海南省护理人力资源现状调查与对策

[目的]了解海南省护理人员的配置现状以及结构组成。[方法]采用自编问卷对海南省6所三级医院、26所二级医院的实际床位数、护理人员数量、职称、年龄与学历等进行调查。[结果]海南省二级、三级医院医护比分别为1∶1.15和1∶1.34;床护比为1∶0.31和1∶0.37。调查对象年龄<35岁占59.0%;中专学历占52.1%,本科及以上学历占9.6%;初级职称占68.6%,高级职称占2.6%。[结论]海南省护理人力资源数量不足,医护比与床护比低于国家标准;护理人员年龄、学历和职称结构不合理;需改善护理环境,加强护理人员培养与培训,完善人力资源管理等以促进护理队伍稳定发展。     

中医院护理人力资源配置与需求的调查分析

目的测定某中医院护理人员的工作时间,了解临床有限人力资源和人才需求的总体状况。方法采用动作时间测定法,对该院12个病区169名注册护士连续2周的"日床边实际工作量"进行测定,并对各班次护理工作内容与时间分配进行跟踪测量与分析。结果护士学历与职称结构均呈梯形分布;年龄结构呈菱形分布;各病区护士平均每天为患者提供直接护理时间和间接护理时间分别占总护理时间的44.47%、55.53%;临床平均床护比1∶0.45,按实际患者数和护理工时分析理想配置的床护比为1∶0.58。结论适当增加病区护士编制人数,优化人才配置结构,最大限度地发挥人才智慧和潜能,提高护理质量与效率,才能适应社会发展的需求。     

河北省护理人力资源现状调查分析

[目的]了解河北省护理人力资源现状,分析存在的问题,并提出建设性意见.[方法]采用问卷调查法对河北省有代表性的201所二级及以上综合医院护理人员的配置、结构等进行调查.[结果]医院平均医护比为1∶1.05,床护比1∶0.35;中专学历护士占44.81%,本科及以上仅占7.90%;中级职称护理人员占29.96%,副高及以上职称护理人员占1.75%.[结论]河北省二级及三级医院护理人员配置不足,医护比与床护比例失调,护理人员学历层次偏低,职称结构不合理.     

中山市镇级医院护理人力资源配置现状及建议

目的探讨镇级医院护理人力资源的配置现状，为医院和卫生行政部门合理配置护理人力资源提供依据，从而加强对护理人力资源的合理使用，保证护理工作质量。方法采用问卷调查的方法，了解中山市镇级医院护理人员学历、年龄、职称结构等方面的配置现状。结果中山市21家镇级医院共有护士1637人，年龄以中青年为主；学历以中专为主；职称以初级职称为主；床位与护士总人数之比为1．00：0．59；医护比为1．00：1．33。结论护理人员配置不足，护理人员的学历、职称结构、年龄构成相对不合理。建议合理配置护理人力资源，建立科学用人机制，保证护理质量。     

我国护理人力资源现状及配置的公平性分析

目的 了解我国护理人力资源的现状及存在的问题.方法 利用<2009年中国卫生统计年鉴>数据,采用Lorenz曲线和Gini系数评价分析方法及描述性分析方法,对我国护理人力资源现状进行分析.结果 护理人力资源按人口分布较为均衡,按地理面积分布的公平性较差;1998至2008年我国护理人员数量有所上升,医疗卫生机构床护比呈上升趋势;护理人员年龄主要集中在25～44岁;具有10年以上工作经验的注册护士接近70％;护理人员学历和职称偏低.结论 应合理配置护理人力资源;加大护理人力资源开发力度;大力培养高学历护理人员.     

我国护理人力资源现状及配置的公平性分析

目的了解我国护理人力资源的现状及存在的问题。方法利用《2009年中国卫生统计年鉴》数据,采用Lorenz曲线和Gini系数评价分析方法及描述性分析方法,对我国护理人力资源现状进行分析。结果护理人力资源按人口分布较为均衡,按地理面积分布的公平性较差;1998至2008年我国护理人员数量有所上升,医疗卫生机构床护比呈上升趋势;护理人员年龄主要集中在25-44岁;具有10年以上工作经验的注册护士接近70％;护理人员学历和职称偏低。结论应合理配置护理人力资源;加大护理人力资源开发力度;大力培养高学历护理人员。     

