基础护理项目成本核算分析

目的：探讨降低基础护理项目成本的方法和措施,推进医院的科学化管理。方法：现场调查护理操作程序及每项基础护理的成本分列(人力成本、护理材料成本、管理费用),对护理管理中比较单纯的基础护理项目：一级护理病人每次床单位更换、口腔护理、预防褥疮护理3项进行成本分析,研究基础护理项目成本的变化。结果：3项基础护理项目成本分列均有不同程度的上涨(床单位更换为13．19％、口腔护理为24．29％、预防褥疮护理为19．11％),以人力成本和护理材料成本最甚。管理费用随人力成本和材料成本变化。结论：加强成本管理,控制人力成本、降低材料成本、注重顾客满意提高社会是降低基础护理成本关键。     

护理部在医院感染管理中的作用

目的 探讨护理部在医院感染管理中的作用。方法 护理部应首先提高对医院感染管理的认识，主动配合医院感染管理，发挥护士长承上启下的管理作用，开展全员教育，使护理人员认识到医院感染与己有责，重点培养骨干力量，确保医院感染管理措施的落实。结果 预防医院感染的消毒、隔离措施得以很好落实。结论 护理部在医院感染管理中起到顺利推进两个规范落实的作用。     

Seroprevalence of pertussis antibody among health care personnel in Spain

Pertussis in healthcare workers is of particular concern, as they can be in contact with infected patients and may transmit the infection to susceptible patients, co-workers and other contacts. This study was carried out to examine the prevalence of pertussis antibodies in hospital personnel. A total of 487 healthcare workers > or = 25 years in age and students (19-24 years) in hospital training were recruited. The overall prevalence of pertussis antibody determined by ELISA was 51.7%. No significant differences on prevalence by age group (19-24, 25-34, 35-44 and > or = 45 years) and occupation (student, physician, nursing personnel and non-healthcare occupations) were found. In Spain, health care personnel in a general hospital will not have a significantly higher risk of serologically detectable contact with B. pertussis. Fifty percent of physicians and nursing personnel working in hospital were seronegative for pertussis antibody. A high percentage of these subjects will be susceptible to infection.     

Who administers? Who cares? Medical administrative and clinical employment in the United States and Canada.

OBJECTIVES. We compared US and Canadian health administration costs using national medical care employment data for both countries. METHODS. Data from census surveys on hospital, nursing home, and outpatient employment in the United States (1968 to 1993) and Canada (1971 and 1986) were analyzed. RESULTS. Between 1968 and 1993, US medical care employment grew from 3.976 to 10.308 million full-time equivalents. Administration grew from 0.719 to 2.792 million full-time equivalents, or from 18.1% to 27.1% of the total employment. In 1986, the United States deployed 33,666 health care full-time equivalent personnel per million population, and Canada deployed 31,529. The US excess was all administrative; Canada employed more clinical personnel, especially registered nurses. Between 1971 and 1986, hospital employment per capita grew 29% in the United States (mostly because of administrative growth) and fell 14% in Canada. In 1986, Canadian hospitals still employed more clinical staff per million. Outpatient employment was larger and grew faster in the United States. Per capita nursing home employment was substantially higher in Canada. CONCLUSIONS. If US hospitals and outpatient facilities adopted Canada's staffing patterns, 1,407,000 fewer managers and clerks would be necessary. Despite lower medical spending, Canadians receive slightly more nursing and other clinical care than Americans, as measured by labor inputs.     

