Clinical Path Based Simulations to Estimate the Necessary Working Hours for Hospital Ward Nurses and to Make the Hours Distributed Reduction. Applications to The Cases Composed of Five Usual Cardiac Catheter Tests and One Additional Urgent Test

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  • Katabami Ryuko
    Department of Nursing, Faculty of Medical Sciences, Teikyo University of Science
  • Ishizuka Hidehiro
    Graduate School of Library, Information and Media Studies, University of Tsukuba (Present title : Emeritus Professor)

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Other Title
  • クリニカルパスに基づくシミュレーションを用いた病棟看護師の時間当たり必要労働時間数の推定と平準化．心臓カテーテル検査5件に緊急検査1件が加わった場合への適用
  • クリニカルパス ニ モトズク シミュレーション オ モチイタ ビョウトウ カンゴシ ノ ジカン アタリ ヒツヨウ ロウドウ ジカンスウ ノ スイテイ ト ヘイジュンカ : シンゾウ カテーテル ケンサ 5ケン ニ キンキュウ ケンサ 1ケン ガ クワワッタ バアイ エ ノ テキヨウ

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Abstract

<p>Aim : Several papers have reported that the risk of making an error is increased when a ward nurse is overworked. When the number of patients exceeds supposed ones, then a ward nurse’s overwork will happen. Therefore, the provision of the overwork will be useful. Then, the present authors set the case of 5 scheduled and 1 urgent Coronary Artery Angiography (CAG) per day, and attempt 1) estimation the necessary working times for ward nurses in 1 minute unit and 2) making distributed reduction of the minutes to obtain reasonable work time plans for the related nurses.</p><p>　Method : In order to make distributed-reduction of the nurses’ working times, the present authors performed the following procedures, based on five scenarios on 5 scheduled and one urgent CAG per day. The procedures are 1) to shift some of medical operations or cares by a nurse within permissible range in clinical pathway, and 2) to make clear number and timetable of relief nurses who are called. The authors set two types of relief nurse : an equivalent nurse and a nurse limited in ones role and functions. In the cases of two types of relief nurse, shared task flows for medical operations and cares are made to check reasonable and to make improved plans to propose.</p><p>　Results : The authors obtained improved plans as follows. Daytime plan includes one equivalent or limited relief nurse between 13 : 30 and 17 : 30, the other relief nurse : one equivalent nurse between 15 : 30 and 16 : 30. Evening plan includes one equivalent or limited relief nurse between 16 : 30 and 20 : 30. Values of necessary working hours per hour in the improved plans are in a good range. Workflow charts including work sharing and waiting time of the improved plans show almost no overwork.</p>

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