河北省护理人力资源现状调查分析

[目的]了解河北省护理人力资源现状,分析存在的问题,并提出建设性意见。[方法]采用问卷调查法对河北省有代表性的201所二级及以上综合医院护理人员的配置、结构等进行调查。[结果]医院平均医护比为1∶1.05,床护比1∶0.35;中专学历护士占44.81%,本科及以上仅占7.90%;中级职称护理人员占29.96%,副高及以上职称护理人员占1.75%。[结论]河北省二级及三级医院护理人员配置不足,医护比与床护比例失调,护理人员学历层次偏低,职称结构不合理。     

不同职级临床护理人员从事工作项目及其比重的调查

目的调查不同护理项目及其比重在不同年资、学历、职称护理人员中的分布。方法采用文献检索和专家会议法自行设计临床护理人员工作项目及其比重情况调查表，随机抽取3所三级甲等综合性医院450名临床护理人员实施问卷调查。结果调查表的内部一致性信度Cronbach＇s α系数为0．783，因子分析累计贡献率为60．91％；不同年资、学历、职称护理人员均从事所有护理项目，其中以大专学历、护士职称所占比例最高；中专及大专学历、护士职称均侧重执行治疗、等级护理和生活照护，本科学历、护师以上职称侧重危重病患者护理、健康教育、临床教学，不同学历、不同职称护理人员所从事的护理项目有统计学差异（P均〈0．01）；工作项目比重从大到小依次为等级护理、执行治疗、生活照护、健康教育、危重病患者护理、病区管理、临床教学、临床科研。结论护理人力资源不足和服务利用低效率现象并存，提示护理管理者应加大对临床护理研究工作的组织与管理，重视临床型科研人才的持续培养，推进护理科研水平的不断提高；并根据不同岗位的专业技术要求配备相应能力的护理人员，实现人力资源的优化管理。     

上海市各级医院普通病房护理人力资源配置研究

目的通过调查上海市部分医院普通病房护理工作量，制定普通病房的护理人力资源配置标准。方法采用分层随机抽样法抽取上海市34所不同等级医院，对其护理人力资源配置现状采用文献回顾法、专家咨询法、现场调查法进行研究。结果上海市三级综合医院的床护比为1：0．63～0．77，三级专科医院的床护比为1：0．49～0．51，二级医院的床护比为1：0．43～0．49，一级医院的床护比为1：0．40～0．44。结论病区护理工作量是制定护理人力资源配置标准的合理依据。     

中山市计划生育技术服务机构护理人力资源配置现状及需求的调查

目的：探讨中山市计划生育技术服务机构护理人力资源配置现状及需求。方法对中山市计划生育技术服务机构1个地级市计生中心、24个乡镇计生服务所、156名医技人员进行问卷调查,了解其医护比例、床护比例以及护师的工作年限、学历、职称等情况,分析护理人力资源配置。结果中山市计划生育服务机构床护比为2.94∶1;医护比为2.53∶1,年龄≥40岁比例为23.53％,工作年限≥5年比例为67.65％,护师以上职称55.88％;编制为合同比例为41.18％,大专及以上学历比例为82.35％;管床数量（≥3）比例为29.41％。91.75％的人员希望增加护理人员数量,68.57％的人员希望减少床护比,53.02％的人员希望护理人员提高学历,24.76％的人员希望护理人员拓展业务。结论目前的中山市计划生育技术服务机构护理人力资源并不能很好地满足日常工作需求,应该提高护理人员数量尤其是乡镇偏远地区的护理人员数量,其次提高护理人员学历,以从事更专业的工作。     

二、三级医院机动护士岗位设置的调查

目的：探讨护士对机动护士知晓度、设岗需求和能力要求，为机动护士的设置和发展提供依据。方法采用便利抽样法调查4省120家医院1415名护理人员对机动护士岗位知晓度、需求意愿和能力要求。结果护士对机动护士的知晓度为84．45％；仅20．83％的医院有机动护士岗位。三级医院、床位使用率≥90％的病区和外科病区对机动护士需求得分分别为（4．40±0．98），（4．46±0．87），（4．35±1．04）分，高于二级医院、床位使用率＜90％和内科病区，差异有统计学意义（ t／F 值分别为20．17，207．49，10．92；P＜0．05）。结论我国机动护士的管理、运行处于起步阶段；三级医院外科病区对机动护士的需求迫切；机动护士需具备全科护士能力和急救监护技能。     