Noncompliance with body weight measurement in tertiary care teaching hospitals

BACKGROUND: Body weight provides vital information for patient care; therefore, measurement at hospital admission should be standard practice. Our objective was to test compliance with this standard. METHODS: This was a study of 300 patients, aged > or = 18 years, admitted to general medicine and surgery services of 3 tertiary care teaching hospitals in Nashville, Chicago, and San Francisco. At 24 to 36 hours after admission, participants were queried as to whether they had been weighed, and if not, they were asked whether they had been questioned by nursing personnel about their weight. Subjects were then weighed by research personnel using identical protocol at all 3 institutions. Any admission body weight documented by nursing was noted. RESULTS: Compliance was similar at all 3 institutions, with only 197 (65.7%) of patients reporting being weighed. There were 213 (71.0%) patients who had a weight documented in the nursing record. Of those who had not been weighed, 69 (67.0%) indicated that they had been queried about their weight. Comparison of documented weights in the nursing records with those measured by research personnel revealed that 55 (25.9%) differed by > or = 5 pounds (2.27 kg). Those who had a documented weight in the nursing record but were not weighed by nursing personnel were also more likely to deviate from the weight measured by research personnel by > or = 5 pounds (2.27 kg) in comparison with those who had been weighed by nursing personnel (42.8% versus 21.8%, respectively, p < .0147). CONCLUSION: Overall compliance with weight measurement is poor. Recorded weights are often inaccurate.     

Does missed nursing care predict job satisfaction?

This study explores the impact of missed nursing care (required patient care that is omitted) on job satisfaction of nursing personnel. Data from 3,135 registered nurses (RNs) and 939 nursing assistants (NAs) on 110 patient care units in ten midwestern hospitals revealed that nursing staff who perceived less missed nursing care on the patient care unit where they work are more satisfied in their current position and occupation. Perceptions of staffing adequacy also significantly predicted both satisfaction variables. Focused interventions aimed at decreasing missed care and ensuring staffing adequacy are needed to improve job satisfaction and patient care.     

Shortage in admission capacity for acute cases

According to Poolman et al. (this issue), 6% of patients visiting the casualty department of a large Amsterdam hospital and requiring hospital admission had to be transported elsewhere at the expense of a considerable administrative effort on the part of the emergency-care physicians. Contributing factors are the way the hospital handles capacity problems, discharge procedures and personnel shortages, and, at the level of the city, the system used to allocate budget for acute care according to the relative needs of the hospitals. However, the major factor is the overall capacity problem in Dutch health care resulting from tight budget control. Despite intense discussions, major changes in this system have yet to be implemented. In the near future lack of qualified medical and nursing personnel will be the main factor that will need to be addressed urgently.     

Severe Acute Respiratory Syndrome Coronavirus 2 Seropositivity among Healthcare Personnel in Hospitals and Nursing Homes,Rhode Island,USA, July–August 2020

Healthcare personnel are recognized to be at higher risk for infection with severe acute respiratory syndrome coronavirus 2. We conducted a serologic survey in 15 hospitals and 56 nursing homes across Rhode Island, USA, during July 17–August 28, 2020. Overall seropositivity among 9,863 healthcare personnel was 4.6% (95% CI 4.2%–5.0%) but varied 4-fold between hospital personnel (3.1%, 95% CI 2.7%–3.5%) and nursing home personnel (13.1%, 95% CI 11.5%–14.9%). Within nursing homes, prevalence was highest among personnel working in coronavirus disease units (24.1%; 95% CI 20.6%–27.8%). Adjusted analysis showed that in hospitals, nurses and receptionists/medical assistants had a higher likelihood of seropositivity than physicians. In nursing homes, nursing assistants and social workers/case managers had higher likelihoods of seropositivity than occupational/physical/speech therapists. Nursing home personnel in all occupations had elevated seropositivity compared with hospital counterparts. Additional mitigation strategies are needed to protect nursing home personnel from infection, regardless of occupation.     

Nursing personnel downsizing in a teaching hospital

The objective of this study was to adjust the downsizing of nursing personnel in a teaching hospital to the resolution of Federal Nursing Council no. 293/2004. The classification of patients in levels of complexity care was done and the required time for the nurse care also was verified. The present number of employees was compared to the measured one. The outcomes showed the levels of patients'care complexity is on intermediate care (42%), and the required time to the nurse care was greater on intensive care patients (42%). The present staff has a deficit of 205 nurses and an exceding of 284 professionals of techinical college level.     

