臨牀透析 Vol.24 No.3(1)


特集名 透析医療と看護必要度 -- その意義と活用の可能性
題名 「看護必要度」と看護の質
発刊年月 2008年 03月
著者 下山 節子 日本赤十字九州国際看護大学
著者 中村 光江 日本赤十字九州国際看護大学
【 要旨 】 「看護必要度」とは，「入院患者に提供されるべき看護の必要量」をいい，看護サービス提供時間の程度によって表されている．「看護必要度」という評価基準の導入により，「『看護必要度』に応じて看護サービス時間が提供されている」ことが前提となる．社団法人日本看護協会による「2006年病院における看護職員需給状況調査」によると，配置基準7対1入院基本料新設の看護現場への影響としては，患者のケアに当たる時間や新人の指導・サポートに費やす時間の増加，超過勤務の減少など，ケアの質の向上や医療安全の確保，労働状況の改善において，効果が示唆されている．このような動向を見据えると，「看護必要度」に応じた看護をいかに提供するかが看護管理者の重点課題といえる．また，看護師の能力開発の方法諭として，看護師個々の看護実践能力の評価基準であるクリニカルラダー (clinical ladder) の意義を述べた．
Theme Dialysis Treatment and Nursing Care Needs -- Significance and Potential Utilization
Title Perspective on intensity of nursing care needs and quality of nursing
Author Setsuko Shimoyama The Japanese Red Cross Kyushu International College of Nursing
Author Mitsue Nakamura The Japanese Red Cross Kyushu International College of Nursing
[ Summary ] The level of nursing care needs is dictated by the number of hours of nursing service necessary to provide quantity nursing care inpatients.
The Japanese Nursing Association developed a study titled, “A Study on the Supply and Demand for Nurses of Japanese Hospitals in 2006”. This study suggested a new standard, suggesting that hospitals should provide one nurse for every seven inpatients. The implementation of these standards has improved the quality of nursing care, security of medical treatment, and brought about improvements in working conditions, including increasing time available for patient care. They have also helped provide educational support for new nurses, while decreasing excessive work loads for nurses.
In view of current nursing trends, one of the most important issues for nursing administrators and managers is how to provide well distributed nursing care in relation to nursing care needs.
The meaning of the term clinical ladder in relation to methodologies for professional development of nurses, as a standard for evaluation of levels of individual nursing practice competence, is also discussed.
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