护士的适当配置不仅反映了护理人力资源管理的状况,还关系到医院的护理质量。本研究调查了中国大型综合医院护士的人员配备情况。
在这项研究中,由国家护理质量控制中心建立的数据库,2017年对中国大陆护士人员配备进行了全国调查,并进行了分析。获得了我国668家大型综合医院20.375个科室的时点调查数据,包括白天(上午10:00)和晚上(晚上10:00)的护士和患者信息。然后,通过计算护士与病人的比率(分配给护士的病人的平均人数,NTP比率)。进行Kruskal-Wallis测试以比较不同地区和部门在白天和晚上的NTP比率。
在大型综合医院,平均而言,一名护士白天照顾8名患者(NTP比率=1:8.0),晚上照顾23名患者(NTP比率=1:23)。白天和黑夜之间存在显著差异。就不同地区而言,西部地区医院的一名护士白天平均照顾7.8名患者(NTP比率=1:7.8),西部地区的护理资源比东部(1:8.0)和中部(1:8.0)地区更充足。晚上,东部地区NTP水平较高(1:23.0)。在部门方面,在ICU工作的一名护士白天照顾两名患者(NTP比率=1:2.0),晚上照顾2.9名患者(NTP比率=1:2.9).肿瘤科的NTP水平相对较高:白天为9.3,晚上为34.0。其他科室包括内科,手术,妇产科,儿科,老年病科白天的NTP比例为1:7-8,晚上为1:18-25。
在中国,大型综合医院的护士人员配备有一些区域和部门模式。夜间护士人员配备水平低可能是一个值得关注的问题;中国政府需要建立不同时期和部门的标准,以提高护理效率和质量。
The appropriate staffing of nurses not only reflects the situation of nursing management of human resource, but also is related to the nursing quality in hospitals. This study investigated the staffing of nurses in large general hospitals in China.
In this study, a database established by the National Centre for Nursing Care Quality Control, which conducted a national survey of the staffing of nurses in China mainland in 2017, was analysed. The time-point survey data of 20 375 departments in 668 large general hospitals in China were obtained, including the information of nurses and patients during the day (10:00 am) and at night (10:00 pm). Then, the staffing of nurses was evaluated by calculating the nurse to patient ratio (the average number of patients assigned to a nurse, NTP ratio). The Kruskal-Wallis test was performed to compare the NTP ratios during the day and at night among different regions and departments.
In large general hospitals, a nurse takes care of eight patients (NTP ratio = 1:8.0) during the day and 23 patients at night (NTP ratio = 1:23) on average. There were significant differences between day and night. In terms of different regions, a nurse in the hospitals in the western region takes care of 7.8 patients during the day (NTP ratio = 1:7.8) on average, and the nursing resource in the western region is more adequate than that in the eastern (1:8.0) and central (1:8.0) regions. At night, the eastern region has a higher level of NTP (1:23.0). In terms of departments, a nurse working in the ICU takes care of two patients during the day (NTP ratio = 1:2.0) and 2.9 patients at night (NTP ratio = 1:2.9). The level of NTP in the oncology department is relatively higher: 9.3 during the day and 34.0 at night. Other departments including internal medicine, surgery, obstetrics and gynaecology, paediatrics, and geriatrics have NTP ratios of 1:7-8 during the day and 1:18-25 at night.
In China, the nurse staffing of large general hospitals has some regional and departmental patterns. The low level of nurse staffing at night may be a problem worthy of attention; the Chinese government needs to establish standards for different periods and departments to improve efficiency and quality of nursing.