УДК:616-051 -[616-006:082/083-039.75]-082.6
АНАЛИЗ ЗАТРАТ РАБОЧЕГО ВРЕМЕНИ МЕДИЦИНСКИХ
СЕСТЕР ОНКОЛОГИЧЕСКОЙ СЛУЖБЫ
1
Н.К. Хайдаров,
2
А.Д. Нормуродова,
2
Д.Ю. Раманова
1
Кафедра нервных болезней и физиотерапии ТГСП, Яшнабадский район, ул. Махтумкули, 103, 100047,Ташкент. ORCID:
.
org'0000-0003-3126-9013.
‘Кафедра повышения квалификации средних медицинскихработниковТГСП, Яшнабадский район, ул. Махтумкули, 103, 100047,
Ташкент.
РЕЗЮМЕ
Введение:
в настоящее время в республике про
водится огромная работа по реформированию си
стемы здравоохранения. В статье приводятся дан
ные, полученные в ходе хронометража рабочего
времени сестринского персонала, работающего в
отделениях лечебных учреждений.
Целью исследования было устранение потерь
и непроизводительных затрат рабочего времени
за счет применения новых технологий и методов
лечения, лучшей организации труда на рабочем
месте.
Методы исследования:
Мы использовали хро
нометраж для изучения затрат рабочего времени
среднего медицинского персонала. Объектом ис
следования является сестринский персонал. Ис
следование проводилось в течение октября-ноября
2019 года. Общее время наблюдения пятнадцати
медсестер составило 9395 минут рабочего време
ни.
Результаты:
в результате анализа затрат рабо
чего времени выявлено, что основная часть рабо
чего времени медсестер тратится на их основную
работу, то есть на оперативное время-6875 минут,
что составляет 73,2% от общего времени наблюде
ния. В целом на подготовительное и заключитель
ное время уходит 880 минут (9,4%). Это время,
затраченное на подготовку или выполнение зада
ния, или его выполнение (получение задания, ме
дикаментов, инструментов, медикаментов, уборка
рабочего места в начале и в конце смены, перевод
смены и т. д.). Время обслуживания рабочего ме
ста составляет 995 минут (10,6%). 645 минут - это
перерывы в работе, то есть время на отдых и лич
ные нужды (6,8%).
Вывод:
Таким образом, при оптимальной орга
низации работы медицинских сестер могут быть
выделены значительные временные резервы: до
5% за счет разгруженного времени, до 5% за счет
других и хозяйственных видов деятельности, до
2-3% за счет работы с документацией и 5-8% -
вспомогательных видов деятельности.
Ключевые слова:
хронометраж, сестринский
персонал,
медицинская
помощь,
онкологическая
служба.
ANALYSIS OF THE COST OF WORKING TIME
OF NURSES OF THE ONCOLOGY SERVICE
1
N.K. Khaydarov,
2
A.D. Normuradova,
2
D.Yu. Ramanova
‘Department of Nervous Diseases and Physiotherapy, TSDI, Yashnabad district,Makhtumkuli str., 103, 100047, Tashkent. ORCID: http://
-Department of advanced training ofsecondary medical stafTSDI, Yashnabad district, Makhtumkuli str., 103, 100047, Tashkent.
ABSTRACT
Introduction:
at present there is a lot to reform
the health care system. There is a wide network of
public health institutions. They provide polyclinic,
outpatient, inpatient, emergency, high-tech specialized
medical care. The article presents data obtained
during the timekeeping of nursing staff working in the
departments of medical institutions.
The purpose of the study was to eliminate losses
and unproductive labor time costs by applying
new technologies and methods of treatment, better
organization of work in the workplace.
Research methods:
We used timekeeping to study
the costs of working hours of paramedical personnel.
The object of the study is the nursing staff. The study
conducted during October-November 2019. The total
time of observation of fifteen nurses was 9395 minutes
of working time.
Results:
As a result of the analysis of the cost of
working time, it was revealed that the bulk of the
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MEDICINE AND INNOVATIONS |
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МЕДИЦИНСКОЙ СПЕЦИАЛЬНОСТИ
nurses ’ working time is spent on their main work, i.e.
on operational time-6875 minutes, which is 73.2%
of the total observation time. In general, 880 minutes
(9.4%) are spent on the preparatory and final time. This
is the time spent on preparing or completing the task
or completing it (receiving the task, medicines, tools,
medicines, cleaning the workplace at the beginning and
at the end of the shift, transferring the shift, etc.). The time
of servicing the workplace is 995 minutes (10.6%). This
is the time spent on maintaining the workplace in a state
that ensures productive work. 645 minutes are breaks in
work, i.e. time for rest and personal needs (6.8%).
Conclusion:
Thus, with the optimal organization
of the work of nurses, significant time reserves can
be allocated: up to 5% due to unloaded time, up to
5% due to other and economic activities, up to 2-3%
due to work with documentation and 5-8% - auxiliary
activities.
