Costs of most frequent nursing activities in highly dependent hospitalized patients / Custos das atividades de enfermagem realizadas com maior frequência em pacientes de alta dependência / Costos de las actividades de enfermería realizadas con mayor frecuencia a los pacientes de alta dependencia hospitalizados

This quantitative study aimed to identify the costs of the most frequent nursing activities in highly dependent hospitalized patients at a medical clinic. The non-probabilistic convenience sample corresponded to 607 observations regarding oral feeding activities (OF), blood pressure verification (BP) / heart rate (HR), body temperature checking (BTC), performance of intimate hygiene and management of feeding probe. The costs identified corresponded to R$2.40 (SD±2.64) for OF feeding; R$1.26 (SD±0.48) to verify the BP/HR; R$1.17 (SD±0.46) for BTC; R$15.59 (SD±8.62) to perform intimate hygiene and R$5.95 (SD±2.13) for management of feeding probe. This study will facilitate cost management, with a view to avoiding waste related to unnecessary resource consumption and establish a correlation between costs and care delivery results.

Este estudo quantitativo objetivou identificar os custos das atividades de enfermagem realizadas com maior frequência em pacientes de alta dependência, hospitalizados em uma unidade de clínica médica. A amostra de conveniência, não probabilística, correspondeu a 607 observações referentes às atividades alimentação via oral (VO), verificação da pressão arterial (PA) / frequência cardíaca (FC), verificação da temperatura corporal (TC), realização de higiene íntima e administração de dieta via sonda. Os custos identificados corresponderam a R$2,40 (dp±2,64) para alimentação VO; R$1,26 (dp±0,48) para verificação da PA/FC; R$1,17 (dp±0,46) para verificação da TC; R$15,59 (dp±8,62) para realização da higiene íntima e R$5,95 (dp±2,13) para administração de dieta via sonda. Este estudo auxiliará o gerenciamento de custos, visando evitar desperdícios relativos ao consumo desnecessário de recursos, bem como o estabelecimento de correlação entre os custos e os resultados da assistência prestada.

El propósito de este estudio cuantitativo fue identificar los costos de las actividades de enfermería realizadas con mayor frecuencia en pacientes hospitalizados con una unidad de alta dependencia en una clínica médica. La muestra de conveniencia, no probabilística, correspondió a 607 observaciones en relación a las actividades de alimentación por vía oral (VO); verificación de la presión arterial (PA) / frecuencia cardiaca (FC), verificación de la temperatura corporal (TC); realización de la higiene íntima y la administración de alimentación a través de la sonda. Los costos identificados correspondía a R$2,40 (DP±2,64) para la alimentación de VO; R$1,26 (DP±0,48) para verificar la PA/FC; R$1,17 (DP±0,46) para la verificación de la TC; R$15,59 (DP±8,62) para la realización de la higiene íntima y R$5.95 (DP±2,13) para la administración a través de la sonda de alimentación. Este estudio ayudará a administrar los costos con el fin de evitar que los desechos relacionados con el consumo innecesario de recursos, así como el establecimiento de una correlación entre los costos y resultados de la atención.

Analysis of Cost and Efficiency of a Medical Nursing Unit Using Time-Driven Activity-Based Costing

PURPOSE: Time-driven activity-based costing was applied to analyze the nursing activity cost and efficiency of a medical unit. METHODS: Data were collected at a medical unit of a general hospital. Nursing activities were measured using a nursing activities inventory and classified as 6 domains using Easley-Storfjell Instrument. Descriptive statistics were used to identify general characteristics of the unit, nursing activities and activity time, and stochastic frontier model was adopted to estimate true activity time. RESULTS: The average efficiency of the medical unit using theoretical resource capacity was 77%, however the efficiency using practical resource capacity was 96%. According to these results, the portion of non-added value time was estimated 23% and 4% each. The sums of total nursing activity costs were estimated 109,860,977 won in traditional activity-based costing and 84,427,126 won in time-driven activity-based costing. The difference in the two cost calculating methods was 25,433,851 won. CONCLUSION: These results indicate that the time-driven activity-based costing provides useful and more realistic information about the efficiency of unit operation compared to traditional activity-based costing. So time-driven activity-based costing is recommended as a performance evaluation framework for nursing departments based on cost management.

