摘要
目的检验相对值工作量测量法对我国护士群体的适用性,并利用该方法对部分护理操作的单次工作量进行测量。方法2018年10月,邀请全国58家医院的58名护士参与研究,以工作时间、体力付出、脑力付出和医疗风险4个维度作为护理工作量测量的构成要素,以117项常见护理操作为评价内容设计调查表,并对参与人员进行问卷调查,通过各维度相对数值的中位数,来反映各项护理操作工作量的平均水平。建立3种不同的回归模型检验其稳定性,通过模型的拟合优度和t检验结果评价其适用性。结果工作量相对值中位数在100~199之间最多(104项, 88.89%),点数在200~299之间其次(9条),点数在0~99之间和≥300点的较少(3条和1条)。工作量点数最低的操作为"测量无创血压",为90(70, 100);点数最高的操作为"PICC置管",为370(200, 500)。3种回归模型均成立(模型Ⅰ:F=10 626.16, P<0.001;模型Ⅱ:F=17 108.22, P<0.001;模型Ⅲ:F=6 694.16, P<0.001),其总体拟合优度在0.8~0.9之间,且本研究选用的工作时间、体力付出、脑力付出和医疗风险4个测量维度均是工作量的关键变量。结论相对值法在我国护理工作量测量上具有良好适用性,基于多维度测量得到的相对点数可能拥有广阔的应用前景。
Objective To test the applicability of the relative value used to measure Chinese nurses′ workload, and measure part of single workload of nursing procedures. Methods Time, physical effort, mental effort and medical risk were used as the four dimensions to evaluate nurses′ workload. Based on these dimensions, a set of questionnaires covering 117 common nursing procedures were designed and 58 nurses form 58 hospitals were surveyed. Establishing three different regulation modals, of which the applicability and stability were evaluated through the good of fit. Results Median of the relative value of different dimensions was used to indicate the average level of the various nursing procedures′ workload. The results showed that the median of relative value between 100 to 199 accounted for the largest share, up to 88.89% of 104 items. The median of relative value between 200 to 299 accounted for 7.69%(9 items). The median of relative value between 0 to 99(3 items)and more than 300(1 item)accounted for a small proportion. The lowest point of workload was blood pressure measuring, having a relative value of 90(70, 100) while the PICC catheterization accounted for the highest point of workload, being 370(200, 500) Three kinds of modals were valid(Model Ⅰ, F=10 626.16, P<0.001;Model Ⅱ, F=17 108.22, P<0.001;Model Ⅲ: F=6 694.16, P<0.001), while the good of fit of these regulation modals was between 0.8 to 0.9. Time, physical effort, mental effort and iatrogenic risk were the key variables of nurses′ workload. Conclusions The applicability of the relative value to measure nurses′ workload is fairly satisfactory, and the relative value points based on multi-dimension will enjoy a promising future.
作者
沈宇驰
朱秋芬
简伟研
Shen Yuchi;Zhu Qiufen;Jian Weiyan(Peking University School of Public Health, Beijing 100191, China;ZhongWei Institute of Nursing Information, Beijing 100086, China)
出处
《中华医院管理杂志》
CSCD
北大核心
2019年第9期761-765,共5页
Chinese Journal of Hospital Administration
基金
美国中华医学基金(CMB-16-259).
关键词
护理
工作负荷量
测量
相对值
问卷调查
Nursing care
Workload
Measurement
Relative value
Questionnaire survey
