基于工时测量法构建的产科病房护理人力资源配置模型

发布时间：2018-04-19 01:06

本文选题：产科 + 护理人力资源　；参考：《昆明医科大学》2017年硕士论文

【摘要】：[目的]护理人力资源是医疗卫生人力资源的重要组成部,高品质的护理质量需要充足的人力来保障,护理人力的不足会导致护理人员工作负荷过重、工作压力过大,造成护理人员身心疲惫、工作满意度降低、职业倦怠感明显、离职现象严重,影响到医院护理质量[1]。产科作为特殊科室,护理对象包括孕产妇和新生儿,不能单纯地按照孕、产妇的床位数计算应配置的护理人员数量,还应考虑到护理人员花费在新生儿护理方面的工时[2],所以,本研究旨在通过测量产科病房实际工作量,构建产科病房护理人力资源配置模型,为我院产科护理人力资源的配置提供可靠、科学的依据。[方法]本研究包括三个阶段:第一阶段:选取10名护理专家通过问卷调查的方法进行德尔菲专家咨询构建出产科病房护理工作量测量表、产科病房护理人力资源配置影响因素调查表、产科护理人力资源配置现状调查表。第二阶段:采用跟班的形式,通过产科病房护理工作量测最表测量2016年7月至 2016年10月期间120天内120名住院孕产妇的直接护理工时、间接护理工时、个人活动工时;通过产科病房护理人力资源配置影响因素调查表收集测量期间120天内各护理人力资源配置影响因素的数据;通过产科人力资源配置现状调查表了解产科护理人力资源配置现状。通过Microsoft Excel 2010建立数据库并利用SPSS 21.0进行统计分析。第三阶段:通过SPSS 21. 0对所收集的数据进行分析,将产科病房的实际护理工作量与影响产科病房护理人力资源配置的影响因素相结合利用多重线性回归分析构建产科病房护理人力资源配置模型。[结果]1.产科病房实际床护比仅为1 :0. 3,未达到国家要求的标准。2.产科病房护理人员年龄结构年轻化,以25～34岁为主;学历结构基本合理但缺乏硕士及以上高学历人才;职称结构未达到W.H.O所规定的初、中、高级职称比1:4:1的比例。3.采用工时测定法测量护理工作量得出,产科病房床护比应达到1:0. 53才能满足实际护理工作量的需要。4.通过比较各项直接护理工时、间接护理项目操作耗时发现,直接护理项目“接收新入院孕产妇”及间接护理项目“算住院费用”单项操作耗时最多。比较不同住院日孕产妇人均直接护理工时发现,住院第二日直接护理耗时最多。不同工作日孕产妇人均间接护理工时、个人活动工时比较,差异无统计学意义。5.产科病房护理人力资源配置模型为:所需护理人员数量=日住院孕产妇数X0. 527+0.010[结论]我院产科病房存在护理人力资源配置不足、内部配置结构不合理的问题。要满足目前产科病房实际护理工作量的需要,应根据护理人力资源配置模型动态配置护理人员数量并且优化护理人力资源配置结构,为产科病房配置数量合理、质量过硬的护理队伍,才能为孕产妇及新生儿提供优质高效的护理服务,提高孕产妇住院满意度。
[Abstract]:[objective] Nursing human resources is an important part of medical and health human resources. The high quality nursing quality needs sufficient manpower to ensure the quality of nursing. The shortage of nursing manpower will lead to excessive workload and excessive work pressure of nursing staff.It caused mental and physical exhaustion of nurses, decreased job satisfaction, job burnout and serious turnover, which affected the quality of nursing care in hospitals [1].Obstetrics, as a special department, includes pregnant women and newborns, and cannot simply count the number of nursing staff to be allocated according to pregnancy, the number of beds for mothers, and also take into account the hours spent by nursing staff on neonatal care [2], so,The purpose of this study was to provide reliable and scientific basis for the allocation of obstetric nursing human resources in our hospital by measuring the actual workload of obstetrical wards and constructing a model of nursing human resources allocation in obstetrical wards.[methods] this study included three stages: the first stage: 10 nursing experts were selected to construct nursing workload scale by Delphi expert consultation.The factors influencing the allocation of nursing human resources in obstetrical wards and the present situation of the allocation of human resources in obstetrics wards were investigated.The second stage: the direct nursing hours, indirect nursing hours and individual activity hours of 120 pregnant women in hospital during the 120 days from July 2016 to October 2016 were measured by the most table of nursing workload in obstetrical wards in the form of following shift.Through the questionnaire of influencing factors of nursing human resource allocation in obstetrical wards, the data of influencing factors of nursing human resource allocation in 120 days were collected, and the present situation of obstetric nursing human resources allocation was understood through the questionnaire on the present situation of obstetric human resources allocation.The database was established by Microsoft Excel 2010 and analyzed by SPSS 21. 0.The third stage: pass SPSS 21. 1.0 analyzing the collected data, combining the actual nursing workload of obstetrical ward with the influencing factors of nursing human resource allocation in obstetrical ward, using multiple linear regression analysis to construct the model of nursing human resource allocation in obstetrical ward.[result] 1.The actual bed care ratio in the maternity ward was only 1: 0.3, does not meet the national standard.The age structure of nursing staff in obstetrical wards was younger, mainly 25 ~ 34 years old; the educational background structure was reasonable, but lack of master's degree and above; the professional title structure was not up to the initial level stipulated by W.H.O, the ratio of middle and senior professional titles to 1:4:1 was .3.The ratio of bed to nurse in obstetrical ward should reach 1: 0.In order to meet the needs of the actual nursing workload.By comparing the working hours of direct nursing, it was found that the operation time of indirect nursing project was the most time-consuming, the direct nursing project "receiving new admission pregnant women" and the indirect nursing project "calculating hospitalization cost" took the most time.Comparing the working hours of direct nursing of pregnant and lying-in women with different days of hospitalization, it was found that the second day of hospitalization was the most time-consuming for direct nursing.There was no significant difference in indirect nursing hours and individual activity hours between pregnant and parturient women during different working days.The model of nursing human resource allocation in obstetrical ward is: the number of nursing staff required is equal to the number of pregnant and lying-in women in hospital per day X 0.Conclusion: there are insufficient allocation of nursing human resources and unreasonable internal configuration in obstetrical wards of our hospital.In order to meet the needs of actual nursing workload in obstetrical wards, the quantity of nursing staff should be dynamically allocated according to the model of nursing human resources allocation and the configuration structure of nursing human resources should be optimized so as to allocate the quantity of obstetrical wards reasonably.In order to provide high quality and efficient nursing service for pregnant women and newborns, the quality of nursing team can improve the satisfaction of pregnant women in hospital.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.71

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