Lee Tso-Ying, Yeh Mei-Ling, Chen Hsing-Hsia, Lien Gieng-Hueu
Nursing Department, Tri-Service General Hospital, Taipei, Taiwan.
J Adv Nurs. 2005 Aug;51(4):406-13. doi: 10.1111/j.1365-2648.2005.03511.x.
This paper reports a study examining the outcome of personnel costs and quality of care after implementing the skill mix practice model for nursing.
In response to ever-tightening government budgets and changes in health insurance reimbursement, it may be necessary for hospitals to reassess their practice models to remain competitive and maintain quality of care.
Using a pre- and post-test quasi-experimental design with questionnaires, participants were recruited at a teaching hospital in Taiwan. Questions were included on both patient satisfaction with nursing care and nurse satisfaction with nursing aides. The data were collected in 2003.
The cost of implementing the skill mix practice model with 22 nurses and seven nursing aides was 2.7% lower than when only using 25 nurses. In addition, there was a statistically significant difference in patient satisfaction and in nurse satisfaction with the performance of the aides. There was no statistically significant difference in the pre- and post-test outcome measures of both the incidence of falls and the medication error rate.
To decrease costs and increase quality of care, the skill mix practice model is worthy of consideration for clinical nursing care. This study presents an investigation of the first hospital implementation of the skill mix practice model for nursing in Taiwan, and the results of which can serve as a reference model for hospital nursing practice reform.
本文报告一项关于实施护理技能组合实践模式后人员成本和护理质量结果的研究。
鉴于政府预算日益紧张以及医疗保险报销政策的变化，医院可能有必要重新评估其实践模式，以保持竞争力并维持护理质量。
采用前后测准实验设计并使用问卷，在台湾一家教学医院招募参与者。问卷涵盖患者对护理的满意度以及护士对护理助理的满意度。数据于2003年收集。
配备22名护士和7名护理助理实施技能组合实践模式的成本比仅使用25名护士时低2.7%。此外，患者满意度以及护士对护理助理工作表现的满意度存在统计学上的显著差异。跌倒发生率和用药错误率的前后测结果指标无统计学上的显著差异。
为降低成本并提高护理质量，技能组合实践模式值得临床护理工作考虑。本研究呈现了台湾首家医院实施护理技能组合实践模式的调查情况，其结果可作为医院护理实践改革的参考模式。
