Nakashima Keisuke, Inoue Yoshiaki, Iwasaki Tomoyuki, Fukushige Haruna, Ishii Atsue
Department of Medical Informatics, Graduate School of Medicine, The University of Osaka, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
Department of Information and Communications Technology, Graduate School of Engineering, The University of Osaka, 2-1 Yamadaoka, Suita, Osaka 565-0871, Japan.
J Nurs Manag. 2025 Aug 28;2025:5540600. doi: 10.1155/jonm/5540600. eCollection 2025.
In many developed countries, a rapidly aging population has increased healthcare demands and the proportion of older nurses in the workforce. This demographic shift requires nursing managers to have a deeper understanding of the physical demands on staff nurses, particularly older ones. In this paper, we aim to provide valuable insights for developing evidence-based strategies to improve work environments in hospital wards. To achieve this, we conducted a statistical analysis of data on walking distance for day, long-day, and night shifts, obtained from a long-term survey across 14 wards in a large acute care hospital in Japan using automated data collection via mobile devices. Using nonparametric multiple comparisons and multiple regression analysis, we evaluated the impact of factors such as age, clinical ladder level, years of service, ward type, nurse calls, weekend, and patient-to-nurse ratio on walking distance. The multiple comparison tests revealed significant differences in walking distance among clinical ladder levels, with small to medium effect sizes. While age and years of service had some impact, their influence was less pronounced than that of clinical ladder levels. Our regression analysis showed that ward characteristics significantly affected walking distance, with emergency wards exhibiting notably longer distances. The number of nurse calls had a significant positive impact on walking distance across all shifts, while the patient-to-nurse ratio significantly affected walking distance only for night shifts. The weekend affected walking distance only for long-day shifts. These findings suggest that ward managers should reexamine the appropriate nursing care systems suited to the characteristics of their ward, and that reconsidering approaches to task assistance for less experienced nurses and night shift allocations for novice nurses could effectively reduce physical burdens on nurses. They also emphasize the importance of workload balancing in task and patient assignments and the consideration of ward characteristics in nurse reshuffling.
在许多发达国家，人口迅速老龄化增加了医疗保健需求以及劳动力中年龄较大护士的比例。这种人口结构的转变要求护理管理者更深入地了解对一线护士，尤其是年龄较大护士的身体需求。在本文中，我们旨在为制定循证策略以改善医院病房的工作环境提供有价值的见解。为实现这一目标，我们对日本一家大型急症护理医院14个病房的长期调查中通过移动设备自动收集的日班、长日班和夜班步行距离数据进行了统计分析。我们使用非参数多重比较和多元回归分析，评估了年龄、临床职级、服务年限、病房类型、护士呼叫次数、周末以及护患比等因素对步行距离的影响。多重比较测试显示临床职级之间的步行距离存在显著差异，效应大小为小到中等。虽然年龄和服务年限有一定影响，但其影响不如临床职级明显。我们的回归分析表明，病房特征对步行距离有显著影响，急诊病房的步行距离明显更长。护士呼叫次数对所有班次的步行距离都有显著的正向影响，而护患比对步行距离的显著影响仅体现在夜班。周末仅对长日班的步行距离有影响。这些发现表明，病房管理者应重新审视适合其病房特点的适当护理系统，并且重新考虑为经验不足的护士提供任务协助的方法以及为新手护士安排夜班的方式，这可以有效减轻护士的身体负担。它们还强调了在任务和患者分配中平衡工作量以及在护士调配中考虑病房特征的重要性。
