運用技術混合照護模式於臨床照護之成效

Evaluation of Skill-Mix Nursing Model in Patient Care

孫培蕾(Pei-Lei Sun) ； 顏芳慧(Fang-Hui Yen)

《榮總護理》 27卷1期 (2010/03) Pp. 1-9

https://doi.org/10.6142/VGHN.27.1.1

摘要

使用技術混合照護模式來減少醫療成本及解決護理人力不足之問題是醫院管理的趨勢。故本研究目的在比較實施技術混合照護模式前後，在各項病患照護指標（包含壓瘡盛行率、發生率、癒合率，跌倒發生率，感染密度及感染率）之成效。研究方法以方便取樣選取南台灣某醫學中心4個內科病房，於2007年1-12月運用技術混合照護模式提供病房白班一位團體照顧服務員，再與2006年1-12月各項病患照護指標資料加以分析比較。研究結果：團體照服員在臨床之主要工作是以協助病患日常生活照顧為主；而實施技術混合照護模式後除了壓瘡盛行率達到顯著下降之外，其餘在壓瘡發生率、癒合率，跌倒發生率，各項感染密度及感染率上皆無顯著差異。於臨床實務之應用：實施技術混合照護模式可降低病患壓瘡盛行率，但其他方面未能見到成效。建議醫療院所在使用技術混合照護模式時，除了考慮人事成本外，應採用適當的人員配置、明確訂定照顧服務員的工作項目，並持續監測臨床照護品質。

關鍵字

技術混合照護模式 ； 照顧服務員 ； 病患照護指標

並列摘要

Background: Many hospitals use skill-mix model in patient care to reduce medical cost and resolve nurse staffing shortage problem. Purpose: To compare the indicators of patients' care (including prevalent rate, incident rate, and healing rate of pressure sores; falling rate of patients; the density and rate of nosocomial infection) before and after implementing the skill-mix nursingmodel. Methods: A nonprobability sample was obtained from four medical wards of a medical center in South Taiwan. Skill-mix nursing model was utilized by providing a nurse aide per ward during dayshift from January 2007 to December 2007, and the result was compared with patient outcome data from January 2006 to December 2006. Results: The results showed that nurse aides were the patients's daily care. After the intervention, only the prevalent rate of pressure sores declined while there was no difference noted in other indicators. Conclusions/Implications: We suggest setting appropriate staffing (the ratio between nurse and nurse aide), defining clearly job scope of nurse aide, and consistency in monitoring patient outcome when using skill-mix nursing model in hospitals.

並列關鍵字

skill-mix model ； nurse aide ； patients' outcome