目標:本文旨在探討護理之家住民照護活動的項目及其成本。 方法:首先研究人員至台北市某醫院附設護理之家觀察、記錄及分析護理之家照護活動項目,據以設計「住民照護活動項目表」,其次從工作人員中挑選工作年資一年以上而且照護技術成熟穩定的工作人員二十三位為研究觀察對象,採連續直接觀察法,由兩位經過練的觀察員採一對一的方式,記錄研究對象被觀察日當天其實際提供各項照護活動的次數、所需時間及其耗用的材料種類和數量,最後再以Microsoft Excel軟體進行資料整理與分析。 結果:照護活動測量總次數最多的前五名序為填寫記錄、給藥、排藥、翻身及送餐;照護活動項目實際成本(包括人力成本及材料成本)最高的前五項依序為出院護理、呼吸問題處理、靜脈注射、上腸胃道出血及溫水拭浴。 結論:研究結果可建立護理之家住民每一照護活動項目的標準時間及成本,提供護理之家經營者人力配置、改善作業流程、住民分類及訂定收費標準之參考。 建議:建議護理之家經營者為對使用頻率多及人力成本高的照護項目應研發更有效率的工作方法,以降低營運成本。
Objectives: This study aims to explore the attending activities of nursing homes and related costs for residents of nursing homes. Methods: First, a table of attending activities for residents of nursing homes was developed based on on-site observation, recording and analysis of the attending activities performed in nursing homes. Next, 23 attendants with at least 1 year of work experience in nursing homes and who were with proficient attending skills were selected as target subjects. Two trained observers then recorded not only the number and frequency of attending activities performed by attendants each day during the observation method, but also the kinds and numbers of materials consumed during the activities. Finally, Microsoft Excel was used to conduct the data analysis. Results: The five most frequently performed attending activities were recording information, delivering medication, arranging medication, rolling the patient over, and delivering meals. The five most costly attending activities (in terms of both salaries and material costs), were discharging nursing, respiration related issues, venous injection,upper gastrointestinal bleeding, and bathing. Conclusions: The findings of this study can help managers in nursing homes arrange human resources, amend regular procedures, classify residents, and impose standardized fees through the establishment of time tables and costs for attending activities performed in nursing homes. Suggest: This study suggested that managers in nursing homes develop effective methods for conducting high-frequency and costly attending activities to reduce operating costs.
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