优质护理服务示范病房责任护士职责及任职资格的调查分析

目的:通过对优质护理服务示范病房责任护士岗位进行工作分析,明确优质护理服务中责任护士的职责及任职资格。方法:自行设计优质护理服务示范病房责任护士岗位工作分析调查问卷,对某三级甲等综合性医院130名护理人员进行调查。结果:优质护理服务示范病房责任护士的岗位职责认同率均达到95.00%,结果显示,年龄30～35岁,工作5年以上,大专及以上学历,护师及以上职称,身体、心理素质较好的才能胜任责任护士资格。结论:对责任护士职责及任职资格的工作描述为优质护理服务示范病房责任护士的科学管理提供了理论依据,为优质护理服务中护理质量的持续改进奠定了坚实的基础。     

三级甲等综合医院优质护理特色病房人力配置研究

[目的]探讨优质护理特色病房护理人力资源配置方法,为“优质护理服务人力资源配置标准”的合理制定提供参考。[方法]采用现场观察法和自我记录法,对四川省某三级甲等综合医院的4个优质护理特色病房的护士工作量进行为期2周的现场跟踪观察、记录。[结果]4个特色病房床护比为1∶0.38;每日护理总时数为5964.8 min±100.2 min,直接护理时间为4158.5 min±24.6 min,间接护理时间为2003.9 min±72.6 min,特色病房共需增配护士23人,增配后床护比1∶0.51。[结论]现行床护比偏低,应制定以满足病人需求为目标、能体现专科护理特色的“优质护理服务人力资源配置标准”,以改善临床护士不足的现状。     

某地级三级甲等医院病区护理工作量测算研究

目的探讨某三级甲等医院护理人员直接护理时间、间接护理时间的分配比例及不同病区之间的差异,为科学、合理配置普通病房护理人员提供依据。方法对咸宁市某三级甲等医院25个病区进行调查分析。采用观察法和记录法对确定的83项直接护理项目和30项间接护理项目进行护理时间测定,计算出护理工作量和护理人员编制。结果直接护理时间占护理总时间的62.26%,80%的病区存在不同程度的缺编现象。病区日均总护理时间为4874.60min(81.24h),适宜的床护比为1∶0.55。结论应对护理工作量进行测定,以确定适宜的护理人力资源。     

Nursing practice environment,quality of care,and morale of hospital nurses in Japan

The purpose of this study was to describe Japanese hospital nurses' perceptions of the nursing practice environment and examine its association with nurse‐reported ability to provide quality nursing care, quality of patient care, and ward morale. A cross‐sectional survey design was used including 223 nurses working in 12 acute inpatient wards in a large Japanese teaching hospital. Nurses rated their work environment favorably overall using the Japanese version of the Practice Environment Scale of the Nursing Work Index. Subscale scores indicated high perceptions of physician relations and quality of nursing management, but lower scores for staffing and resources. Ward nurse managers generally rated the practice environment more positively than staff nurses except for staffing and resources. Regression analyses found the practice environment was a significant predictor of quality of patient care and ward morale, whereas perceived ability to provide quality nursing care was most strongly associated with years of clinical experience. These findings support interventions to improve the nursing practice environment, particularly staffing and resource adequacy, to enhance quality of care and ward morale in Japan.     

Assessment of nursing management and utilization of nursing resources with the RAFAELA patient classification system--case study from the general wards of one central hospital

Background. RAFAELA is a new Finnish PCS, which is used in several University Hospitals and Central Hospitals and has aroused considerable interest in hospitals in Europe. Aims and objectives. The aim of the research is firstly to assess the feasibility of the RAFAELA Patient Classification System (PCS) in nursing staff management and, secondly, whether it can be seen as the transferring of nursing resources between wards according to the information received from nursing care intensity classification. Methods. The material was received from the Central Hospital's 12 general wards between 2000 and 2001. The RAFAELA PCS consists of three different measures: a system measuring patient care intensity, a system recording daily nursing resources, and a system measuring the optimal nursing care intensity/nurse situation. The data were analysed in proportion to the labour costs of nursing work and, from that, we calculated the employer's loss (a situation below the optimal level) and savings (a situation above the optimal level) per ward as both costs and the number of nurses. Results. In 2000 the wards had on average 77 days below the optimal level and 106 days above it. In 2001 the wards had on average 71 days below the optimal level and 129 above it. Converting all these days to monetary and personnel resources the employer lost €307,745 or 9.84 nurses and saved €369,080 or 11.80 nurses in total in 2000. In 2001 the employer lost in total €242,143 or 7.58 nurses and saved €457,615 or 14.32 nurses. During the time period of the research nursing resources seemed not have been transferred between wards. Conclusions. RAFAELA PCS is applicable to the allocation of nursing resources but its possibilities have not been entirely used in the researched hospital. The management of nursing work should actively use the information received in nursing care intensity classification and plan and implement the transferring of nursing resources in order to ensure the quality of patient care. Relevance to clinical practice. Information on which units resources should be allocated to is needed in the planning of staff resources of the whole hospital. More resources do not solve the managerial problem of the right allocation of resources. If resources are placed wrongly, the problems of daily staff management and cost control continue.     

