Measurement and analysis of nursing time based on patients requirement in geratic treat-care model department / 中国实用护理杂志

Objective To measure the nursing time that the geriatric patients need daily in a large general hospital in Anhui province,thus to understand the direct and indirect nursing items and time.Methods Timing and recording nursing operations to meet the conditions of the geriatric patients for 7 consecutive days by field recording method were done.Results The average time of each nursing procedures was calculated.Direct nursing time was 146.10 min,accounting for 84.70％ of the total nursing time,including primary care (42.81％) and respiratory/drain management proportion (15.86％); Indirect nursing time was 26.39 min,accounting for 15.30％ of the total nursing time.The actual number of nurse needed was 158,the suitable bed protection ratio was 1 ∶ 0.68.Conclusions Direct nursing time of geriatric patients needed was longer than that of indirect nursing time.To increase direct nursing hours and reduce the indirect nursing time can satisfy the need of elderly patients.In addition,the current nursing staffing cannot satisfy the clinical needs of the elderly,thus,nursing resources allocation should be reasonable arranged as soon as possible.

Application of work flow rebuilt on intravenous infusion center / 现代临床护理

Objective To explore the effect of intravenous infusion flow rebuilt on the patients’safety and nursing quality in intravenous infusion center.Methods Risk safety factors about intravenous infusion process in intravenous infusion center were analyzed and the work flow were rebuilt and optimized?The satisfaction rate,the reception time and the disinfection time for tourniquets were compared before and after work flow rebuilt.Results After work flow rebuilt,the satisfaction rate raised from 92?5%to 94?5%?There were significant differences among the reception time and the disinfection time for tourniquets before and after work flow rebuilt (all P<0?05)?After work flow rebuilt,both the reception time and the time for dealing with tourniquets are shorter than before. Conclusions The rebuilt work flow can make nurses work efficiently and enhance the patients’nursing quality?

Effect of Changes in Nursing Delivery System on Satisfaction of Nurses and Patients and Direct Nursing Time / 간호행정학회지

PURPOSE: Purpose of this research was to identify effects of application of a modified primary nursing system. METHODS: Measurement was done of direct nursing time and satisfaction of nurses and patients before and after one month of the modified primary nursing system in a surgery unit in C university hospital, Seoul. RESULTS: There was no statistically significant difference between average for patient satisfaction (4.24) before and (4.11) after application of the modified primary nursing system. Total average for nurse satisfaction with the nursing delivery system was 2.89 before application and, 3.34 after, indicating some significant differences (t=-4.06, p<.001). The KPCS-1 was 10.19 before application of the modified primary nursing system and 9.52 after application. Recalculated into direct nursing time, the average direct nursing time for one patient was 92 minutes before application, and 85.98 minutes after, indicating no significant difference. CONCLUSION: Through this research an attempt was made to build and test a modified primary nursing system. Results indicate that the most important thing is to clearly regulate office work and safely implement the new system.

Study on Non-Value-Added Nursing Activities in a Tertiary Hospital / 간호행정학회지

PURPOSE: Purposes of this study were to identify non-value-added nursing activities (NVANAs) and to estimate the amount of time spent on NVANAs among total nursing activities. METHODS: Non-value-added nursing activities were identified though the use of a focus group. The nurses in the focus group were nurses working in a tertiary hospital. They discussed possible activities that could be NVANAs. Based on the focus group discussion, a pilot study was done to examine the actual occurrence of NVANAs in clinical settings. RESULTS: The focus group discussion showed that NVANAs occurred in ten categories of nursing performances including communication with physicians, communication with other departments, medications, equipment/supplies, nursing records, tests, admission, discharge, and transfer. Direct nursing activities accounted for 35.5% of total nursing activities while indirect nursing activities accounted for 64.5%. Of indirect nursing activities, 16% were NVANAs. Most NVANAs were related to communication and equipment/supplies. CONCLUSIONS: To improve the quality and efficiency of nursing activities, it is necessary to identify NVANAs and their causes. Results of this study suggest that improvement in the work process and nursing unit structure, support for equipment/supplies, and effective communication are needed to reduce NVANAs in tertiary hospitals in Korea.

Development of a Tool for Predicting Nursing Times in Occupational Accident Patients / 산업간호학회지

PURPOSE: This study aims to develop a tool to predict occupational health patients' nursing needs or nursing time. METHOD: A tool was composed based on the materials and opinion of experts, and to verify the reliability and validity of the tool, nursing time of total 311 inpatients in 2 occupational health hospitals were surveyed. RESULTS: The developed tool was total 151 items and composed of physical function, cognitive function, communication, emotional and disturbance behavior, nursing skill, and rehabilitation need. The reliability of the tool was high, showing Cronbach's alpha coefficient of 0.95. But several items should be deleted for low corrected item-total correlation. According to the multiple regression analysis, physical function and rehabilitation need were shown to be the most powerful predictive variables for nursing time. CONCLUSION: The developed tool was appeared to have high reliability and validity. But further refinement of the tool is needed.

Study on clinic nursing personnel's work load in our hospital / 中国实用护理杂志

Objective To explore the collocation ratio of direct nursing time to indirect nursing time of clinic nursing personnel in our hospital and the difference between different departments, so as to offer academ-ic evidence to collocate the nursing personnel resources reasonably. Methods Observation method was adopted to choose six typical clinics such as respiration internal medicine and so on as observed objects, and then tested the working hours of 22 nursing proceedings which were defined by the topic group, so as to get the work load and average working hours of nurses. Results Time needed for direct and indirect nursing pro-ceedings in different departments was obtained, as well as the ratio of 5 proceedings accounted for the total 22, also deficiency of nursing personnel in 6 departments were tested. Conclusions Evaluation of clinic nursing personnel's work load as an important index to measure the labor intensity of chnic nursing personnel can offer important evidence to optimize allocation of clinic nursing human resources.

