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Determining the level of nursing workload and the optimal number of nursing staff in selected standard hospital bed care departments
STACHOVÁ, Klára
Current situation: Educated and qualified nurse can fully do her job, give a patient bio-psycho-social-spiritual needs and satisfy them. This can happen only if optimal conditions are given to her, which means the optimal number of nursing staff. The aim of the study was to set the optimal number of nursing staff at surgical department in the Hospital of the Vysočina region, which was chosen. A standardized methodology of Pochylá and Pochylý (1999 and 2008) was used. Methodology and the research complex: Quantitative-qualitative method was used in the research. Detailed interviews were used in the first part of the study while talking to nurses of the surgical department of the Hospital of the Vysočina region. In phase two, 26 special nursing procedures were selected and divided into four thematic parts. 520 measurements were made in total, average time of making each special nursing procedure was set. In phase three, average values of nursing one patient in 12 hours at surgical department were set. Daily shots of the procedures were being taken for 14 days (Monday-Sunday). Optimal numbers of nursing staff and their qualified substitution in the Hospital of the Vysočina region were set in the last stage of the research. Results: The research question and three hypotheses were answered by performing and processing the research. The result is that there are statistically major differences in average value of basic and special nursing. 21 patients in average were treated in the hospital in the first week of research. The average nursing time for this number of patients in 12 hours was 3585 minutes 1027 minutes of basic nursing care and 1718 minutes of special nursing procedures. In the second week of research, 24 patients were treated at the department in average. The average nursing time for this number of patients was 3647 minutes in 12 hours 1036 minutes of basic nursing care and 1675 minutes of special nursing procedures. Statistically major differences were confirmed even during special nursing procedures. The longest average time was measured while incoming of patients, transferring, discharging (14,31 minutes) and the shortest average time was measure while applicating medicine into body cavities (0,5 minutes). Based on the research we can say that the number of staff at selected department is for a 12-hour shift optimal. Recommended number of full-time employees is 5, the real number is 5,4. Conclusion and recommendation: The output of this thesis is recommendation for management of nursing care regarding the issue of getting and maintaining the optimal number of nursing staff.
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Quantification of Basic and Special Nursing Performance on Standard Units of the Children's Department
SOROKANETS, Viktorie
Abstract Quantification of General and Special Nursing Procedures at Standard Units of Paediatric Departments The present thesis is divided into two parts, a theoretical and practical part. The theoretical part deals with the history of paediatrics, training and competencies of paediatric nurses, contemporary paediatric care and the range of provided services. There is a separate part describing general and special nursing care. Due to a limited scope of the bachelor's thesis, attention was paid to principal activities of paediatric nurses. Within the first part of the research survey two objectives and five hypotheses were established. The work aimed to inventory general and special nursing care at standard units of paediatric departments. The following hypotheses were set: H1: The most frequent general nursing procedure is patient personal hygiene care. H2: The most frequent special nursing procedure in the "Medication Administration" category is the oral (per os) administration of medication. H3: The most frequent special nursing procedure in the "Monitoring" category is the monitoring of body temperature. H4: The most frequent special nursing procedure in the category of "Special and Diagnostic and Therapeutic Procedures" is biological sampling. H5: The most frequent special nursing procedure in the category of "Other Patient Related Activities" is the reception of a patient. The research survey was carried out as a quantitative survey. The research sample consisted of 49 nurses of standard paediatric departments at five selected hospitals, namely the hospitals in České Budějovice (Nemocnice České Budějovice, a. s.), Prachatice (Nemocnice Prachatice, a. s.), Strakonice (Nemocnice Strakonice, a. s.), Písek (Nemocnice Písek, a. s.) and Český Krumlov (Nemocnice Český Krumlov, a. s.). The second part of the survey focused on assessing the selected nursing procedures. General nursing procedures included meal preparation, feeding and diapering a baby. Special nursing care included oral (per os) and rectal (per rectum) medication administration, also intravenous injection, infusion and its monitoring, assisting in examinations, blood and faeces sampling, taking part in the round and patient handover. Each procedure was measured ten times and the result was counted up and divided by their number in order to obtain the average value. The hypotheses were tested by means of the Kruskal-Wallis test where the mean rank value was set. On the basis of the test the set hypotheses were either confirmed or disconfirmed. In the area of general nursing care where three categories were compared, the highest value (463.68) was obtained for the nutrition care. The first hypothesis was therefore not confirmed. In the area of special nursing care, the "Medication Administration" category, the highest value (403.07) was obtained for medication preparation and oral administration. Again, the hypothesis was not confirmed. The hypothesis in the "Monitoring" category was confirmed since the highest value (539) was obtained for body temperature monitoring. Following, there are "Special and Diagnostic and Therapeutic Procedures" where the hypothesis was not confirmed as well since the most frequent procedure is the preparation of a child for an examination (662.21). Based on the arithmetic mean calculation in the last category of "Other Patient Related Activities" where the highest value (8.09) was obtained for filling out nursing diagnoses, the hypothesis was not confirmed as well. The results of the observation part served for creating a draft of a software application aimed at calculation of the nursing load in a monitored number of patients. This application is ready for further development.
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