Fann Wen-Chih, Lee Bih-O, Hsiao Cheng-Ting, Chuan Yu-Shan, Kuo Chiu-Ya
Chiayi Chang Gung Memorial Hospital Department of Emergency Medicine Chiayi Taiwan.
Chiayi Chang Gung Memorial Hospital Department of Nursing Chiayi Taiwan.
J Acute Med. 2019 Dec 1;9(4):161-171. doi: 10.6705/j.jacme.201912_9(4).0002.
The overcrowded environments of emergency departments (EDs) lead to increased clinical workloads for nurses and infl uences the quality of patient care. This study aimed to evaluate whether the quality of patient care meets the expectations of emergency nurses in Taiwan by measuring the amount of time nurses spend on patient care activities.
The direct observation study was conducted in one suburban academic hospital with approximately 80,000 annual ED visits. This study observed emergency nurses and the time they spent on their nursing activities. The directly measured times and nurse expected patient care nursing times were compared.
For all 88 types of nursing activities recorded, each measured nursing time was less than the expected nursing time. On average, the measured nursing time was 82% less than the expected nursing time (2.0 ± 0.3 minutes vs. 11.6 ± 1.5 minutes, < 0.01). Among the 88 types of nursing activities recorded, the average measured time spent on 76 types (86%) was less than 3 minutes. The nursing activity on which the longest time was spent was cerebrospinal fl uid study nursing (7 minutes). The most frequent nursing activity was documentation.
The nursing time spent on patient-care activities in EDs was much less than the nurses expected. The results may provide a basis for nursing quality measurements and manpower calculations for EDs.
急诊科拥挤的环境导致护士临床工作量增加，并影响患者护理质量。本研究旨在通过测量护士在患者护理活动上花费的时间，评估台湾急诊科患者护理质量是否符合急诊护士的期望。
在一家每年急诊科就诊量约80000人次的郊区教学医院进行直接观察研究。本研究观察急诊护士及其在护理活动上花费的时间。比较直接测量的时间和护士预期的患者护理时间。
在记录的所有88种护理活动中，每种测量的护理时间均少于预期护理时间。平均而言，测量的护理时间比预期护理时间少82%（2.0±0.3分钟对11.6±1.5分钟，<0.01）。在记录的88种护理活动中，76种（86%）的平均测量时间少于3分钟。花费时间最长的护理活动是脑脊液检查护理（7分钟）。最常见的护理活动是记录。
急诊科用于患者护理活动的护理时间远少于护士的预期。这些结果可为急诊科护理质量测量和人力计算提供依据。
