患者分類護理在泌尿外科護理人力資源配置的效果評價*

□ 楊嬌弟 YANG Jiao-di 沈瑩瑩 SHEN Ying-ying 吳陳丹 WU Chen-dan 葉青 YE Qing

Objective To explore the effect of patient classification in nursing human resource allocation in urology department. Methods The patients in the urology department was classified using nursing item frame table combined with the disease characteristics of the urological patients. Then the number of nurses needed for the nursing hours was calculated. The average length of nursing per patient and nurses' satisfaction were compared before and after the adoption of patient classification. Results After the adoption of patient classification, the average length of nursing per patient was 168.39±15.26 minutes, which was significantly lower than that before adoption of 240.83±20.51 minutes (p＜0.05). After the adoption of patient classification, the satisfaction score of nurses was 95.32±5.27, which was significantly higher than the 83.27±4.19 of before, and the difference were statistically significant (p＜0.05). Conclusion Patient classification is effective in nursing human resource allocation of urology department with shortening the average length of nursing per patient and improving nurse satisfaction.

護理人力資源是否合理，決定了臨床護理質量，并影響著護理學科發展[1]。目前，我國醫院護士總配比采用1978年原衛生部規定的床護配置標準，即臨床總體床護比為1∶0.4，這與臨床實際護理工作有出入[2]。目前國內大型醫院普遍存在床位使用率高、專科特點突出、護理工作量大等特點，如果按此規定比例配置護士數量，可導致臨床護理人力缺乏與浪費共存等不良現象[3]。如何有效、科學配置護理人力資源，實現優化管理，是護理管理者關注的問題[4]。范媛等[5]將兒童早期預警評分應用到PICU護理人力資源配置中，提升了護理質量和醫護人員滿意度。我院泌尿外科探索利用患者分類護理來改善護理人力資源配置管理，取得很好效果。

對象與方法

1.研究對象。選取我院泌尿外科護理人員為研究對象，納入標準：(1)取得護士執業資格證書；(2)年齡≥18周歲；(3)工作年限≥1年；(4)對本研究知情同意，且自愿參與本研究者。排除標準：(1)實習、進修、休產假等原因者；(2)無法溝通交流者；(3)中途退出者；填寫問卷有明顯規律或漏填＞20%者；(4)專職從事護理管理和護理教育者，最終納入25例。

2.干預方法。(1)組建護理管理小組：組長由護士長擔任，組員為4名高年資從事護理管理、護理教育的人員，現均不參與臨床護理工作。前期, 由組長對組員進行培訓，同時,一名臨床護士對護理操作進行計時，記錄護士操作內容，與4名組員交流，保證同一項操作時間差控制在10秒內。(2)構建泌尿外科護理項目框架表：研究者通過查閱文獻[8]，結合泌尿外科護理特點制定護理項目框架表?！?br>