急性病房護理照護活動與照顧時間之探究

Analysis of Nursing Care Activities and Time Spent on Nursing Care in Acute Wards

臨床護理照護活動項目繁雜且病人平均護理需求增加，人力配置攸關護理照護品質。本研究旨在調查急性病房護理人力配置概況及瞭解護理師護理照護活動內容及照顧時間。本研究的方法採回溯性研究設計，取南部某醫學中心急性病房26個單位電腦資料庫資料，再以SPSS 20.0進行資料鍵入與統計分析。結果顯示急性病房護理照護活動前五名，排序為給藥、護理評估、檢體收集、交班及護理指導項目；每日照顧時間耗用最多的前五名，排序為護理評估、交班、給藥、檢體收集及護理指導項目。三類護理照護活動中，以「照護類」的平均照顧時間最高，「處置類」次之；四大科室中，以「內科」平均每日照顧時間最高，「外科」次之，綜合科最低。內科為護理照護活動與照顧時間耗用最高的單位，除提供適當的護理人力外，建議導入資訊科技將急性病房護理人力做有效的調派，緩解臨床護理人力短缺問題。

Given that clinical nursing care is complex and patients’nursing needs are increased, the allocation of nurses is critical to the quality of nursing care. This retrospective study determined the manpower allocation for nurses in acute wards, the content of nursing care and the time spent on nursing care. Data collected from the computer database for acute wards in 26 units at a medical center in southern Taiwan and was analyzed using SPSS 20.0.
The results showed that the top five activities for nursing care in acute wards were administration of drugs, nursing assessment, sample collection, shift handovers and nursing instructions. The activities requiring most daily care time were nursing assessment, shift handovers, administration of drugs, sample collection and nursing instructions. For three categories of nursing care activities, the average time was spent on nursing care, followed by medical care. For four major departments, the average daily care time spent on the Department of Internal Medicine was the greatest, followed by the Department of Surgery and the Department of General Medicine.
The Internal Medicine Department had the greatest need for nursing care and time. In addition to providing appropriate nursing manpower, information technology was used to deploy nursing manpower in acute wards, in order to alleviate shortages of clinical nurses.