| Objective: To research a scientific and reasonable method of measuring clinical nursing workload, comparing the facticity and objectivity of Delphi methods and man-hour method in measuring clinical nursing workload. To measure the actual nursing workload of the First Affiliated Hospital of Medical college of Shihezi University, find the difference of nursing workload among sections in order to understand the current status of clinical nursing workload, so as to evaluate the intensity of nursing work indirectly, and to offer objective evidence for management of nurses resource.Methods: Adopting the observation, interviews as well as the Delphi methods to practice this study. The use of Delphi methods, to quantify the intensity of nursing work, clinical nursing workload survey to evaluate the intensity of nursing work.. Reading the related articles of clinical nursing workload both of home and abroad, to understand the current status and development in this field. The nurses were selected randomly means of group sampling in ICU, Emergency Department, Pediatrics, Gynecology, Cardiology Department, Digestive and Endocrine Department, Hepatobiliary Surgery, Cardiothoracic Surgery of the First Affiliated Hospital of Medical college of Shihezi University, All the calculation and statistics were performed with the computer program, SPSS version 13.0.Results: The best working hours is of 45 hours of per work units , that means within every person works 45 minutes effectively per hour. By measuring the workload and intensity of nursing, we calculated that the intensity of nursing is 7 fold of nursing workload,and the best work intensity is 315 per hour. The workload and intensity of nursing in the first and the second sections both are full-load, more than ideal values, even overload; the workload and the intensity of nursing which pick-up in the fourth time slots decreased significantly in the third time slots, then dropped again in the fifth time slots, and increased significantly in the 6,7,8 time slots, in addition to the ICU, the intensity and workload of nursing decreased in the various sections in the 9,10,11,13 time slots, reached a peak in the 12 time slots. when compared the average daily nursing workload and intensity through 13 time slots in a whole week, the largest one is in the ICU, Cardiology Department, Cardiothoracic Surgery ,while Gynecology and Hepatobiliary Surgery are in minimum.Conclusion: The workload and intensity of nursing, which is different during the different time slots in the same sections,is not exactly the same among different sections in same time slots. Though in the same period,the intensity of nursing is also diverse. The average daily nursing time is longer than standard, the nursing staff worked overload and undertake too many practices, especially indirect works such as writing of nursing file and mixing drug and so on, which affects the working efficiencies. The difference of nursing workload and intensity also depends on time slots ,shift model; The investigation also indicated that the nursing articles are invalid and responsibilities of nursing workers are not clear. We claim that no technical nursing articles are practiced by the primary nurse instead of the advanced nurses. These evidences suggest that the grading nurse management has not yet be performed in the classification of nursing practices which result to the waste of human resources. To ensure the safety of care, and promote quality of nursing continuously. Study of intensity of nursing is still in its infancy stage of currently, the majority methods of comparison concentrated in the measurement of nursing workload. when caring patients with different illness, the work of nurses is not the same intensity at the same time. The weighted methods of evaluation intensity of the work is more representative, sensitive and reliable, the actual evaluation of the nursing intensity would be more objective in reflecting the difference between different department. The workload of differences and we could evaluate the workload of nurses not just from nursing time but from all sections that seems more objectively. It suggests that we should set up nursing resources in accordance with Nursing labor intensity dynamically (flexible scheduling), in order to allocating nursing resources more reasonable, to resolve or alleviate at less the labor intensity of nursing. |
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