- 期刊
護理師逾時下班之改善專案---台灣某醫學中心燒傷加護病房
Project to Improving the Nurses Working Overtime ----A Medical Center Burn ICU in Taiwan
摘要
目的：隨著燒傷病人數逐年減少，燒傷加護病房在醫院的政策中逐漸轉型為重症加護照護之角色，燒傷護理師必須同時面對多科別之重症、疾病複雜病人照顧情境。目前臨床護理師逾時下班情形普遍，而工時過長對護理師自身健康、病人照護等方面皆有負面影響。此專案為調查逾時下班現況，進行改善策略，降低逾時下班時間。方法：本專案自2014年4月至2014年12月止，透過柏拉圖及魚骨圖分析確立逾時下班主要因並進行對策措施，包括：（一）彈性調整照護之人力（二）改變交班方式（三）精簡護理記錄。結果：（一）依當班業務複雜度適當調整照護之人力之策略達100%；（二）統一交班方式，其操作率達96.7%；（三）完成一個護理焦點記錄所需時間從6.6分降為4.1 分；（四）完成一個病人紀錄時間從38.1分降為30.4 分；（五）每位護理師平均逾時下班時間從98.3分降低為43.8分，達專案之目標。結論：此專案改善策略可以推展至其他加護單位，使其能更了解護理工時及業務分工，減少逾時下班情形。
並列摘要
Objectives: Duo to decreasing the number of patients with burns. Burn intensive care unit gradually transitions to the role of the intensive care in the hospital policy, burns nurse have to face the multiple divisions of severe disease complex patient care situations. Now, clinical nurse overtime work situation in general, long working hours bring about negative impact on health and patient care. This project is investigating overtime to offer improve strategies to reduce working overtime.Methods: This project is from April, 2014 to December, 2014, through Plato and fishbone diagram analysis mainly reason of work overtime and Get on countermeasures, including: (a) flexibility to adjust care of human (b) change in shift mode (c) simplify care records.Results: 1. With appropriate adjustments to shift business complexity of Manpower's strategy up to 100% ; 2. Integrate with shift mode, the operating rate of 96.7%; 3. The completion time required for recording a nursing focus was reduced from 6.6 to 4.1 points, 4.The complete record time of patient was reduced from 38.1 to 30.4 points; 5.The average working hours per nurse overtime was reduced from 98.3 to 43.8 points, to reach the project's goals. Conclusion: The project's results can be extended to other intensive care units, so that it can better understand the business division, reducing overtime work.