護理人員人力有效運用之研究--以產科病房為例

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Title:	護理人員人力有效運用之研究--以產科病房為例
Other Titles:	Enhancing the Efficiency and Human Resources Utilization of Hospital Medical Staff--Obstetric Ward as an Example
Authors:	徐廣鵬 TSUI, KWONG-PANG
Contributors:	王本正 Wang, Ben-Jen 企業管理學系高階企業經營碩士在職專班
Keywords:	產科;產房;護理;護理人力 Obstetric ward;delivery room;nursing;nursing manpower
Date:	2016
Issue Date:	2016-10-20T08:09:17Z (UTC)
Abstract:	從全民健康保險開始到總額支付制度實施，面對總額預算醫療院所在健保給付壓力下大幅縮減護理人力，加上整體護理人力供需失衡，造成護理人員的薪酬與工作壓力不成比例，使得各醫療單位人力調配已成一大學問。本研究目的是在有限人力下，又要如何不影響病患的權益，以及不增加護理人員的負荷與不減少人員的情況下，可使各護理單位更有效運作。研究方法是一敍述性研究，觀查兩家中部的大型醫療機構，其一為醫學心中另一則是區域教學醫院。以產科護理站人員在三班輪值的情況下，病人入出院時的人力配置是否需調整。兩院產科收集樣本皆從 2008年1月1日到 2008年12月31日止。其醫學中心共收集了1,175位產婦，而區域教學醫院共收集743位產婦。經研究結果發現，兩家醫院生產人數最多的時段在早上的 08:00 到中午過後的 14:00 點，另外晚上的 22:00 到午夜的02:00 有一小彼的高峰。根據上述的研究發現，產婦在半夜生產的人數不少，雖然只佔生產人數的13.7%~15.3%不等，但半夜人力最缺乏和精神也最疲憊之時。為了減少護理專業人員的負荷，以及減少醫護病人之間壓力，因此良好且適當的人力資源政策與計畫是應該有所調整。 Taiwan has implemented the National Health Insurance Scheme and commencing the National Health Insurance Administration (NHIA) changed the payment system to a global budget, but due to budget constraints, medical and health care institutes faced tremendous financial difficulties and as a result, have to drastically cut down the establishment of health care professionals. Compounded with an imbalance of the overall supply and demand of medical health care professionals, and the extreme workload placed upon medical staff but who were not suitably remunerated, the deployment and utilization of human resources became a central issue faced by all medical units.The purpose of this research was based on the under a reduction of human resources, to safeguard patients’ rights, to enhance the operating efficiency and to minimize the pressure upon medical staff. This is a descriptive research using the examples of two large hospitals in central Taiwan. One of which is a medical center while the other is the obstetrics department puerpera of a metropolitan hospital, to study the deployment of human resources under a 3-shifts system against the rate of admission and discharge of patients. The research was collected from the obstetrics and gynecology department of the two hospitals during the period 1 January and 31 December of 2008. Medical center collected data of 1175 pregnancy, while 743 data sets were collected from metropolitan hospital. Upon analysis, it was found that the peak birth delivery period each day was during 8:00 am until about 1:00-2:00 pm, and another peak occurred between 10 pm and 2 am at night. The conclusion was based on the analysis, birth delivery rate during the midnight hours were substantial as it represented about one-fifth of the total births. However, during these late night period, staffing resources were minimum and staff fatigue was also an influencing factor. Consequently, it is necessary to develop an appropriate human resources policy and a workable plan to adjust staff deployment accordingly in order to alleviate the stress upon medical professionals and to relieve the tension between medical staff and patients.
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