急診室臨時性短期護理人力 指派最佳化之探討

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题名:	急診室臨時性短期護理人力指派最佳化之探討
作者:	陳銘瑋;Chen,Ming-Wei
贡献者:	土木工程學系在職專班
关键词:	急診室;臨時性;三班制輪值;人力指派;最佳化;整數規劃;勞基法;emergency room;ER;provisional;three shifts;manpower dispatch;optimization;integer programming;Labor Standard Law
日期:	2016-07-18
上传时间:	2016-10-13 12:07:09 (UTC+8)
出版者:	國立中央大學
摘要:	摘要近年來因為氣候變遷異常，各類型流行性感冒盛行，尤以今年年初為盛，於流感高峰時短期內大量流感病患和夾雜其他病患同時塞爆各醫學中心急診室，原急診室醫護人員無法負荷湧入之急診病患，各醫院只得緊急抽調各科室醫護人員臨時性短期編組支援。現今各種文明病及傳染病盛行，民眾只能仰賴醫療體制，而在醫院的編制中，護理人員是人力資源需求最多單位，但隨著長時間日夜顛倒的輪班及長期休憩時間不足、睡眠品質不良，多數護理人員選擇轉業不願再從事護理工作，導致醫療單位嚴重缺乏護理人員，而護理人員的短缺正是影響醫療品質提升的主要因素之ㄧ。現今護理人員輪班大都以三班制輪值，且醫院工作特性是每日24小時全年無休形態，一般值班班表的排定，大多由各單位護理長或資深護理人員依經驗採人工排班方式，未經科學方法客觀判斷，容易有個人主觀意識、人員喜好或人為疏漏而影響排班公平性及需花費較多時間來完成人力排班。本研究針對以上問題以中部某醫院急診室為範例，以最佳化建構數學模型，運用LINGO-12套裝軟體，以0-1整數規劃模式求解急診室臨時性短期編組護理人員最平均工數與人力指派最佳化，更加入勞基法對於護理人員工作每週不得超過40小時工時限制要求。經研究後發現本模式較人工經驗指派方法為佳，其成果顯示本研究指派模式不但排程時間短、人力利用效益佳且更具公平性，可做為醫療單位對於臨時性短期編組護理人員人力指派實務上之參考。 ;Abstract Due to abnormal climate change in recent years, various types of influenza have been prevalent, especially in the beginning of this year. During the flu peak, large numbers of flu patients, as well as other patients, flock into the emergency room (ER) of medical centers, resulting in existing ER medical and nursing personnel’s inability to cope with the ER patients that rush in and leaving hospitals no choice but to immediately organize and dispatch provisional medical and nursing personnel from other departments and offices for short-term organization and support. Due to all kinds of widespread urban diseases and contagious diseases these days, the general public can only rely on the medical system. However, in hospital organization, nursing departments the units with the greatest human resources demand. However, because of reversed day and night shifts, long-term lack of rest, and poor quality of sleep, most nurses opt for a career change instead of continuing to engage in nursing care work, thus resulting in a serious lack of nursing staff in medical units. In fact, adequate nursing staff is one of the main factors affecting the quality of medical care. Currently, nursing staff mostly take three shifts, since hospitals are characterized by 24-hour work, all year round. As for general duty scheduling, manual scheduling is generally adopted by department head nurses or senior nurses based on experience. This scheduling lacks objective judgment through scientific methods. Therefore, personal subjectivity, staff preferences, or human omissions may result, which may affect the fairness of scheduling and may take more time to complete manpower scheduling. Targeting the above issues, this study adopted the ER of an anonymous hospital as an example. An optimization mathematical model was constructed. With the LINGO-12 package software, the 0-1 integer programming model was employed to obtain the most average work hours and manpower dispatch optimization of ER provisional short-term organization of nursing staff. The “work hours not exceeding 40 hours per week” requirement in the Labor Standard Law, LSL was even incorporated. The research finding shows that this model is better compared to the manual experience-based dispatch method. The results show that this study’s dispatch model shortened the scheduling time and achieved better manpower utilization effectiveness and fairness. The results shall serve as a reference for medical units during provisional short-term organization of nursing staff manpower dispatch practices.
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