護理人力評估系統方法之探討

THE METHODOLOGY OF STAF－FING EVALUATION

護理人力需求的評估，一直是行政主管經常探討的問題，目前被認為較科學也較客觀的護理人力評估法是採用病人分類系統來估測。本文即藉著病人分類系統的發展過程，提出一個護理人力評估系統的研究架構並探討其方法，作為未來發展病人力推估上的良好指標，在研究架構中含蓋四大精神：一是兼顧病患嚴重度不同就應接受不同量的護理照顧，及護理人員負荷過程就應減少照顧病人數的兩大概念，二是提供一個檢討改進護理業務的機會３是事先訂定研究工具的限制，規範病患護理時數的範圍僅包括直接護理及變動性間接護理，四是指出護理人力評估應隨科技、工具的改進作修正，以符合實際需要。在方法上則分三方面探討：先系統性評估病患護理需要，依病患嚴重度分級，測出個不同等級病患所需的護理時數；再利用瞬間觀察法，觀察護理人員工作活動情形，了解各類護理工作的時間分配，訂出護理人員應負荷的病患護理時數；兩者相互配合即可計算人力，以提供人力分配和編制的參考。

Staffing evaluation is prevalently discussed by nursing executives. So far, the most scientific and objective measures to evaluate nursing staffing is that via patient classification system（PCS）.This article sought to submit a research framework of staffing evaluation approached by PCS and , then,explore the methodology. It provides a nice conductor to develop PCS, evaluate patient nursing care needs, in addition, predict staffing. There are four dimensions in the research framework: first, considering both patient illness severity and nurse’s workload; second, providing an opportunity to improve clinical nursing affairs; third, setting up the limitation of the research instrument which only includes direct and constant indirect nursing care; forth, pointing out staffing evaluation should be able to modify due to the promotion of nursing technique. Moreover, methodology consists of three sessions: measuring nursing hours of different severity in patients by evaluating their nursing care needs systematically, setting up the workload hour of staff according to work-sampling nurses” activities, and finally predicating manpower by the first two sessions.