STUDY ON THE RELATIONSHIP BETWEEN NURSING BURDEN FEELING AND PLAN OF ADVANCED ACUTE-PHASE-WARDS

<p> Japan is presently in the era of super-aging and population decline. A reformed medical and long-term care insurance provision system will be introduced in 2025, which necessitated a closed cooperation in patients' early hospital discharge in medical and nursing care facilities, especially in the advanced acute-phase-wards. However, these wards have several problems like the increase in patients due to the increasing elderly population, lowered degree of job-satisfaction, quitting due to job-burnout, and harsh working conditions.</p><p> </p><p> This paper clarifies the relationship between the nurses' burden feeling and the advanced acute-phase-wards plan. The questionnaire was sent to the acute-phase-wards of 496 hospitals in Kanto and Tohoku regions in consideration that the sense of burden in nurses differed by region, and 674 people from 70 wards gave an effective response. The ward plan was classified into five types based on three conditions: the direction from the staff station (SS) to the bedside, bed arrangement type, and the position of the SS relative to the entire bed arrangement.</p><p> </p><p> According to a tabulation of the standard degree of fatigue during normal working days based on the plan type and the number of beds category, nearly 90% of the respondents experienced nursing burden. Consequently, it was established that the basic burden feeling due to daily work was quite high regardless of plan type and number of beds category.</p><p> Next, the correlation between the nursing burden feeling and architectural elements of the ward were analyzed. The correlation ratio indicated no relationship between the facility characteristics, nurse characteristics, and nursing burden feeling as each characteristic offset the other, thereby cancelling the nursing burden feeling.</p><p> Analysis of the quantification type I indicated that the ward plan clearly influenced the nursing burden feeling. Additionally, the relationship between the patientʼs severity and burden feeling from the combination of plan type categories was analyzed. The plan types with low sense of nursing burden differed for each analysis and items of nursing burden feeling (work, movement flow line, and observation). Additionally, the tendency of the sense of burden in the result of quantification I and the seriousness category condition also differed.</p><p> </p><p> This paper clarified the following：</p><p> 1. Number of directions to look from the SS affects the degree of fatigue during normal working days, watch over, and observation</p><p> 2. The bed arrangement and concentration of nursing and equipment moving lines in the moving line space affected the feeling of burden in the work environment.</p><p> 3. The feeling of burden between the plan types and items of nursing burden depending on the severity differed.</p><p> </p><p> In the advanced acute-phase-ward, the possibility of the plan contributing to the reduction of the nursing burden that differed by seriousness was indicated, because the content and quantity of nursing differed by consciousness level and patientʼs early rehabilitation.</p><p> From these results and considerations, the following problems remained: Grasp of nursing service content in the seriousness category and examination of the relation of the sense of burden by other factors such as the counter of the staff-station and face-to-face ratio of the sickbeds.</p><p> The examination of the architectural element affecting the nursing burden feeling at advanced acute-phase-wards in future was considered necessary.</p>