对护士留职率的影响。一项排班实验。

Effects on nurse retention. An experiment with scheduling.

作者信息

Choi T, Jameson H, Brekke M L, Podratz R O, Mundahl H

出版信息

Med Care. 1986 Nov;24(11):1029-43. doi: 10.1097/00005650-198611000-00007.

DOI:10.1097/00005650-198611000-00007

Abstract

Four randomly selected nursing groups were assigned to three experimental groups and one control group to test the relative impact of three experimental nursing schedules, using a before-after design. The three experimental treatments were straight shifts; regular schedule but with unlimited requests for changes; and individual station-designed schedules. Before treatment, score differences between the experimental and control groups were limited to one of 36 highly reliable scales specifically constructed and pretested to gauge effects of scheduling. This single difference was judged not to be significantly related to experimental outcomes. Because of a poor job market situation, retention was not affected significantly by any of the three treatments, but root causes of turnover were. Results of the experiment showed that individual station-designed schedules triggered the most changes that favor retention. In contrast, the other two treatments unexpectedly increased nurses' own sense of marketability and reduced teamwork among nurses. Reasons accounting for the results are discussed in the text.

摘要

随机选取四个护理小组，分为三个实验组和一个对照组，采用前后对照设计来测试三种实验性护理排班表的相对影响。三种实验性处理方式分别是连续班次；常规排班但可无限制地申请调班；以及各科室自行设计的排班表。在处理前，实验组和对照组之间的得分差异仅限于36个高度可靠量表中的一个，这些量表是专门构建并经过预测试以评估排班效果的。这一单一差异被判定与实验结果无显著关联。由于就业市场形势不佳，三种处理方式中的任何一种都未对留任意产生显著影响，但却影响了离职的根本原因。实验结果表明，各科室自行设计的排班表引发了最有利于留任的变化。相比之下，其他两种处理方式意外地增强了护士自身的市场意识，并降低了护士之间的团队合作。文中讨论了导致这些结果的原因。