護理人員延遲下班之改善專案

A Project to Improve Nurses Working Overtime

專案小組觀察收案之內外科病房護理人員常有延遲下班之情形，其每班平均總工時為9 小時7 分鐘，以人次計，延遲下班率高達64.4%。為避免延遲下班造成工作倦怠、工作滿意度低，而影響護理品質，故針對臨床護理活動做進一步分析改善。分析發現問題為：書寫記錄耗時、交接班耗時、給藥掃描不順暢、點班作業耗時、核對藥車內藥物耗時。為改善護理人員延遲下班之情形，藉由舉辦護理記錄、交接班、點班及掃描藥袋條碼等教育訓練，推行護理記錄資訊化操作、推行資訊化交接班作業、提升給藥掃描流暢度作業、簡化點班作業及取消核對藥車內藥物作業等解決方案。經專案實施，護理人員延遲下班率由64.4% 下降至28.8%，平均每班護理工時下降為8 小時37 分鐘，縮短30 分鐘，能簡化臨床護理工作流程，有效降低護理人員延遲下班率及每班護理工時。

This study investigated a work simplification program for nursing staff and the effect of its daily working hours on shift duration and the proportion of nurses working overtime. Currently, 64.4% of nursing staff in medical and surgical units work overtime, and the average shift duration is more than 9 hours and 7 minutes. To prevent the drawbacks associated with late working hours (which lead to job burnout) and low job satisfaction (which influences nursing quality), this study analyzed clinical nursing activities for improving nursing quality. According to the analysis, the factors attributed to the aforementioned problems are as follows: time-consuming processes for documenting medical procedures, inefficient shift handover procedures, inefficient medication scanning systems, and the necessity of inspecting numerous medical devices and the unit doses of medications. To prevent nursing staff in both medical and surgical units from working overtime, it is imperative to develop educational training programs on how to effectively organize medical records, efficiently conduct shift handover procedures, and efficiently inspect medical equipment and medications. Furthermore, nursing quality can be improved by developing nursing information systems for documenting and analyzing nursing records, developing shift handover modules within those nursing information systems, enhancing nurses’ skills in inspecting medications, simplifying the procedures involved in inspecting medical devices, and obviating the necessity of checking the unit doses of medications. These recommendations were implemented, and the results indicate that the proportion of nursing staff working overtime decreased from 64.4% to 28.8%, and the average shift duration reduced to 8 hours and 37 minutes, a decrease of 30 minutes. The developed program can simplify nursing tasks as well as efficiently reduce shift duration and the porportion of nursing staff working overtime.