| ObjectiveThe study aimed to measure the nursing working hour each day of 5 surgical wards in Sheng Jing Hospital of China Medical University. In order to make authorized nursing staff meet the needs of clinical nursing workload.MethodsBoth the field survey and the time recording action were used to observe and record the job content of 37 nurses working in the Hepatobiliary and Pancreatic Tumor Transplant ward(ward 1), the First Minimally Invasive Biliary Tract surgical ward(ward 2), Gastrointestinal surgical wards(ward 3), Colorectal Cancer Anus surgical wards(ward 4), Liver and Gall Breast surgical ward(ward 5)from July to October 2009. Measured positions included responsibility classes, auxiliary classes, admissions classes, morning and evening classes and night shifts. The database was established by EXCEL software. The use of hospital information system could check the frequency of charged nursing activity. The use of "nurses vacation details" brought the number of vacation days of ward nursing staff together in 2009 to calculate the maneuver coefficient. All parameters were brought into the manpower formula, finally required nursing staff were computed. SPSS16.0 statistical software was used to analyze sample and population's general information. The differences between the sample and the population in the age, education, title and the form of employment distribution were tested using chi-square test.Results1. There were no differences between the sample and the population in the age, education, title and the form of employment distribution. 2. Identified the average working hours of 30 charged nursing activity. The operation hours of intravenous blood sampling and enema were detailed.3. 46 items of free nursing activity were determined, which included 25 items of direct care activity and 21 items of indirect care activity. The most time-consuming items were measuring and drawing the temperature, writing nursing records, shift relief, disposal of preparation and processing of medical advice. The operation of "measure and draw the temperature" cost the longest time, for 1072min/24h.4. The charged and free nursing activity were subtotaled. The result showed ward 1 spent the most amount of hours on the charged nursing activity, which was 1619.4min.The ward 5 spent the least, which was 802.2min.The ward 3 spent the least time on the free nursing activity, which was 1279min,the other wards cost basically the same hours. The hours spent on the free nursing activity were far more than those charged nursing activity.5. The existing performance distribution software could not completely reflect the ward nursing staff workload. After increasing with the temporary liquid configuration time, all wards'workload were increased. Especially, the differences between the ward 3 and ward 4, from the original 83.5min reduced to 1.5min.6. In 2009 the number of leave days of investigated wards were 1052, which included the maternity leave, sick leave, marriage leave and personal leave. The days of maternity leave were 806, which accounted for 76.62% of total days. The number of people leave in ward 1 were 70 days, the number in ward 5 were up to 456 days.7. The maneuver coefficient calculated by the annual leave days of 2009 was less than 20%.The original nurses number of different wards was equivalent to 13 people. The required amount of nursing staff calculated by the nursing workload were different between different wards, which was more than the original number.8. A method of determining authorized nursing staff which suited to the investigated hospital was summed up.ConclusionClinical nursing workload can be determined scientifically by the measurement of nursing working hour. The amount of clinical nurses should be allocated according to the nursing workload.
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