Study On Establishing A Mathematic Model Of Nursing Workload On The Basis Of The Nursing Dependence Among Patients

ObjectiveThe study aimed at establishing a convenient, scientific and reasonable mathematic model for calculating nursing workload to predetermine different ward units nursing workload, to provide the rational basis for allocating staffs, planning, predetermine nursing manpower and making the reasonable fee standard.MethodsIn this study,thirty two items of indirect care time had been measured in a three level of first-class comprehensive hospital (not including the operating room, emergency room, ICU, and blood purification room) for one week. Commonly used direct care items were randomly tested5322person-times,and nursing dependence and activities of daily living (ADL) among patients were assesssed respectively. Direct care items associated with inpatients had been track recorded for24hours,and nursing dependence and ADL among inpatients had been assessed as well. We calculated24hours possible care time including direct and indirect care (using95%Confidence interval, CI) according to different levels of nursing dependence. We tried to establish a mathematic model of normal ward nursing workload according to the24hours nursing time that different dependence levels of patients required and four kinds monomial nursing time including admission, discharge, switch departments and surgical care. Results(1) There is different direct care time among patients of different nursing dependence levels. There is a Decrease Relationship between nursing dependence and direct care time (95%CI) as the nursing dependence is on the decrease. Variance Analysis shows the difference has significant statistics meaning.(2) There is different direct care time among patients of different ADL levels. There is a Increase Relationship between ADL level and direct care time (95%CI) as the ADL is on the decrease. Variance Analysis shows the difference has significant statistics meaning.(3) The mathematical model shows that daily nursing time in one ward including direct and indirect care time=A-I95%CI (including direct and indirect care time)×N1+A-Ⅱ95%CIxN2+A-Ⅲ95%CI×N3+A-Ⅳ95%CI×N4+B-Ⅰ95%CI×N5+B-Ⅱ95%CI×N6+B-Ⅲ95%CI×N7+B-Ⅳ95%CI×N8+C-Ⅰ95%CI×N9+C-Ⅱ95%CI×N10+C-Ⅲ95%CI×N11+C-Ⅳ95%CI×N12+admission care single time×N13+discharge care single time×N14+switch departments care single time×N15+surgical care for individual time×N16:That is, the daily nursing time within one ward=410(minutes, min)×Ni+213(min)×N2+187(min)×N3+149(min) xN4+193(min)×N5+156(min)×N6+128(min)×N7+104(min)×N8+132(min) xN9+130(min)×Nio+116(min)×Nn+82(min)×Ni2+23(min)×N13+17(min) xN14+33(min)×N15+50(min)×N16.Notes:N means number of patient; Ⅰ,Ⅱ,Ⅲ and Ⅳ mean level1, level2, level3and level4respectively. ConclusionsThis mathematic model for calculation of ward nursing workload shows pretty good representativeness, feasibility and conciseness because it is established by different levels of nursing dependence and four kinds monomial nursing time including admission, discharge, switch departments and surgical care.