Allocation of nurses according to actual nursing workload measured by nursing time / 中国实用护理杂志

Objective We aimed to provide references for nurses allocation by selecting the nursing items and measuring nursing time. Methods We recorded the nursing workload of 130 nurses in 10 wards within one week by literature review, Delphi method and questionnaire investigation. Results Totally 125 items of nursing items were included,101 of which were direct nursing items and 24 of which were indirect ones.The average time per day per patient was 185.1 minutes for level one nursing,95.4 minutes for level two nursing, 58.5 minutes for level three nursing.Average nursing time per day,working time per day per nurse and nursing time per day for per patient in each unit had statistical difference,P<0.05.The time for direct nursing items was 64.13% and for indirect nursing items was 35.87%. Conclusions Allocation of nurses according to measurement of nursing time could reach the aim of reasonable allocation and effective utilization of nursing human resource.

Estimation of Nursing Costs by a Patient Classification System(PCS) in ICU / 간호학회지

PURPOSE: The objective of our study was to figure out costs of nursing services in ICU based on the PCS in order to determine an appropriate nursing fee schedule. METHOD: Data was collected from 2 hospitals from April 15-16 to April 22-23, 2003. The costs of nursing services in the ICU were analyzed by nursing time based on the nursing intensity. The inpatients in the ICU were classified by a PCS tool developed by the Korean Clinical Nurses Association(2000). RESULTS: The distribution of patients by PCS in the ICU ranged from class IV to Class VI. The higher PCS in ICU consumed more nursing time. As a result, the higher nursing intensity, the more the daily average nursing costs in the ICU. CONCLUSION: Our study provides evidence to refine the current nursing fee schedule that does not differentiate from the volume of nursing services based on nursing time. We strongly recommend that the current reimbursement system for nursing services should be applied not only to the general nursing units but also to the ICU or other special nursing units.

The Effects of Nursing Information System on the Nursing Job: Focused on Direct and Indirect Nursing Time, the Number of Cases and of Patient's Treatment Fees / 대한의료정보학회지

The purposes of this study were to identify the effects of the Nursing Information System on time of the direct and indirect nursing activities, the frequencies of verbal and telephone order, the number of cases and patient's treatments fees before and after NIS. 10 nursing units in the S.N.U.H. were se lected. The data were colle cted for 6 month prior and pa st to NIS. The frequencies of verbal and telephone order were reported from staff nurses for 3 days. The numbers of cases and fees of patient's treatments were taken for 3 month before and after NIS. The results of this study were as follows: 1. 66.9% of participants said direct nursing activities were increased. Any changed nursing performances were patients education, nursing rounds, care of patient's hygiene, care for patient's movements, oral and tracheal suctioning, changing position, and feeding. 2. The difference of amount of time of dir ect and indirect nursing activities 1)There was 14 minutes increase indirect,4 minutes decrease in indirect. 2)NA's activities we re increased by 30minute in direct, decreased by 16 minute in indirect. 3. The frequency of telephone order decreased 16 and verbal order decreased 46 per day. 4. The difference of the number of patient treatment case before and after NIS was increased 9,907 per 3 months and of fees for patient treatment was increased 797,811,067 won per 3 months.

Accuracy of Temperature Measurements, Nursing Time for Measuring Temperature and the Validity of Fever Detection / 기본간호학회지

The aim of this study was to investigate what is the most accurate and quick temperature measurement among rectal, auxiliary and tympanic routes. The body temperatures of 86 preterm infants in incubators, a controlled environment, were measured at three different sites. The measurements were taken to examine the accuracy of the temperatures, proper nursing time for measuring the temperatures and the validity of fever detection. The results were as follows : 1. The mean temperature was significantly lower in the auxiliary site(36.71degrees C) and higher in the tympanic site(37.27degrees C) than in the rectal site(37.03degrees C). 2. The mean nursing time for measuring body temperature was significantly longer in the auxiliary site(171.65 seconds) and shorter in the tympanic site(17.70 seconds) than in the rectal site(83.33 seconds). 3. The nursing time for measuring body temperature included the time needed for preparation, measuring, as well as the post-measuring time. It was found that the time required to prepare for measuring the temperature of the rectal site was significantly longer than for other sites. In addition, the time needed to measure the temperature of the auxiliary site was significantly longer than in the other sites. Finally, the nursing time needed for measuring the auxiliary temperature(171.65 seconds) was the longest among the three sites whereas the nursing time for the tympanic site was the shortest(17.70 seconds). 4. Rectal temperature was significantly correlated to the tympanic(r=0.67) and auxiliary temperatures(r=0.69). Tympanic temperature was also significantly correlated to the auxiliary temperature(r=0.74). 5. The sensitivity, specificity, positive and negative predictive values of tympanic temperatures for detecting fever were 1.00, 0.80, 0.24, and 1.00, respectively. Those for the auxiliary temperatures were 0.00, 0.99, 0.00, and 0.94, respectively. Thus the level of fever detection was lower in the auxiliary temperatures than in tympanic temperatures. The above findings indicate that the tympanic method of temperature measurement offers a useful alternative to conventional methods.