影响临床护理人员护理安全因素调查

目的探索临床工作中护理安全的影响因素,为制定预防措施提供依据。方法对笔者所在医院74名临床护士进行护理安全相关问题的问卷调查。结果临床护理操作技能规程得分最高,其次是护理人员的急救意识及急救能力、新护士岗前培训、协调及沟通等,得分最低的为护士排班模式。结论临床护理工作中,护理安全至关重要。     

Work-satisfaction and Health of Hospital Nursing and Medical Personnel

The implementation of new service demands and increasing rationalisation measures exercise stress and pressure on medical and nursing personnel in German hospitals. However, their satisfaction and health are important quality criteria in the ranking of a hospital. Basing on the introduction of a new tool, an inquiry was conducted among the medical and nursing personnel of two hospitals (A and B) in respect of the quality of their working conditions. The scope of the questionnaires covered the nature and kind of the work, opportunities of professional success, management of co-operation and conflicts, physical and structural obstacles to smooth working as well as the management of quality. Finally, a scale of complaints and a burn-out scale served to assess the personnel's subjective health situation. The questionnaire was submitted in hospital A between November 1999 and February 2000 to a total of 39 doctors (58 % compliance) and 84 nursing personnel (47 % compliance) of the specialist departments concerned with internal medicine, rheumatology, urology, general and accident surgery. In hospital B the questionnaire was completed between March and July 2001 by a total of 40 doctors (54 %) and 91 nursing personnel (68 %) of two departments of internal medicine, surgery, neurosurgery and gynaecology. Comparable to other studies, the nursing personnel in both the hospitals rated the working conditions more negatively than the medical personnel. The differences, however, are more of a quantitative (number of frequency of problems) than of a qualitative nature (type or kind of problems). With both groups, problems connected with structural difficulties in working and with quality management were by far most important while the nursing personnel also underlined physical stress. Individual health condition were also classified more negatively by the nursing personnel than by the doctors, and the overall physical complaints of the nursing personnel were generally greater than with the average population, whereas medical personnel registered fewer complaints. Health promotion measures in hospitals may help to prevent negative developments. Such measures are too rarely translated into reality.     

Analyzing the nursing organizational structure and process from a scheduling perspective

The efficient and effective management of nursing personnel is of critical importance in a hospital’s environment comprising approximately 25 % of the hospital’s operational costs. The nurse organizational structure and the organizational processes highly affect the nurses’ working conditions and the provided quality of care. In this paper, we investigate the impact of different nurse organization structures and different organizational processes for a real-life situation in a Belgian university hospital. In order to make accurate nurse staffing decisions, the employed solution methodology incorporates shift scheduling characteristics in order to overcome the deficiencies of the many phase-specific methodologies that are proposed in the academic literature.     

探讨民营医院的护理队伍建设

通过分析护理发展及护理人才对医院发展的重要性,分析民营医院护理队伍的现状和深圳博爱医院的护理队伍建设经验,从护理人才的世界性缺乏和护理人才培养的社会责任立足,探讨民营医院如何为未来的发展建设高素质的护理人才队伍。     

Modeling the effects of influenza vaccination of health care workers in hospital departments

Nowadays health care worker (HCW) vaccination is widely recommended. Although the benefits of this strategy have been demonstrated in long-term care settings, no studies have been performed in regular hospital departments. We adapt a previously developed model of influenza transmission in a long-term care nursing home department to study the effects of HCW vaccination in hospital wards. We study both the effectiveness and efficiency in reducing the hazard rates of influenza virus infection for patients. Most scenarios under study show a similar or higher impact of hospital HCW vaccination than has been predicted for the long-term care nursing home department. Therefore, it seems justified to extend the recommendations for HCW vaccination, based on results in the long-term care setting, to short-term care settings as well.     

