Abstract
The purpose of this study was to identify a comparison of nursing service amounts at a hospitals specializing in treating acute patients and related factors which influenced nursing service amounts around the time of the introduction of Diagnosis Procedure Combination(DPC). Nursing service amounts and related factors were analyzed by t-test and descriptive statistics during the 1-year period before DPC was introduced(May 2002─April 2003), and the 1-year period after DPC was introduced(May 2003─April 2004), utilizing the Kitasato Nursing System(KNS).
As a result, it was found that there were variables of a significant increase in hours spent on other treatments and examinations, hours spent on admitting patients to hospital, hours spent on ambulation and rehabilitation, and hours spent on respiratory care. Significant decreases were in hours spent for special instruction. In the comparison of numbers of patients by type, there were increases in type 5 = patients requiring critical care, and type 4 = patients requiring intensive care ; and there were significant decreases in type 0 = minimal care. The introduction of DPC led to the reduction of hospitalization days, but nursing service amounts increased to critical care and intensive care patients because patients of hospitalization and an aged patients increased, and critical path ways were introduced. Then standardized measurements were required to apply nursing service amounts to DPC classification. It has been revealed that, with more and more critical care and intensive care cases, the number of so-called high-maintenance patients who require care day and night has been increasing for the hospital. Assigning staff to provide safe medical care by which it is possible to deal with the increases in critical care and intensive care cases is an urgent task.