An Analysis of Cost and Profit of a Nursing Unit using Performance-Based Costing: Case of a General Surgical Ward in a General Hospital / 간호학회지

PURPOSE: The aim of this study was to analysize net income of a surgical nursing ward in a general hospital. METHOD: Data collection and analysis was conducted using a performance-based costing and activity-based costing method. RESULT: Direct nursing activities in the surgical ward were 68, indirect nursing activities were 10. The total cost volume of the surgical ward was calculated at won 119,913,334.5. The cost volume of the allocated medical department was won 91,588,200.3, and the ward consumed cost was won 28,325,134.2. The revenue of the surgical nursing ward was won 33,269,925.0. The expense of a surgical nursing ward was 28,325,134.2. Therefore, the net income of a surgical nursing ward was won 4,944,790.8. CONCLUSION: We suggest that to develop a more refined nursing cost calculation model, a standard nursing cost calculation system needs to be developed.

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.

Sistema de classificação de pacientes na especialidade enfermagem psiquiátrica / Patient system classification in psychiatric nursing

OBJETIVO: Estudar um Instrumento para Classificação do Nível de Dependência de Pacientes Psiquiátricos aos Cuidados de Enfermagem, foi objetivo deste estudo. MÉTODOS: Os indicadores críticos do cuidado (aparência e higiene, expressão do pensamento, humor e afeto, interação social, atividades, alimentação e hidratação, sono, medicação, eliminações, sinais vitais e outros controles, problemas e queixas somáticas). RESULTADOS: Com gradação de 1 a 3 pontos permitiram identificar os níveis de dependência. Foi aplicada a técnica Delphi e, os avaliadores concordaram pela manutenção dos 11 indicadores críticos. CONCLUSÃO: Os resultados deste estudo mostram que o instrumento é valido e pode contribuir para o avanço tecnológico e científico da Especialidade no Brasil.

Relación demanda-oferta de enfermería en sectores de internación / Relation demand-supply of nursing in hospitalization areas

En esta investigación exploratoria, los autores pretenden aplicar una metodología de análisis de datos que permita obtener información respecto de las características de la demanda y la oferta de atención de enfermería en servicios de internación de dependencia pública y privada. Se utilizan para ello indicadores que permiten ver la utilización y el rendimiento de las camas, la complejidad de los usuarios, las actividades de enfermería en términos de tiempo de atención, así como la cuanticalificación de la oferta mediante la disponibilidad y el nivel de formación del personal. La importancia de este estudio es que problematiza la relación oferta/demanda en términos de situaciones de compensación y descompesación de la misma

Sistema de Classificaçäo de Pacientes - parte II: custo de enfermagem / System's of patients classification-part II: nursing costs

Nesta parte, o autor afirma que a determinaçäo do custo de enfermagem na área hospitalar tem sido uma grande preocupaçäo dos administradores de enfermagem, especialmente nos países desenvolvidos. A determinaçäo do custo de enfermagem é, geralmente, vista como uma grande vantagem para os profissionais de enfermagem. Três métodos de se alocar custos de enfermagem säo descritos. O primeiro é o método do custo diário (per diem) que relaciona os custos de enfermagem diretamente com a média de permanência. O segundo método, medida de intensidade relativa, tenta relacionar o uso dos recursos de enfermagem com as condiçöes médicas do paciente. A terceira alternativa de custos é baseada nos sistemas de classificaçäo de pacientes, que medem as exigências do cuidado prestado ao paciente ou a força de trabalho da enfermagem.