https://scholars.lib.ntu.edu.tw/handle/123456789/515246
標題: | Influence of patient and provider factors on the workload of on-call physicians A general internal medicine cohort observational study | 作者: | NIN-CHIEH HSU Huang C.-C. JIH-SHUIN JERNG Hsu C.-H. Yang M.-C. Chang R.-E. Ko W.-J. CHONG-JEN YU |
公開日期: | 2016 | 出版社: | Lippincott Williams and Wilkins | 卷: | 95 | 期: | 35 | 起(迄)頁: | e4719 | 來源出版物: | Medicine (United States) | 摘要: | Factors associated with the physician workload are scarcely reported. The study aims to investigate the associated factors of on-call physician workload based on a published conceptual framework. The study was conducted in a general internal medicine unit of National Taiwan University Hospital. On-call physician workloads were recorded on a shift basis from 1198 hospitalized patients between May 2010 and April 2011. The proxy of on-call workloads included night calls, bedside evaluation/management (E/M), and performing clinical procedures in a shift. Multivariable logistic and negative binomial regression models were used to determine the factors associated with the workloads of on-call physicians. During the study period, 378 (31.6%) of patients had night calls with related workloads. Multivariate analysis showed that the number of patients with unstable conditions in a shift (odds ratio [OR] 1.89 and 1.66, respectively) and the intensive care unit (ICU) training of the nurse leader (OR 2.87 and 3.08, respectively) resulted in higher likelihood of night calls to and bedside E/M visits by the on-call physician. However, ICU training of nurses (OR=0.37, 95% confidence interval: 0.16-0.86) decreased the demand of performing clinical procedures by the on-call physician. Moreover, number of patients with unstable conditions (risk ratio [RR] 1.52 and 1.55, respectively) had significantly increased the number of night calls and bedside E/M by on-call physicians by around 50%. Nurses with N1 level (RR 2.16 and 2.71, respectively) were more likely to place night calls and facilitate bedside E/M by the on-call physician compared to nurses with N0 level. In addition, the nurse leaders with ICU training (RR 1.72 and 3.07, respectively) had significant increases in night calls and bedside E/M by the on-call physician compared to those without ICU training. On-call physician workload is associated with patient factors and the training of nurses. Number of unstable patients in a shift may be considered in predicting workload. The training of nurses may improve patient safety and decrease demand for clinical procedure. Copyright ? 2016 the Author(s). Published by Wolters Kluwer Health, Inc. All. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84987704180&doi=10.1097%2fMD.0000000000004719&partnerID=40&md5=3ecb9387ec37cde6e036175c39a15f90 https://scholars.lib.ntu.edu.tw/handle/123456789/515246 |
ISSN: | 0025-7974 | DOI: | 10.1097/MD.0000000000004719 | SDG/關鍵字: | aged; Article; clinical practice; cohort analysis; female; human; intensive care unit; internist; leadership; major clinical study; male; night care; night work; nurse training; observational study; patient; point of care testing; priority journal; work schedule; workload; education; intensive care; intensive care nursing; internal medicine; medical staff; organization and management; patient safety; personnel management; Taiwan; university hospital; Aged; Critical Care; Critical Care Nursing; Female; Hospitals, University; Humans; Internal Medicine; Male; Medical Staff, Hospital; Patient Safety; Personnel Staffing and Scheduling; Taiwan; Workload |
顯示於: | 醫學系 |
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