Research On The Allocation Of Nursing Human Resources In A Large General Hospital

Human resource is the first important part of health resource, and nursinghuman resource is the key element of the health human resource. Theallocation of nursing human resources is not only related to patients’ vitalinterests, but also influences nursing staff’s enthusiasm and the stability of thenursing team, ultimately affects the long-term development of the hospital. Atpresent, there exists a serious shortage and unreasonable allocation of nursinghuman resources. How to reasonably allocate the nursing human resource inorder to satisfy the current hospital medical need and improve the quality ofnursing care, becomes an outstanding problem in nursing management studies.This study has two parts: fristly, an investigation into the job satisfactionand burnout of nursing staff was started. Secondly, we used Observation andDelphi method to survey the working time of frequently-used nursing skillmanipulation items and the nursing workload in42departments or wards. Finally, based on the workload estimates, we draw the ratio of the sickbednumber and the number of nurse staff which can satisfy the needs of nursingworkload and nursing care requirement.Main results of the study:1. The total seore of job satisfaetion, working condition, work relationshipsubscore and the emotional exhaustion subscore in burnout factor were in thegeneral level. And it showed high levels of depersonalization and reducedpersonal accomplishment.2. We studied that the daily working hours of department or ward werelonger than standard working time. The average actual operating time of theday shift nurses was7.24±0.60hours, evening shift nurses was7.47±1.42hours, night shift nurses was6.37±1.60hours, stay the night shift nurses was7.25hours,and Auxiliary night shift nurses was6.83hours.3. Besides the actual operating time of the three items, venous catheterinfusion, shampooing in bed and patients handover, was longer than thestandard operating time, the average actual operating time was45.37%lessthan the standard time. Thereinto, the actual operating time of the9items,such as hospitalizing education, education of patients discharge, preoperativeeducation, and so on, was cut by more than70%.4. At present the number of bed was1712in clinic department undersurvey. The number of nursing staff at present was781and the ratio of thebed-nurse was only1:0.46. By the research results, the scientific numbershuold be1335and the bed-nurse ratio should be1:0.78. Each departmentexisted different degree of shortage, the range of shortage number was from4to41persons and the added number was554, the average percent of lackage was41.50%.5. The ratio of bed/nurse in internal medicine departments was1:0.35, theratio in surgical departments was1:0.34, and that in ICU department was1:1.40. They were not getting the standard ratio which Promulgated by theMinistry of Health in1978. And our research results show that, the ratio of thebed-nurse in internal medicine departments should be1:0.62, the ratio insurgical departments should be1:0.63, and that in ICU department should be1:2.08.The conclusions of this research are as follows:1. The job satisfaetion of nursing staff in this hospital was in the mediumlevel, but the job satisfaction to nursing hours was not high, and the degree ofburnout in nurses is quite serious. From which we can see this hospital didn’thave enough staff and required reasonable allocation of human resources.2. Nurses in most departments under research worked longer thanstandard working hours a day. It showed standard time of workload can’t meetthe need for nursing of patients. Shortage of manpower was an importantfactors which influenced the nursing quality.3. The actual operating time of frequently-used nursing skill manipulationitems was shorter than the standard operating time, which showed a problemon the hospital nursing service quality. With insufficiency of personnel, nurseshad to cut the nursing care time offered to each patient in order to complete theheavy task. That caused a sacrifice of the nursing work quality. It revealed theimportance of reasonable nursing staffing on enhancing the nursing quality andthe competition of the hospital.4. The ratio of bed/nurse in this hospital was not getting the standard ratio which Promulgated by the Ministry of Health in1978. To satisfy the nursingcare needs, the ratio of the bed-nurse in internal medicine departments shouldbe1:0.62, the ratio in surgical departments should be1:0.63, and that in ICUdepartment should be1:2.08. The quantity of nurses allocated and bed-nurseratio can be referred to nursing staffing in each department.