| [Objective] To formulate allocation standards of nursing human resources by defining the high quality nursing items and measuring nursing workload in high quality nursing wards.[Method]1. Determing items of the direct, indirect, related nursing, and designing expert consultation questionnaire through the literature review. Inviting nursing management experts from the A level in the third grade comprehensive hospitals in Nanjing to consult expert consultation questionnaire of the "high quality nursing items" by two-wheel Delphi expert consultations. Statistically analyzing the expert consultation results and determing the high quality nursing items.2. According to the Delphi expert results,recording the nursing time of all high quality nursing specialties with the method of observation by the researchers and the nurses in a third-level grade-A comprehensive teaching hospital in Nanjing from June to September in2012.30different qualification registered nurses from general departments by stratification sampling were chosen to operate the nursing operations. Each nursing operation were operated for30times and measured the average direct nursing hours. The "indirect nursing time sheets","indirect nursing time sheets" and "the related nursing time sheets"which were self-designed were distributed to each nurse in shifts, and the nurses should fill in and record them.The "indirect nursing time sheets"were used to continuouslly record the direct nursing operations and frequencies of30patients in each degree for one week or until they change the nursing level or discharge in all departments."The indirect nursing time sheets" and "the related nursing time sheets" were used to record the indirect and the related nursing time for one month. Measuring average daily direct nursing time, indirect nursing time and related nursing time, and calculating the workload and the allocation standards of all specialists according to the human resource establishment formula.[Results]1. A total of126nursing items of three categories which were direct, indirect and related nursing, were defined by two-wheel Delphi expert consultations.There were102direct nursing items,19indirect nursing items and5related nursing items.2. The daily direct nursing time of different nursing degrees in all specialists were different. The direct nursing time of first degree nursing patients was more than the secondary degree nursing patients. The proportions of basic nursing, disease observation and rehabilitation and health guidance are high.3. The daily indirect nursing time in all specialists was different. The hand-over, audit processing orders, Nursing records, items and drug management, disinfection sorting and ward management (such as dealling with problems, answering consulting) time constituent ratios were2.64%-12.70%、26.98%-49.36%、14.68%-37.34%、5.17%-14.86%.0.85%-15.78%'4.14%-36.12%..4. The average daily direct nursing time was about53.10%～81.51%, the average indirect nursing time was about17.63%-45.02%, and the average daily related nursing was about0.24%-1.89%.5. The bed-nurse ratios had a great difference among high quality nursing wards, and they were higher than the standarded of1:0.4making by the Ministry of Health.[Conclusion]1. The nursing project quantity and contents had the distinctive features of ages. There were102direct nursing items,19indirect nursing items and5related nursing items in our study.2. Clinical nursing workload increased greatly since the high quality nursing had carried out. Great changes had taken place in constitution of nursing time.The average daily direct nursing time was about53.10%-81.51%, the average indirect nursing time was aboutl7.63%-45.02%, and the average daily related nursing was about0.24%-1.89%in our study.3. The demands of nursing human resources were big in different specialists. The bed-nurse ratios were0.22-0.70in our study,and it was necessary to determine the nursing human resources allocation according to the characteristics of all specialists. |
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