日本护理人力配置现状及对中国的启示

日本的“护理人力配置基准”与美、英等国以实际护理工作时间为基准的计算方式不同,它主要从供给角度出发,针对床位与护士的比例而设置并与医疗收费标准紧密联系,确保了该基准在医疗机构中得到非常有效的贯彻和实行。日本的护理人力配置基准体现了日本“公平性和效率性”的医疗原则,确保医院经营效果和促进护理人力市场供需间的平衡。该基准确保了必要的护理人力,并且在每年度的医疗收费标准改定中不断得到完善而日趋合理。该基准对我国护理的启示:完善我国护理人力统计标准;采取有效的法律法规,保证护理人力配置基准的实行;学习日本经验,护士人力配置基准以病房为单位,并适当与护理收费标准挂钩;护理人力配置必须考虑临床工作量的动态影响;结合中国实际考虑护理职称和专科护士的影响。

Nurse Staffing Ratio (NSR) Standard in Japan and the proposals for Nurse Staffing Ratio in China

The Nurse Staffing Ratio (NSR) Standard in Japan is different from that in the other developed countries such as USA and UK. The NSR in USA or UK is based on the actual clinical nurse workload and nurse time to estimate the number of nurse staffing, but the NSR Standard in Japan is related to the medical payment standard under guidelines established by the Japanese Ministry of health, Labor and Welfare, according to Nurse-to-patient Ratio to calculate the NSR from medical-market supple side. Due to associate with medical payment standard, this led to implement this standard effectively. The NSR in Japan reflected the Japanese clinical guidance of fairness and efficiency, guarantee the effect of health care economic and promote the balance of nurse market supply and demand.It could guarantee the necessary nurse staffing and be perfected continuously with annual adjustment in the medical payment standard. So according the experience in Japan, we hope to provide some proposals for Nurse Staffing Ratio in china: Firsty, adjustment for the statistical standard of nurse staffing in China. Secondly, use the necessary methods such as laws or orders to guarantee to practice the NSR. Thirdly, the NSR should base on the hospital wards as statistical units and associate with medical payment standard. Fourthly, the NSR also need consider the objective nurse workload charge. Fifthly, the NSR also pay attention to impact of the nurse professional title and nurse specialist in China.