SCI晨读：护士如何花费时间？某内科病房护理活动时间及动作分析
护士如何花费时间？某内科病房护理活动时间及动作分析
护士如何花费时间？某内科病房护理活动时间及动作分析
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摘要
目标
描述护理活动的性质和持续时间，以及注册护士在瑞士大学医院内科病房中分配给其实践范围不同维度的时间。
设计
单中心观察性描述性研究。
方法
使用时间和动作研究，两名研究人员在 2018 年的 46 个完整工作班次中对医护人员（N = 21）进行了跟踪。他们使用平板电脑实时记录了观察到的每项活动，其中包含预先注册的 42 项活动列表，分为 13 个维度.
结果
共观察到 507.5 个工作小时。注册护士不到三分之一的工作时间花在病人身上。他们在“沟通和护理协调”和“护理计划”方面分配了最多的时间，而在“优化护理质量和安全性”、“整合和监督员工”和“客户教育”方面分配的时间最少。
结论
本研究为护士在工作中的时间使用提供了可靠的描述。它强调了对整个护理实践范围的次优使用。
影响
应重新考虑工作组织和文化，以促进更好地使用护理技能。实践优化应重点关注以下三个主要方面：（1）注册护士更多地参与建立关系并直接照顾患者及其家属；(2) 在必要的活动中更好地利用注册护士的技能，包括护理临床评估和患者教育，以及 (3) 更系统地更新注册护士的知识。
Abstract
Aim
To describe the nature and duration of nursing activities and how much time registered nurses allocate to the different dimensions of their scope of practice in a Swiss university hospital internal medicine ward.
Design
A single-centre observational descriptive study.
Method
Using a time and motion study, two researchers shadowed healthcare workers (N = 21) during 46 complete work shifts in 2018. They recorded each activity observed in real time using a tablet computer with a pre-registered list of 42 activities classified into 13 dimensions.
Results
A total of 507.5 work hours were observed. Less than one third of registered nurses’ work time was spent with patients. They allocated the most time to the dimensions of ‘communication and care coordination’ and ‘care planning’, whereas ‘optimizing the quality and safety of care’, ‘integrating and supervising staff’ and ‘client education’ were allocated the least time.
Conclusion
This study provided a reliable description of nurses’ time use at work. It highlighted suboptimal use of the full scope of nursing practice.
Impact
Both work organization and culture should be reconsidered to promote better use of nursing skills. Practice optimization should focus on the following three main areas: (1) greater involvement of registered nurses in building relationships and directly caring for patients and their families; (2) better use of registered nurses’ skills in the activities required of their proper roles, including nursing clinical assessments and patient education and (3) more systematically updating registered nurses’ knowledge.
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