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

本研究旨在探讨“个人护理基地”的新概念如何影响日本急性病房的护理活动。PNB的定义是指医院在推广计算机化医疗和病历系统的过程中，以固定设置或移动方式靠近病床的护理基地。以下是在四个医院病房进行的调查结果：1）直接护理时间约占总护理职责的50%，并且没有因计算机化而变得更长。2)目前的车载电脑系统在这一时刻无法有效地工作。3).尽管直接护理病人的时间没有增加，但护士在PNB病房中与病人保持密切联系的时间更长。4)在固定PNB设置类型的病房中，护士的步行距离变短。本模拟旨在阐明PNB概念与普通护理基地相比，在缩短护理人员步行距离方面的效率。以下是在4个医院病房进行的调查结果：1）在调查病房中的3个病房中，PNB已被引入。此外，在所有病房都引入了团队护理，每个团队由一名组长护士和一些成员护士组成。2）成员护士经常在病房通道的PNB上记录和参考。3）在病房，在病房引入计算机信息系统的情况下，记录和参考活动并不经常发生。成员护士尝试与组长或护士长沟通。5）护理人员之间的确认和讨论不是通过移动的电话进行，而是通过直接对话进行。6）计算机模拟结果表明，每个工作区设置一个PNB可以有效缩短护士的步行距离，而设置更多的PNB则没有效果

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