[[alternative]]The Effectiveness of Using Patient Classification System to Assist of Clinical Nursing Manpower

[[abstract]]護病分配 (Nurse Patient Assignment, NPA) 是由病人、護理人員及環境之間相互驅動的複雜過程，共有17項因素影響護病分配的決策，研究顯示，透過結構化的病人分類系統 (Patient Classification System, PCS) 可以客觀量化護理工作量並提供臨床決策。本研究為前實驗研究設計 (pre-experimental design)，單組後測設計 (one-shot case study)，於南部某一區域醫院外科病房進行，透過介入一資訊化PCS輔助護理人員執行護病分配，比較介入前使用傳統護病分配與介入後使用資訊化PCS執行護病分配，護理人員工作負荷之變化。研究採非隨機立意取樣，樣本數為80人，介入前之研究問卷共調查80位護理人員，有78.8%的人曾面臨過工作負荷不均的經驗，65%的人不曾聽過PCS，70%的人不了解PCS的內容，85%的人不曾使用過PCS，研究結果顯示護理人員普遍對PCS認知匱乏。單因子變異數分析 (ANOVA) 結果，有使用PCS經驗的護理人員比沒有使用經驗的人更重視護病分配需考量的護理人員因素，其F values為14.122，P值<0.05具顯著水準。介入期共收案75人，流失率6.2%，介入前PCS離差值變異數平均為65.12，介入後為15.00，顯示使用資訊化PCS執行護病分配產生的護理負荷不平衡之程度低於傳統護病分配，檢定P值<0.001具顯著性。而此資訊化PCS經驗證PCS分級AUC值達0.894，為一具「良好」護理負荷分級鑑別力之工具，可輔助科護理人員執行科學化的護病分配。介入後的研究問卷融合Davis科技接受模式及DeLone及McLean資訊系統成功模式，以了解護理人員對於資訊化PCS的科技接受程度，研究問卷共調查75人，整體均值3.03為高度接受此系統。而影響護理人員使用態度和意願的因素，經皮爾森 (Pearson) 相關性及線性回歸檢定結果，主要為「能增加執行護病分配的便利性」及「對我的工作有用」，此檢定結果顯示，影響護理人員的使用態度和意願主要取決於使用者是否感受到資訊化PCS對護病分配的便利性及是否有助於臨床工作。此研究結果可提供未來臨床實務平行導入之參考。[[abstract]]It is a complex process that Nurse-Patient Assignments (NPA) by patients, caregivers, and the environment. A total of 17 factors affects the decision-making of NPA. Research has shown that a structured Patient Classification System (PCS) can objectively quantify nursing workload and inform clinical decisions. This study is aimed at the nursing staff in the surgical ward of a regional hospital in the south of Taiwan, through the intervention of an informatization of PCS to assist the nursing staff to carry out NAP. And monitor the changes in nurses’ workload before and after intervention were compared. Before the intervention, the questionnaire surveyed 80 nursing staff. As a result, 78.8% of them had faced uneven experience in work load. 65% of them had never heard PCS. 70% of them did not understand the content of PCS. 85% of them were PCS has not been used. It showed nursing staff generally lacks PCS knowledge. ANOVA analysis results, nursing staff who use PCS experience more pay more attention to nursing staff factors that NPA needs to consider than those who do not use experience. Its F Values is 14.122 and P value <0.05 has a significant level. A total of 75 cases were included in the study. The mean PCS variance was 65.12 before intervention and 15.00 after intervention. The results show that the unbalanced nursing workload generated by the use of informatization of PCS for NPA is lower than that of traditional NPA. The P value