Health service activities.

Background Health system performance depends on the availability, accessibility, acceptability, and quality of health workforces. Policymakers seek whether the number of nurses is optimally matched based on patients’ needs. This study aimed to assess the workforce stock, workload activities, activity standards, and workload pressure to determine the number of required nurses in different types of hospitals in Iran. Methods This study applied the workload indicators of staffing needs (WISNs) method and was conducted in 22 surgical and internal medicine wards at five hospitals in the southwest of Iran during six months. A time-motion study, and several group discussions, interviews were used to extract the required data. Descriptive statistics were used for data analysis. Results All selected hospitals faced nursing shortages. The highest shortage (-47) and workload pressure (WISN ratio 0.45) were observed in the general-educational hospitals. In the specialized hospitals, the workload pressure was high (WISN ratio 0.49). The lowest shortage belonged to the private hospital. Based on our assessment, in all of the hospitals, nurses typically worked overtime due to high workload. The studied hospitals covered an average of 25% of their shortage with nursing overtime working. We noted that nurses were predominantly occupied with health service and supportive activities (≈90% of their time). Conclusions Based on the WISN method, all of the hospitals faced nursing shortages from moderate to high. However, it would be essential to consider current labor market analysis based on accurate data to adopt appropriate policies in HRH planning.研究背景 卫生系统的绩效取决于卫生人力的可获得性、可及性、可接受性与质量。政策制定者亟需明确护士数量是否与患者需求实现最优匹配。本研究旨在评估伊朗不同类型医院的人力存量、工作负荷活动、活动标准及工作负荷压力，以测算所需护士人数。 研究方法 本研究采用人员配置需求工作量指标法（Workload Indicators of Staffing Needs, WISNs），于伊朗西南部5家医院的22个外科与内科病房开展，研究周期为6个月。研究通过时间-动作研究、多组讨论及访谈采集所需数据，并采用描述性统计方法进行数据分析。 研究结果 所有纳入研究的医院均存在护士短缺问题。综合教学医院的护士短缺程度最为严重（缺口为-47），且工作负荷压力最大（WISN比值为0.45）；专科医院的工作负荷压力同样较高（WISN比值为0.49）。私立医院的护士短缺程度最低。经评估，所有医院的护士均因高工作负荷普遍加班，受访医院平均通过护士加班弥补了25%的护士缺口。研究发现，护士绝大多数时间都投入在医疗服务与支持性工作中（约占总工作时长的90%）。 研究结论 基于WISNs法测算结果，所有受访医院均存在中重度护士短缺问题。不过，在开展卫生人力规划、制定适配政策时，还需结合精准数据开展当前劳动力市场分析，这一点至关重要。