| Research backgroundHealth human resource is the first part of the health resources, nursing human resource is the important component of human health system. Reasonable allocation of human and nursing care is still a topic that managers, experts and scholars have been studied and discussed , has not yet found a reasonable scheme. China now follow the standard of the draft issued by ministry 1978, which compiled by comprehensive hospital organization. The standard not only has lagged behind the requirements of The Times, and no classification, the formulation of standards. For how to configure hospital nursing staff, there are a wide controversy. though some nursing researchers developed several configuration management mode, but the results obtained are not widely used and is not suitable for other hospitals. For this reason, it is necessary for hospitals that reasonable nursing human resources configuration should be discussed the further research, and provids the scientific basis for new medical institutions nursing personnel allocation standard instituted by the health administration department .Research purposes1 Analysis of the internal structure characteristics of nursing staff in first-class hospital .2 Explores the problem of hospital nursing human resources situation , analyzes its cause and puts forward countermeasures and suggestions in first-class hospital.3 Determination of nursing staff working time in first-class hospital admission and understanding of clinical nursing workload in different specialty units .Research methods 1 Secondary data analysis method:1.1 Data sources:《The total table of nurse information》,《the table of hospital beds in various units》,《the statistics table of hospital periodic work》.1.2 The data processing methods:Using constituent ratio describe nursing human resource distribution in 12 hospital units. Chi-square is used in statistical analysis of 12 units of nursing staff qualification, titles and age.2 On-site investigation2.1 Survey tool: The tables of 6 kinds records of nursing working time include following projects: information table of nursing basic situation 12 units; working table of each weekend; statistics table of beds number utilized ;the table of direct or indirect nurses working time ;the statistics table of direct or indirect nursing project .2.2 Survey methods: using the site investigation and determination of operating time summarize random 12 hospitalization units. training 20 observer, observers in 2 period of time(12 months, and 1 month) follow-up and observe various nursing activity to night and day nurses with unified specification timer , work with each project and frequency per day are recorded .1-2 divisions are tracked, each time of each units is tested for 2 weeks. Finally recorded data will be classified.2.3 calculation and statistical analysis, calculation formula: total nursing working time = care average time X operating frequency; The average each patient day need nursing time = (directly nursing time of every day+ indirect nursing time )/total patients; nurse numbers of need = bed numbers x using rate of bed numbers x (average rate of each berth on patients need care hours / 60min) x (1 + rest coefficient 0.4 + motor coefficient 0.2) /8h work, All the sample data input Excel2003, and PEMS 3.1 statistical software is applied to description, normal analysis and t test. Results1 Academic qualification of nursing staff in 12 units was diamond distribution. There was no nursing master degree, undergraduate , junior college and secondary specialized school accounted for 19.42% ,59.22% and 21.36% respectively. Although the hospital nurse degree level has reached the national requirements, but the lack of nursing staff master or doctor degree is serious . Enhancing clinical nurse degree through training certain proportion of the nurses master or doctor degree has a pivotal role in hospital nursing scientific research level and handling complicated problem .2 Age of nursing staff in 12 units was diamond distribution. One of 24 years or less, 25-34 years , 35-44 years and more than 45 years old accounted for 25.24% ,55.34%,17.48% and 1.94% respectively. On the whole, the nurse who lack age 34 accounted for 80.58% of total number of nurses, and more than 45 years old nurses in 12 units were only four. Hospitals have a lot of work to strengthen in attracting investment clinical nurse and reducing the backbone nurse drain .3 In according to statistics of Health in 1995 ,the ratio of the national deputy director nurses,senior nurses and junior nurses is 1:30:206. but the ratio of the hospital is 1:42:310 ,and the proportion of 12 units is 0:28:75. Nurses nursing professional titles is lack .we hope to formulate corresponding management rules that nursing personnel can work according to the title and is given full play to the rich experience and knowledge with clinical complex situation .4 206 nurse of 12 units includes formally nurses and flexible employment, flexible employment nurse accounts for 19.90% of nurses. They are formal graduates from technical secondary school, and no more than 30 years. they are the first important clinical backbone strengths.5 Through evaluating ,patients need following working time: indirect nursing working time 87.78±159.36 )min, direct nursing working hours (121.04±342.32)min, t = 2.741 , P﹤0.01. The most time-consuming nursing hours of 10 sorting, direct nursing project is 6 items, indirect nursing project is four.6 The selection of 12 units hospital , the original 206 nurses is less than average bed and their ratio is 1:0.41 . By this survey, it is essential to increase 59 nurses. The ideal proportion between nurses and bed is 1:0.52.Conclusion1 As soon as possible we should formulate new ratio standard between nurses and bed in medical institutions .This research suggests that the rational proportion should be 1:0.52 in comprehensive hospital . the largest ratio is nerve medicine and the smallest one is bone surgery .2 To establish and perfect the hospital nursing care and increase the technical support system of gold.The following measures should be suggested to solve higher proportion problems in unskilled jobs and low technical content jobs .(1) Medical supplies distribution center should be established, it may deliver various drugs, specimens, other medical business documents , shipping patients to check ,therapy and surgical (2) It should be suggested to established drug compound center . Nurses will be liberated from heavy intravenous former preparations. (3) A certain number attendant should be engaged from regular nurse school graduates.3 reasonable allocation, flexible scheduling, improving the status quo Of the clinical nursing staff relative deficiency.To make full use of the existing nursing human resource, elastic scheduling watches and reasonable allocation must be performed. |
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