现阶段基层护理人力资源管理的难点分析及策略

目的：探讨提高基层医院护理人力资源管理的方法。方法：分析现阶段基层医院护理人力资源管理难点,提出积极应对的管理策略。结果：该院护士职业满意度和住院患者对护士的满意度均达到95%。结论：合理配置及调配护理人力资源,提高护理人员工作积极性,加强培训,可提高护士职业满意度和住院患者对护理工作的满意度。     

风险管理在护理管理中的应用

目的：探讨风险管理在护理管理中的应用。方法：选取2014年5月~2015年5月我院收治的820例住院患者做为研究组。另外选取2013年2月~2014年2月我院收治的780例住院患者做为对照组。对照组给予常规护理,研究组实施护理风险管理。观察两组患者治疗期间风险事件与护理纠纷发生情况。结果：研究组意外事件与护理纠纷发生率明显低于对照组;观察组护理时期护理人员风险管理质量明显高于对照组（P＜0.05）。结论：护理风险管理能够提高护理质量,减少护理风险事件发生率。     

延续护理在托老院压疮高危人群中的应用及成效

目的探讨延续护理在托老院高危人群中预防与治疗压疮的应用价值。方法将本市2011年4月-2013年4月28家托老院中的282人纳入研究范围,予以延续护理,对护理员进行严格培训,并对已发生压疮者每天访视一次,Braden≤12分的2天访视一次,Bradenl3-18分,每周访视2次。结果施行延续护理后,护理员对于压疮预防知识及技能的知晓率显著提高。结论实施延续护理加强了托老院护理人员对预防压疮的意识和技能,降低了托老院高危人群压疮的发生率。     

Staffing intensity, skill mix and mortality outcomes: the case of chronic obstructive lung disease.

The hospital re-engineering movement has resulted in major changes in hospital staffing. These staffing changes have the potential to reduce staffing intensity and skill mix, both generally and within specific caregiver groups. Prior research has shown that both skill mix and staffing intensity are positively associated with outcomes indicative of the quality of hospital care. This study extends beyond prior research by expanding the scope of staffing intensity and skill mix measures beyond that of physicians and nursing personnel and by focusing on a specific diagnostic group, patients with chronic obstructive pulmonary disease (COPD). Multiple regression analysis was performed using the 30-day post-admission observed mortality rate for Medicare patients being treated for COPD relative to the predicted rate as the dependent variable. Analyses were repeated for 1989, 1990 and 1991. Among the explanatory variables were staffing intensity measures for health care workers that were thought to contribute significantly to the care needed by patients with COPD. The results indicate that the only group of health care workers which showed staffing intensities positively associated with better outcomes in this group of patients was respiratory care practitioners, respiratory therapists and respiratory therapy technicians. The results relative to skill mix were inconclusive. It was concluded that during the 1989-1991 period, hospitals with higher staffing intensities for both respiratory therapists and respiratory therapy technicians had better outcomes for their Medicare inpatients being treated for COPD.     

Estimating the nursing staff required in a new hospital

Opening a new hospital poses a complex and consequential set of challenges. One of these challenges is to estimate the nursing staff. The aim of this article is to report the entire process adopted to estimate the required nursing staff for a new Hospital in Brazil. The nursing staff was projected according to the Brazilian Federal Nursing Council (Cofen). We applied an equation to estimate nursing staff and compared the results with two other existing hospitals. A significant difference (p<0.05) was observed when comparing the Nurse-License Practice Nurse ratio recommended by Cofen between the new Hospital and other hospitals. This statistical difference is mostly due to reduced nurse staff in intensive care units. Almost one year after the hospital opened its doors, it is necessary to review nursing staff hours with the real information to reinforce the expenditure on these personnel and to evaluate the decisions made so far.     

优质护理服务在手术室的实施

目的探讨和分析优质护理服务在手术室中的具体应用和实施[1]。方法选取我院曾接收的80例患者,并随机分为两组,即对照组和观察组,每组40例,对照组采取常规护理,观察组则采取优质护理,对两组患者的满意度进行调查。结果观察组患者的满意度明显高于对照组,而且观察组并无一例医疗纠纷发生。结论在手术室中对患者实施优质护理不但可以提高患者对医务人员的信任度,同时也会提高对护理的满意度[2]。