Reconstruction the ward plan along with the appearance of the Personal Nursing Bases by the computerization of the medical treatment and the patient information

本研究旨在阐明“个人护理基地(PNB)”的新概念如何影响日本急症医院病房的护理活动。PNB的定义是，由于医院推广计算机化的医疗和患者记录系统，PNB被定义为以固定环境或轮子的形式靠近患者床位的护理基地。以下是在4个医院病房进行的调查结果：1)直接护理时间占总护理工作时间的50%左右，电脑化并没有延长。2)当前车轮系统上的PC此时不能高效工作。3).尽管直接护理病人的时间没有增加，但护士在PNB病房与病人的亲近时间更长。4)固定设置PNB类型的病房护士步行距离变短。本模拟旨在阐明与普通护理基地相比，PNB概念在缩短护理人员步行距离方面的有效性。此外，所有病房都引入了团队护理，每个团队由一名领队护士和一些成员护士组成。2)成员护士经常在病房通道上的PNB记录和参考资料。3)在病房引入计算机信息系统的情况下，记录和参考资料的活动并不频繁。4)成员护士试图与领队或护士沟通。5)护理人员之间的确认和讨论不是通过手机进行的，而是通过直接对话进行的。6)计算机模拟表明，每个工作区1个PNB对缩短护士的步行距离是有效的，而更多的PNB没有效果

The research aims at clarifying how new concept of "Personal Nursing Base (PNB)"influences nursing activities in acute hospital wards in Japan. The PNB is defined as nursing base closely located to patients' beds either in the form of fixed setting or on wheels, stemming from dissemination of computerized medical and patients' record system in a hospital. The followings are the results of the surveys carried out in four hospital wards ; 1) The length of direct nursing time is around 50% of total nursing duties and it has not become longer by computerization. 2) The current PC on a wheel system does not work efficiently at this moment. 3).Nurses stay longer in close to patients in PNB wards despite of the fact that direct patient care time does not increase. 4) Walking distance of nurses becomes shorter in wards which have fixed setting type of PNB.This simulation aims at clarifying the efficiency of PNB concept compared with ordinary nursing bases in terms of shortening walking distances of nursing staff.The followings are the results of the surveys carried out in four hospital wards ;1) In three wards of the wards surveyed, PNB has been introduced. Moreover, the team nursing has been introduced in all wards, and each team is composed of one leader nurse and some member nurses.2) Member nurses often taking records and references at PNBs located in ward passages.3) In patients' rooms, activities of records and references are not frequently happened in the case of wards introducing computerized information system.4) Member nurses tried to communicate with a team leader or matron.5) Confirmation and discussion among nursing staff are not carried out by the mobile phones but by direct conversation.6) Computer simulation shows that one PNB in each working area is effective for shortening the walking distance of nurses while more numbers of PNB have no effect