adopted by head nurse in each unit with manual work scheduling in accordance with his/her own experience. Individual subjective consciousness and personnel preference could be easy to influence on fairness of work scheduling. Meanwhile, manual work scheduling without objectivity through scientific judgment might spend much more time. Aiming at the aforesaid problems with example of a ward in one hospital of central Taiwan, this study constructed optimized mathematical model by using LINGO-12 software package based on liner 0-1integer programming to solve optimization of the most average man-hour and manpower assignment, and further adding nursing personnel’s pregnancy during working period and requirements of breastfeeding limit in accordance with Labor Standards Act. The study found that this mode is superior to manual assignment with experience, and the outcome showed this assignment mode is more effectiveness and fairness, which can be used for medical unit’s practical reference of nursing personnel assignment.

參考文獻


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