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面对死亡和疾病,不可避免经常性地加班,护士很容易遭受护理工作倦怠综合征的困扰。在辽宁省某三甲医院开展的试验表明,护士每月夜班数与其工作倦怠程度有显著的正相关关系。在一定的假设前提下,建立了有限时域的马尔科夫决策支持模型,研究了不同倦怠程度护士每周最优夜班数的指派问题,目标是最小化护士工作倦怠惩罚、夜班成本和护士空闲惩罚。通过解析分析,为不同倦怠程度的护士指派最优夜班数是一个阀值型的控制策略。数值试验结果表明,模型中不同参数的组合会对最优策略产生影响。最后,敏感度分析考虑了工作倦怠成本,状态转移概率和决策末期各状态成本对最优控制策略的影响。
Faced with death and illness, inevitable regular overtime, nurses are vulnerable to nursing job burnout syndrome. Experiments conducted at a top three hospital in Liaoning Province have shown that there is a significant positive correlation between the night shift number of nurses and the degree of job burnout. On the premise of certain assumptions, a limited time-domain Markov decision support model is established to study the assignment of weekly optimal night shifts for nurses with different degrees of burnout. The objective is to minimize nuisance burnout, night shift costs and nurses’ idleness punishment. Through analytic analysis, it is a threshold-based control strategy to assign the optimal number of nights to nurses with different degree of burnout. The numerical results show that the combination of different parameters in the model will affect the optimal strategy. Finally, the sensitivity analysis considers the impact of job burnout costs, state transition probabilities and the cost of each state at the end of the decision-making process on the optimal control strategy.