运用护理人力配置需求方法的工作量指标进行护理人力规划：来自越南四家医院的证据。
Applying the workload indicators of staffing needs method in nursing health workforce planning: evidences from four hospitals in Vietnam.
机构信息
Department of Health Management and Organization, Institute for Preventive Medicine and Public Health, Hanoi Medical University, 1A Ton That Tung Street, Dong Da District, 10000, Hanoi, Vietnam.
Department of Hospital Management, Health Management Training Institute, Hanoi University of Public Health, 1A Duc Thang Road, Duc Thang Ward, North Tu Liem District, 10000, Hanoi, Vietnam.
出版信息
Hum Resour Health. 2022 Jan 28;19(Suppl 1):124. doi: 10.1186/s12960-021-00668-y.
BACKGROUND
Vietnam has encountered difficulties in ensuring an adequate and equitable distribution of health workforce. The traditional staffing norms stated in the Circular 08/TT-BYT issued in 2007 based solely on population or institutional size and do not adequately take into consideration the variations of need such as population density, mortality and morbidity patterns. To address this problem, more rigorous approaches are needed to determine the number of personnel in health facilities. One such approach is Workload Indicators of Staffing Need (WISN) developed by the World Health Organization (WHO), a facility-based workforce planning method that assists managers in defining the responsibilities of different workforce categories and improving the appropriateness and efficiency of a staff mix.
METHODS
This study applied the WISN approach and was employed in 22 clinical departments at four hospitals in Vietnam between 2015 and 2018. 22 targeted group discussions involving nurses were conducted. Hospital personnel records have been retrieved. The data were analyzed according to WISN instructions.
RESULTS
Of the 22 departments, there was a shortage of 1 to 2 nurses in 10 departments, with WISN ratios ranging between 0.88 and 0.95. Only 01 clinical colleges at Can Tho Hospital lacked 05 nurses, facing a high workload with a WISN ratio of 0.78. Administrative time represented 20-40% of the total work time of a nurse. In comparison, nurses at Can Tho Hospital spent time on administration from 24 onwards. 5-41.7% of their working time while nurses at Thanh Hoa Hospital spent 21-33%.
CONCLUSIONS
The application of the WISN enabled health managers to analyze the workload of nurses, calculate staffing needs, and thus effectively contribute to the workforce planning process. It is expected that the results of this research will encourage the use of the WISN tool in other hospitals and health facilities across the health system. At provincial and national levels, this study provides important evidence to help policy makers develop guidelines for personnel norms for health facilities in the context of limited resources, while the existing regulation is no longer appropriate.
背景
越南在确保卫生人力的充足和平等分配方面遇到了困难。2007 年发布的 08 号通函规定的传统人员配备规范仅基于人口或机构规模，没有充分考虑到需求的变化，如人口密度、死亡率和发病率模式。为了解决这个问题，需要更严格的方法来确定卫生机构的人员数量。世界卫生组织（世卫组织）开发的一种方法是工作人员需求工作量指标（WISN），这是一种基于机构的劳动力规划方法，可帮助管理人员定义不同劳动力类别的职责，并提高人员组合的适当性和效率。
方法
本研究应用了 WISN 方法，并于 2015 年至 2018 年在越南的四家医院的 22 个临床科室中进行。进行了 22 次涉及护士的目标群体讨论。检索了医院人员记录。根据 WISN 指令对数据进行了分析。
结果
在 22 个科室中，有 10 个科室的护士短缺 1 至 2 人，WISN 比率在 0.88 至 0.95 之间。只有芹苴医院的 01 个临床学院缺少 05 名护士，工作量大，WISN 比率为 0.78。行政时间占护士总工作时间的 20-40%。相比之下，芹苴医院的护士将 24 小时后的时间用于管理。21-33%用于管理，而清化医院的护士则花费 21-33%的工作时间用于管理。
结论
WISN 的应用使卫生管理人员能够分析护士的工作量，计算人员需求，从而为人员规划过程做出有效贡献。预计本研究的结果将鼓励在卫生系统内的其他医院和卫生机构使用 WISN 工具。在省和国家一级，本研究为决策者提供了重要证据，帮助他们在资源有限的情况下为卫生机构制定人员规范指南，而现行法规已不再适用。
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