|Budget Amount *help
¥2,000,000 (Direct Cost : ¥2,000,000)
Fiscal Year 1994 : ¥500,000 (Direct Cost : ¥500,000)
Fiscal Year 1993 : ¥1,500,000 (Direct Cost : ¥1,500,000)
Today the hospital economical environment in Japan is drastically changing toward cost containment and efficient quality care. To meet these needs, the specific and unique roles and functions of nursing professions must be redefined and the work-load of the nursing staff must be restructured by alleviating the non-professional nursing activities and responsibilities in order to improve the productivity of nursing care delivery system.
For this research, the author first redefined the 8 unique roles of clinical nursing by using the breakthrough thinking approach proposed by D.Nadler, then conducted a work-sampling survey at a general medical ward to determine how much non-professional nursing activities were being performed by the nursing staff and to restruct the work-load of the nursing staff according to the preset unique roles.
The assumption is that when the non-professinal activities now performed by nurses are delegated to other health care coworkers, such as unit clerks, pharmacis
ts, clinicians, clinical laboratory technicians, nurse aides, and other helpers, nurses would be free from the activities, and would be able to spend the hours saved giving patients professional nursing care. Based on this assumption, the changes in the work-load of the coworkers and the hours nurses would be removed from the activities were calculated by means of each time sequence. Before determining which activities were able to be delegated to which coworkers, the legal aspects and salary base of these coworkers were carefully examined.
The results were (1) about 20 hours of nurses' hour would be delegated per day, (2) the health care coworkers mentioned above all significantlly could contribute to alleviating of nurses' non-professional tasks, (3) by means of the time sequence analysis, the hours economized by delegation and the realistic and feasible method of delegation were identified, (4) because of few economical back up to the bed-side activities of these coworkers by the present reimbursement system, the delegation to the non-professionals, such as nurse aides and unit clerks, is advisable.
Under the circumstances of general lack of manpower, the multidisciplinary care team must cooperate each other and acknowlege each expertise and unique functions to improve the quality of patient care. Less