基于流行病学调查和工时测定的急诊抢救室护理人力配置研究

Research on the allocation of nursing manpower in emergency room based on epidemiological investigation and working hour determination

目的通过流行病学调查和工时测定确定急诊抢救室的护理工作量,探讨其人力资源的合理配置。方法回顾性分析2017年1月—2019年12月北京市某三级甲等医院急诊抢救室收治患者的情况,编制护理项目观察表,培训观察员,采用观察法测量每项护理操作的平均工时及总护理工作量,进而对护理人力资源进行合理配置。结果2017年—2019年急诊抢救室共收治患者9735例,年龄以60~70岁居多(23.4%),以循环系统疾病患者为主(34.2%),患者抢救室中位滞留时间为0.94 d,收治患者高峰时间段为12:00—17:59和21:00—23:59。急诊抢救室护理操作项目涉及直接护理85项、间接护理18项,平均每例患者24 h护理项目总工时为411.13 min,理想床护比为1∶1.69,理想护患比为1.54∶1。结论急诊抢救室护理工作量较大,护士人力配置较为不足。护理管理者可根据患者人群特点,加强护士理论培训,增加人员配备,动态补充人力,优化队伍结构,改善医院支持系统,提高急诊抢救室工作效率。

Objective To explore how to allocate the nursing manpower resources reasonably by calculating nursing workload in emergency room through epidemiological investigation and working hour determination.Methods A retrospective analysis was made on the patients in the emergency room from January 2017 to December 2019.We designed the observation table of nursing items and trained the observers to measure average working hours and the total nursing workload of each nursing operation,then allocated the nursing human resources reasonably.Results 9735 patients were treated in emergency room from 2017 to 2019,mostly aged 60 to 70(23.4%).Diseases were mostly circulatory diseases(34.2%).The patient’s median stay length in the emergency room was 0.94 days,and the peak treatment time was 12:00—17:59 and 21:00—23:59.The emergency department involved 85 items of direct nursing procedures and 18 items of indirect nursing procedures.On average,the total work time of nursing care for each patient was 411.13 min per 24 h,the theoretical bed-nurse ratio was 1∶1.69,and the nurse-patient ratio was 1.54∶1.Conclusion Nursing workload was heavy and manpower was insufficient in emergency room.According to the characteristics of the patient,nursing managers should strengthen nurse’theoretical training,increase staffing,dynamically replenish manpower,optimize team structure,improve hospital support system and improve the work efficiency in emergency room.