Keywords:
timekeeping,
nursing
staff
medical
care, oncology service
Introduction:
For the effective work of medical
personnel of medical institutions, based on the use of
sophisticated diagnostic equipment, new methods of
treating diseases, characterized by a large number of
intra-production and information flows in the field of
management [1, 2, 3, 7, 8, 10]. There is a need for a
clear organization of the labor process of medical and
other personnel, progressive time standards, number
standards, effective systems of material incentives
for high-performance personnel work. This is the
basis for the organization of work in the health care
facility, its planning, organization and management of
the treatment and prevention process as a whole in the
institution [4, 5, 6, 9,11].
The purpose of the study: to eliminate waste and
unproductive costs of working time by applying
new technologies and methods of treatment, better
organization of work in the workplace.
Materials and methods of research.
To study the
cost of working time of secondary medical personnel,
the timekeeping of working time was used. The object
of the study is the nursing staff. The study was conducted
during October-November 2019. In general, individual
photos of the working hours of fifteen nurses of the
oncology department were analyzed:
1. Nurses of the operating unit - 5,
2. Nurses of the treatment room - 5,
3. Nurses of the dressing room-5,
The entire observation time was divided into 4 main
positions:
4.
Preparatory and final time, operational (main
and auxiliary) time of maintenance of the workplace
(technological and organizational) and time of breaks
(for rest and personal needs).
Preparatory and final (PF) - the time spent on
preparing your workplace for the execution and
completion of a production task.
Operative time (ОТ) - lead time manufacturing jobs:
including: main (process) (ОТ main) - time direct
impact on the subject of work; minor (ОТ minor) - the
time it takes an employee to perform actions aimed at
implementing the main work.
Workplace maintenance time (MT) - time spent
on maintaining the workplace in working order:
including: technical (MT tech) - time spent on
equipment
maintenance
and
tool
maintenance;
organizational (MT org) - time spent on workplace
maintenance Break time (ВТ) - time during which the
performer is not engaged in work. It can be regulated
and unregulated (this is the loss of working time,
depending and not depending on the employee, i.e.
organizational).
Results and discussion:
The total observation time
of fifteen nurses was 9395 minutes of working time.
Because of the analysis of the cost of working time, it
was revealed that the bulk of the nurses' working time
is spent on their main work, i.e. on the operational
time - OP) - 6875 minutes-it is 73.2% of the total
observation time, of which:
• The main (ОТ main) is-5515 min-58.7% this time
is directly related to the impact on the patient
• Auxiliary (ОТ minor) - 1360 min-14.5%, which is
not directly spent on the patient, but is associated
with him.
In addition, we identified the main problems in the
care of cancer patients: the difficulty of combining basic
employment and patient care - 67%, significant financial
costs - 48%, lack of special skills and information about
the specifics of patient care - 43%, delays in obtaining
preferential medicines - 23% and the inability to relieve
the suffering of the patient - 69%.
In operational time, the share of the main one is
80%, the auxiliary one is 20%
In general, 880 minutes (9.4%) are spent on the
preparatory and final time (PF). It’s the time spent
training or the job or the end (getting a job, medicines,
tools, medicines, cleaning the work surfaces at the
beginning and at the end of the shift, transmission
shift, etc.).
The service time of the workplace (MT) - 995 min
(10.6 per cent). Spent on maintaining the workplace in
a state that ensures productive work:
Technological (MT tech) - 690 min-7.3% - time
spent on the care of equipment, tools (69% of the OM
as a whole)
Organizational (MT org) - 305 minutes-3.3% - the
time spent on maintaining the workplace during the
shift in proper condition. (31% of OM as a whole).
136,645 minutes are breaks in work (VP), i.e. time
for rest and personal needs - (6, 8%). It should be
noted that nurses in their spare time from work are
engaged in self-education. Moreover, the question
"How do nurses improve their skills and experience
independently in providing palliative careto cancer
7
patients?’’ received the following answers: read
magazines «Nurse» (Hamshira) - 59% and medical
books - 35%; newspapers - 7%; attend training
seminars - 33%; get acquainted with medical manuals
-11%; exchange experience with employees - 11%
and watch TV shows based on improving the level of
medical knowledge - 4%.
With an average follow-up time of 626 minutes,
which is spent by all nurses: PF - 58 minutes, OP -
459 minutes, ОТ - 66 minutes, ВТ - 43 minutes.
Conclusions: From the study of the cost of working
time of nurses in an oncological hospital, the following
conclusions can be drawn:
Works hard: operational time, i.e. the time of
performing their direct functional duties, ranges from
81-78% to 62-53% of the total observation time and
averages 73% (6875 minutes of observation). This
is due to the large flow of patients, as well as the
imperfect organization of work and recreation.
The time for servicing the workplace is higher
(31-32%) in the treatment room, dressing room and
operating unit and the minimum forward nurses (2%),
which is explained by the technology of the treatment
process and the specifics of this type of activity.
Ward and procedural nurses spend the maximum
preparatory and final time, but in general, the share of
this time is small: from 11-12% to 2-4% of working
time.
The minimal time is spent on rest and personal
needs: 2-4% of almost all nurses, except for ward
nurses, who have the opportunity to restore their
working capacity during working hours (9%), due to a
small share of time for servicing the workplace.
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