建置以治療性措施為基礎之加護病房病人分類系統

Establishing the TISS-28 Based Patient Classifi cation Informatic System in Intensive Care Units

本研究之目的為建立以治療性措施為主之資訊化加護病房病人分類系統，及分析加護病房之直接護理時數與護理人力利用率。研究方法分為二階段：第一階段是規劃及開發加護病房病人分類資訊系統，病人分類之內容以「加護病房病人直接護理需要分類表」為主，並結合醫囑系統，能對應項目則依病人之醫囑自動匯入病人分類系統，無法對應項目則可另行點選；第二階段為分析加護病房直接護理時數，以中部某醫學中心之10個加護病房之護理人員及病人為研究對象，運用第一階段建立之加護病房病人分類資訊系統收集病人分類資料作統計分析。研究結果顯示加護病房病人分類資訊系統已於2012年建置完成，平均每日每位病人之護理時數為13.3±2.87小時，大夜之護理人力利用率為126.97%，白班之護理人力利用率為126.91%，小夜之護理人力利用率為121.58%。施行加護病房之病人分類電腦化，可了解人力負荷與人力運用情形，作為人力資源與成本分析之參考。

The purpose of this study was to develop TISS-28 based patient classification information system of intensive care unit (ICU), and to analyze ICU direct nursing care hours. The research method was divided into two stages: The fi rst stage was the planning and development of the patient classifi cation information system. The system was based on "patients" direct care activities of ICU,and with computerized physician order entry (CPOE) system, according to the matching item automatically imported into the patient classification system, the not correspond item being input data by nurses. The second phase was to apply the patients classifi ed information system of ICU to collect data in 10 ICUs. The results showed that the patient classifi cation information system was established. The average daily nursing care hours were 13.3 ± 2.87 hours per-patient. The night shift of nursing manpower utilization was 126.97%; day shift nursing manpower utilization was 126.91%, evening shift nursing manpower utilization was 121.58%. Conclusion: The patient classification information system of ICU provides the information of nursing manpower and workload as evidence-based resources for manpower policy.