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Determination of the nursing load at the aftercare department
TRACHTOVÁ, Pavlína
Abstract Current status: The basic condition of quality nursing care is to ensure sufficient number of qualified nursing staff. Main aim of this research was to determine the optimal number of nursing staff at the after-care and rehabilitation department of a selected hospital in the South Bohemian Region. The starting point was the standardized methodology of Mr and Mrs Pochylý (1999, 2008). Methodology: The research was carried out quantitatively. The first phase of the research was conducted by means of in-depth interviews with six nurses from the after-care and rehabilitation department of a selected hospital in South Bohemia. In the second phase of the research, the average time value of basic nursing care per patient hospitalized at the aftercare department was determined for a 24 hour period. A total of 140 time units of basic nursing care tasks were performed. In the third phase of the research, the total daily period of nursing care was determined for all patients hospitalized at the after-care and rehabilitation department in the period from 7 January to 20 January 2019. Subsequently, the optimal number and qualification representation of nursing staff in this department for the monitored period was defined. Results: The average period of basic nursing care for one patient requiring increased supervision was 76.1 minutes / 24 hours and the average basic nursing care per immobile patient was 125.3 minutes / 24 hours, the difference was statistically significant (p < 0.001). On average, 23.9 patients were hospitalized in the follow-up and rehabilitation department during the reporting period. The total nursing care time for this patient group was 4871.3 minutes / 24 hours on average, of which 1/2 of the total nursing care was represented by basic nursing care, 1/4 by special nursing care and 1/4 by the organization of care including documentation. The difference between primary and special nursing care was statistically significant (p < 0.001). According to the methodology of Pochylá and Pochylý (1999, 2008), the recommended average number of nursing staff at this load was 10.2 persons for 24 hours. In fact, there was 9.4 nursing staff members at the department. The difference between the recommended and actual number of staff was 0.8 and which is a statistically significant difference (p = 0.015). Pochylá and Pochylý (1999) recommend 17.2 nursing staff members(36.4% of nurses and 63.6 % of other nursing staff) in this type of nursing ward. In reality, only 17.5 nursing staff are employed at this department. Of these, 54.3 % are nurses and 45.7 % are other nursing staff. Conclusions and recommendation for practical use: It is clear from these results that basic nursing activities outweigh special performances in the aftercare departments. Therefore, when planning the optimal number of nursing staff, it is necessary to adapt the qualifications of nursing staff to the spectrum of tasks typical of the given department. The output of this work is a proposal of a motivational program for managers, with the aim to acquire and maintain enough nursing staff in a given healthcare organization.
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