MNUMS-School of Public Health, Mongolia
Background: In healthcare system nursing care and nursing professionals are the essential parts and implementing advanced, professional nursing care remains inseparably required for quality improvement in health.
Study aim: We aimed to study workload of nursing professionals and to define future tendencies
Materials and methods: We surveyed our study by cross-sectional design in hospital based setting. Subjects were randomly recruited from primary and advanced level healthcare facility nurses. Some nurses were recruited by stratified sampling method from advanced level hospitals and total of 179 nurses from 22 specialties working in 32 facilities. By organization based observational method we analyzed for each specialties (1) and workload of nursing professionals (2) with “Job evaluation” criteria, documentary, and observational methods.
Results: Everyday routine duties were 469.8 minutes in primary level nurses, which is 25.6 minutes longer than advanced level hospitals. Average of time spent for each procedure or action in primary and advanced level hospitals for nurses are 13.1 and 12.4 minutes respectively. Customer load for primary level nurses were higher than advanced level hospital nurses as of 23.0 and 21.5, respectively. However time spent for healthcare services were lower in primary setting (234.0) than in advanced level setting (276.0). In cases timekeeping analysis were unavailable, “Job evaluation” criteria were used for determining skills, knowledge, practice, educational background, responsibilities according to duty and job, personal effort, given freedom, and working conditions. Total scores were calculated and degree of workload was evaluated based on the score. Analysis revealed that the subjects were belonged to III-V degree workloads and of these primary care nurses classified in III-IV degree, and advanced care nurses into III-V degree of workload. Until 1990, number of nurses produced into healthcare human resources were constantly increased, however declined overtime following the open market system. In 2015, 37.5 nurses were recorded per 10000 populations, which is the highest since 1995, although 267 populations are given to a nurse. Currently, nine of the eleven universities that train nurses have bachelor program in nursing education. These findings suggest dominancy in bachelor degree nurses is beingcommon in nursing education comparing other nursing programs. The prediction tendency until 2020 is shown based on the last decade statistics signifying possibilities to reach 13061 by 2020 and 13626.8 by 2024.
Conclusion: Primary care nurses have longer working time of 469.8 minutes, which is 25.6 minutes longer than advanced level care nurses. Although hospital service level and specialty of nurses differ from each other, job evaluation signifying workload classified between III-V grades. Statistical analysis based on last decade statistics revealed that nurses number tend to reach 13061 by 2020 and subsequently 13626.8 by 2024, however physician to nurse ratio may reach only 1:1.16. Population ratio per nurses may decrease gradually by 2024 to 249.5 persons per nurse due to increase of nursing professionals and slowing of population growth.