van Wyk A J, Muller M E
Curationis. 1995 Dec;18(4):31-7.
This study of patient activity level plans (PALP) to determine nursing levels for in-patients units was carried out by means of an exploratory, descriptive instrumental study within the context of a nursing situation. With the literature study serving as background, a patient activity level plan (PALP) was designed, according to accepted criteria, to find data on which to base post determination of nursing staff. This study was done at a private research hospital in Johannesburg where all the patients and nursing staff (first- as well as second-in-charge) were involved. The PALP-instrument was designed by the researcher, and under supervision of the researcher it was implemented in seven nursing units in the hospital. (The instrument proved to be highly reliable p = 0.999). The difference between nursing post determination as recommended and determined by PALP, and nursing post determination as determined by means of a pragmatic subjective approach by the nursing service manager of the hospital, proved to be statistically insignificant. The PALP instrument showed, however, that more nursing staff were needed in four of the seven units. The quality of the nursing care was not investigated nor was a productivity study carried out. The total difference between the recommended and actual nursing hours needed for all the nursing units shows a statistically significant difference (p = 0.0001) on a 1% significance level. The instrument proved to be easily comprehended, easily implemented and relevant to its purpose. It also shows a high inter-rator reliability (a chronbach alpha value of 0.999). Thus a reliable PALP-instrument was developed and successfully implemented at a research hospital for the determination of nursing posts. The most significant recommendations include national standardization of the PALP-instrument in hospitals and refining and testing of the PALP-instrument in other clinical areas e.g. out-patients and critical care units. This instrument could also contribute towards a more cost-effective post determination in nursing.
这项关于患者活动水平计划（PALP）以确定住院病房护理等级的研究，是在护理情境下通过探索性、描述性工具性研究开展的。以文献研究为背景，依据公认标准设计了患者活动水平计划（PALP），以获取用于确定护理人员数量的数据。该研究在约翰内斯堡的一家私立研究医院进行，所有患者及护理人员（包括主管和副主管）均参与其中。PALP工具由研究者设计，并在研究者的监督下在医院的七个护理单元实施。（该工具被证明具有高度可靠性，p = 0.999）。PALP推荐并确定的护理岗位数量与医院护理服务经理通过务实主观方法确定的护理岗位数量之间的差异，在统计学上不显著。然而，PALP工具显示，七个单元中有四个单元需要更多护理人员。研究未对护理质量进行调查，也未开展生产率研究。所有护理单元推荐的与实际所需护理时长的总体差异在1%显著性水平上显示出统计学显著差异（p = 0.0001）。该工具被证明易于理解、易于实施且与目标相关。它还显示出较高的评分者间信度（克朗巴哈α值为0.999）。因此，开发了一种可靠的PALP工具，并在一家研究医院成功实施以确定护理岗位。最重要的建议包括在医院对PALP工具进行国家标准化，以及在其他临床领域（如门诊和重症监护病房）对PALP工具进行完善和测试。该工具还可为护理岗位确定中更具成本效益的决策做出贡献。
