感染控制的人员配备要达到多少才足够？一种通过人员需求工作量指标视角的确定性方法。
How much is adequate staffing for infection control? A deterministic approach through the lens of Workload Indicators of Staffing Need.
作者信息
Wundavalli LaxmiTej, Agrawal Uma Shanker, Satpathy Sidhartha, Debnath Baby Rani, Agnes Th Asanai
机构信息
Department of Hospital Administration, All India Institute of Medical Sciences, New Delhi, India.
Infection Control Unit, Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
出版信息
Am J Infect Control. 2020 Jun;48(6):609-614. doi: 10.1016/j.ajic.2020.02.010. Epub 2020 Apr 5.
BACKGROUND
Staffing ratios based on hospital beds and norms do not adequately address the requirement of infection preventionists (IP) in hospitals. We, therefore, aimed to determine staffing of IP (nursing category) based on actual workload involved.
METHODS
The study design was quantitative and longitudinal conducted for 1 year. The study was structured around the steps of the World Health Organization's Workload Indicators of Staffing Need (WISN).
RESULTS
We identified infection control activities, support activities and additional activities to be performed by 4 IP with a total available working time of 6,132 hours for an annual workload of 6,238.25 (±372) hours in an acute care hospital with 182 beds and 69,331 annual admissions. Core infection control activities consumed 78% time. Support and additional activities consumed the remaining 22% time. Active surveillance required 44% time and education consumed 32% time. WISN ratio of available staff and required staff was 0.75.
DISCUSSION
A WISN ratio less than 1 suggests inadequate staffing. Therefore, the WISN method recommends 4 IP instead of 3 based on existing workload. We compared our results with the existing quantification-based staffing studies.
CONCLUSIONS
WISN is a valuable method to measure all infection control activities and translate workload into IP (nursing) full time equivalents.
背景
基于医院病床数量和规范的人员配备比例无法充分满足医院感染预防专员（IP）的需求。因此，我们旨在根据实际工作量确定IP（护理类别）的人员配备。
方法
本研究设计为定量纵向研究，为期1年。该研究围绕世界卫生组织人员配备需求工作量指标（WISN）的步骤展开。
结果
我们确定了4名IP需要开展的感染控制活动、支持活动和额外活动，在一家拥有182张床位、年入院量为69331例的急症医院中，每年工作量为6238.25（±372）小时，总可用工作时间为6132小时。核心感染控制活动占78%的时间。支持活动和额外活动占其余22%的时间。主动监测需要44%的时间，教育工作占32%的时间。可用人员与所需人员的WISN比率为0.75。
讨论
WISN比率小于1表明人员配备不足。因此，WISN方法根据现有工作量建议配备4名IP，而不是3名。我们将我们的结果与现有的基于量化的人员配备研究进行了比较。
结论
WISN是一种衡量所有感染控制活动并将工作量转化为IP（护理）全职等效人员的有价值方法。
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