病房护士人力配置与工作超时相关性研究

目的:探讨我国医院病房护士人力配置与工作超时情况及其相关因素。方法:本研究对我国内地不同地区的181家三级、二级医院的9698名病房护士的调查资料进行二次分析。本研究属描述性研究,采用患护比测量我国医院病房的护士人力配置,通过护士在一个班次中实际工作时间与预定时间之差计算其工作超时时间。将不同病区特征的护士人力配置与国家最低配置标准进行比较,并进一步分析护士人力与工作超时的关系。结果:病房患护比平均为1∶(0.36±1.51),其中西部地区医院、二级医院和非省会城市/直辖市医院病房患护比较高,护士短缺更严重。护士在最近的一个工作日,工作超出8h的高达46.6%,超过10h的占12.7%。患护比每增加1,护士工作超时的几率增加23.4%。结论:我国大部分医院的病房护士人力未达到国家最低配置标准,临床一线护士工作超负荷,尤以西部地区、非省会城市/直辖市和二级医院更明显。增加病房护士人力,降低患护比,可以改善护士工作超时的现象。

Relationship between nurses staffing and overtime work in inpatient units

Objective: The aim of this study was to identify the correlation between nurses staffing and overtime work among inpatient units in China. Methods: It was the secondary analysis of the study of national nursing human resource. Nurses staffing status in units was calculated by using ratio of nurse to patient, and gap between statutory working time and actual working time was defined as overtime workload. Nurses staffing status was compared between different units and the minimum national standard, and relationship of staffing and overtime work was further investigated. Results: The patients/nurse ratio was 1:0.36±1.51 on average, nurse shortage status in level 2 hospitals, hospitals located in western region, and non-capital city were even more severe. During the regular working days, 46.6% nurses worked more than 8h in the latest shift, 12.7% nurses worked even more than 10h. When the patients/nurse ratio increased one point, the risk of work overtime would increase 23.4%. Conclusion: The nurse shortage status was serious and work overtime was common in China, especially in western hospitals, non-capital hospitals and level 2 hospitals. Increasing nurses staffing may decrease nurses’ overtime workload.