Jung Se Young, Moon Hui-Woun, Park Da Som Me, Sung Sumi, Jung Hyesil
Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Office of eHealth Research and Business, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Int J Gen Med. 2023 Sep 6;16:4067-4076. doi: 10.2147/IJGM.S424424. eCollection 2023.
Inpatients commonly experience problems with elimination due to incontinence, urinary retentions, and complications with indwelling catheters. Although elimination care (EC) is an important nursing area, few studies explore the burden of EC on nurses.
To identify the burden on EC by analyzing nurses' opinions using sequential explanatory mixed method.
This research was conducted using a sequential explanatory mixed-methods design. A total of 59 nurses at a tertiary hospital in South Korea participated in the study from January 1 to March 31, 2022. For quantitative analysis, information about number of delays of work due to EC, required time for serving bedpan or diaper changes, percentage of EC per shift, and percentage of patients who need EC was collected through a survey. For qualitative analysis, focus group interviews were conducted to identify factors that put a burden on EC. Important themes were derived by analyzing nurses' opinions on EC.
For nurses in intensive care units, general wards, and integrated nursing care wards, the number of work delays due to EC was 3.6 ± 1.5, 2.3 ± 1.2, and 4.8 ± 2.4 (<0.01), respectively. The mean percentage of EC work out of total nursing tasks per shift was 36.2 ± 19.0, 29.3 ± 14.4, and 43.8 ± 14.1 (=0.02), respectively. The mean percentage of patients requiring EC out of patients a nurse cares was 85.4 ± 16.6, 41.3 ± 26.1, and 58.8 ± 21.9 (<0.01), respectively. Following qualitative analysis, four themes related to nurses' EC burden were derived: physical burden, frequent care needs, delay of other jobs due to EC, and complications. Among them, frequent care needs were found to be the primary factor requiring consideration to reduce nurses' burden.
This research found that EC is one of the most burdensome tasks that nurses want to avoid. To alleviate their burden, effective EC protocol or smart medical devices assisting with EC should be developed.
住院患者常因失禁、尿潴留及留置导尿管并发症而出现排泄问题。尽管排泄护理（EC）是一个重要的护理领域，但很少有研究探讨EC给护士带来的负担。
通过采用序列解释性混合方法分析护士的意见，确定EC带来的负担。
本研究采用序列解释性混合方法设计。2022年1月1日至3月31日，韩国一家三级医院的59名护士参与了该研究。对于定量分析，通过调查收集了因EC导致的工作延误次数、提供便盆或更换尿布所需时间、每班EC的百分比以及需要EC的患者百分比等信息。对于定性分析，进行了焦点小组访谈，以确定给EC带来负担的因素。通过分析护士对EC的意见得出重要主题。
对于重症监护病房、普通病房和综合护理病房的护士，因EC导致的工作延误次数分别为3.6±1.5、2.3±1.2和4.8±2.4（<0.01）。每班EC工作占总护理任务的平均百分比分别为36.2±19.0、29.3±14.4和43.8±14.1（=0.02）。一名护士护理的患者中需要EC的患者平均百分比分别为85.4±16.6、41.3±26.1和58.8±21.9（<0.01）。经过定性分析，得出了与护士EC负担相关的四个主题：身体负担、频繁护理需求、因EC导致的其他工作延误以及并发症。其中，频繁护理需求被认为是减轻护士负担需要考虑的主要因素。
本研究发现EC是护士最想避免的负担最重的任务之一。为减轻他们的负担，应制定有效的EC方案或开发辅助EC的智能医疗设备。
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