The Development of Nursing Workforce Allocation Standards for Acute Care General Wards in Taiwan

台灣急性病房護理人力配置標準之建構

10.1097/JNR.0000000000000002

林秋芬(Chiou-Fen Lin)；黃秀英(Hsiu-Ying Huang)；盧美秀(Meei-Shiow Lu)

各層級醫院 ； 急性一般病房 ； 護理人力配置 ； 護病比 ； hospital tiers ； acute care general wards ； nursing workforce allocation ； nurse-to-patient ratios

The Journal of Nursing Research

21卷4期（2013 / 12 / 01）

298 - 306

英文

背景　合理的護理人力配置能增進病人安全，減少異常事件發生。目的　本研究旨在瞭解和比較目前各層級醫院急性一般病房之護理人力配置，進而研擬各層級醫院急性一般病房合理護理人力配置標準和三班護病比。方法　本研究採用多元研究法，包括：文獻探究法、問卷調查法、專家焦點團體座談法，最後再以公聽會和問卷調查等方式達成共識。結果　各層級醫院因病人疾病嚴重度不同，所以護理人力配置有差異，計算合理護理人力配置標準建議採用人床比和護理時數。建議現階段人床比／護理時數分別為：醫學中心0.53：1/2.8小時、區域醫院為0.49：1/2.6小時、地區醫院為0.40：1/2.1小時；3年後人床比／護理時數分別為：醫學中心0.57：1/3.0小時、區域醫院0.53：1/2.8小時、地區醫院0.44：1/2.3小時；5年後人床比／護理時數分別為：醫學中心0.61：1/3.2小時、區域醫院0.57：1/3.0小時、地區醫院0.48：1/2.5小時。結論　本研究結果能提供各層級醫院、醫策會醫院評鑑標準訂定和行政院衛生福利部推估護理人力需求之參考。

Background: Adequate nursing workforce is critical to ensure patient safety and reduce the incidence of adverse events.Purpose: This study explores and compares the nursing workforce allocation situation in the acute care general wards of Taiwan's three hospital tiers and, based on findings, develops standards for adequate nursing workforce allocation and nurse-to-patient ratios in acute care general wards at each tier.Methods: This study uses multiple research methods, including literature review, questionnaire survey, and expert focus group discussion. Final consensus is achieved using a public hearing and questionnaire survey.Results: The severity of patient conditions differs among hospital tiers. Therefore, each tier requires a nursing workforce allocation standard appropriate to its situation. Study findings indicate that nurse-to-bed ratios and nursing hours are valid indicators of nursing workforce allocation needs. The results of expert discussions and public hearings recommend 0.53 nurses per bed and 2.8 nursing hours for academic medical centers, 0.49 nurses per bed and 2.6 nursing hours for metropolitan hospitals, and 0.40 nurses per bed and 2.1 nursing hours for local community hospitals for the current stage of healthcare development; 0.57 nurses per bed and 3.0 nursing hours for academic medical centers, 0.53 nurses per bed and 2.8 nursing hours for metropolitan hospitals, and 0.44 nurses per bed and 2.3 nursing hours for local community hospitals in 3 years; and 0.61 nurses per bed and 3.2 nursing hours for academic medical centers, 0.57 nurses per bed and 3.0 nursing hours for metropolitan hospitals, and 0.48 nurses per bed and 2.5 nursing hours for local community hospitals in 5 years.Conclusions: Study results may provide a basis for better allocating nursing workforce in hospitals, setting formal standards for minimum nurse-to-patient ratios, and assessing nursing workforce needs at the national level.

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