Staffing in acute hospital wards: part 1. The relationship between number of nurses and ward organizational environment

This paper is one of two that explores relationships between nursing staff resources, ward organizational practice and nurses' perceptions of ward environments. Here we examine relationships between staff numbers, care organization and nursing practice. A subsequent paper examines the effects of grade mix and staff stability. The data were collected in the mid-1990s from a nationally representative sample of 100 acute hospital wards and 825 nurses. Our analyses provide important insights for managers seeking to achieve the strategic aims set out in Working Together, and subsequent National Health Service (NHS) policy placing emphasis on making the best use of nurses, focussing on mobilising their knowledge, skills and talents within the context of extended work roles. Findings show that number of nurses is associated not only with ward organizational systems but also with a range of care processes and staff outcomes which hitherto have been linked only to ward organizational systems. The latter have been identified as providing different opportunities for developing multidisciplinary working and nurses' autonomy but the central importance of having an adequate number of staff to achieve these aims has been largely overlooked in research. Having fewer nurses was associated with both hierarchical ward organizational structures and hierarchical attitudes to care provision, denoting lower standards of nursing practice. A larger nursing complement was significantly associated with devolved organizational structures but no link was established between more staff and higher standards of nursing practice. When there were more staff there was a positive association with nurses' perceptions of multidisciplinary collaboration, their ability to cope with workload and job satisfaction. Employing an adequate number of nurses to provide care is clearly beneficial for nurses themselves. Patients are also likely to benefit from a lower incidence of 'hierarchical practice' associated with having a low nurse/bed ratio within a ward.     

优质护理服务示范病房不同学历、职称、工作年限护理人员工作现状调查分析

目的:调查山东省三级综合性医院优质护理服务示范病房不同学历、职称、工作年限护理人员工作现状。方法:采用问卷调查法,对山东省6所三级医院优质护理服务示范病房546名护士工作现状进行调查。结果:优质护理服务示范病房护理工作的主力是大专学历、初级职称及工作年限1～3年的护士,夜班护理工作主要由大专学历、护士职称及工作年限1～3年的护士承担;不同学历、职称、工作年限护士从事各护理项目有所侧重,差异有统计学意义(P<0.001),但均从事所有工作项目。结论:不同学历、职称、工作年限护士任职标准、岗位职责不明确,应构建合理的优质护理服务示范病房护理人员能级体系,确保护理质量的持续改进。     

上海市三级综合性医院骨科护理人力资源配置现状及对策研究

目的 了解和分析上海市三级综合性医院骨科护理人力资源配置现状,为合理配置和开发护理人力资源提供实证依据.方法 采用问卷调查法进行资料收集,并对资料进行分析.结果 2009年上海市三级综合性医院骨科核定床位数为1866张,实际开放床位数为2007张,在岗护士数为595人（男2人）,按照核定床位数和实际开放床位数计算的床护比分别为1∶0.319和1∶0.296.护士长平均年龄（37.53±6.11）岁 平均工作年限（17.87±6.16）年 大专及以上学历占95.56% 中级职称占62.22%.护士大专及以上学历占75.13%,以初级职称为主占92.10% 年龄主要集中在20～29岁占67.06% 年资集中在10年以内占73.11% 护理员（护工）学历以小学为主占45.83% 年龄集中在40～49岁占60.42% 工作年限集中在6年以上占55.21%.结论 上海市三级综合性医院骨科护理人员配备数量不足,结构配备不合理,缺乏男护士,护理员准入管理有待规范.     

根据实际护理工作量探讨护理人力资源的合理配置

[目的]通过对住院病人进行护理工时测定,确定病区平均每日护理工作量,为合理配置护理人力资源提供依据。[方法]采用自行设计的护理工时测定表,选取咸宁市中心医院25个病区为调查现场。采用观察法和记录法,对课题组确定的83项直接护理项目和30项间接护理项目进行护理时间测定,计算每个病区的实际护理工作量。[结果]直接护理时间占护理总时间的65.18%,80.00%病区存在不同程度的缺编现象,日均护理时间4973.99 min（82.90 h）,适宜的床护比为1∶0.54。[结论]对护理工作量进行测定,以合理配置护理人力资源。