摘要
背景：台灣目前採用的護理倫理規範2005年修訂版本，實施17年多以來，雖未出現窒礙難行處，但隨著時代推演和科技的進步，對倫理問題的判斷方式，所重視的倫理觀點和護病關係，已有明顯改變。目的：旨在更新台灣護理倫理規範，以符合現今社會及醫療照護環境之行為指引要求。方法：採用多元研究法，參照六個國際護理組織護理倫理規範分類，和以實證為基礎的倫理與哲學思維文獻，並納入衛生福利部護理職場爭議通報平台主要通報訴求，初擬台灣護理倫理規範修訂版之面向及條文，再進行專家焦點團體座談、Delphi專家學者共識及公共論壇等程序。結果：經三回合專家焦點團體座談完成的結構式問卷，由50位六大領域Delphi專家學者進行線上問卷填答，經二回合共識，四面向47項倫理規範條文的重要性及清晰度之收斂度分別達100%及99.8%；不同領域專家與面向條文間評分無顯著差異，顯示結果具一致性。台灣護理倫理規範修訂版包含：護理人員與照護對象（14項條文）、護理人員與執業（13項條文）、護理人員與專業（10項條文）、護理人員與社會（10項條文）。結論／實務應用：在教育面，應將新版護理倫理規範納入護理院校的常規課程，並作為繼續教育的教材。在政策面，則應列為醫院評鑑基準及查核項目。此外，應促使機構高層主管重視與支持，建立道德困境案例處理流程和諮詢機制，輔導護理主管培養處理能力，以營造正向職場及團隊尊重氛圍。各專業團體應共同參與推動護理倫理相關議題，舉辦研討會及繼續教育活動，將新版護理倫理規範及案例置於網頁，以供全國護理人員參考。
並列摘要
Background: The 2005 revision of the code of ethics for nurses has been in effect in Taiwan for more than 17 years. Although this code has been smoothly implemented during this time, changing social expectations and ethical perspectives, advancements in science and technology, and the evolution of the nurse-patient relationship suggest this code should be once again be updated. Purpose: This study was conducted to suggest revisions to the Taiwan code of ethics for nurses necessary to meet current needs and address social and medical care environment trends. Methods: A multivariate research approach was adopted. The classification of the code of ethics for nurses norms in six international nursing organizations and evidence-based ethical and philosophical thinking literature were referenced, with the main notification demands incorporated into the Ministry of Health and Welfare's Nursing Workplace Controversy Reporting Platform. After drafting the aspects and provisions of Taiwan code of ethics for nurses norms, expert review procedures such as focus groups, Delphi expert consensus, and public forums were conducted. Results: After three expert focus group discussion rounds, a structured questionnaire was completed, and 50 Delphi experts in six fields completed the online questionnaire. After the second consensus round, the importance and clarity of the 47 ethical code provisions in the four aspects were determined with 100% and 99.8% agreement reached, indicating no significant difference in scores between the multidisciplinary expert group and the ethical code. The resulting revision proposed for the Taiwan code of ethics for nurses includes: nursing staff and care recipients (14 provisions), nursing staff and practice (13 provisions), nursing staff and the profession (10 provisions), and nursing staff and society (10 provisions). Conclusions/ Implications for Practice: In terms of education, the revised Taiwan code of ethics for nurses should be integrated into the nursing education curriculum of nursing colleges and used as teaching material for the continuing education of nurses. In terms of policy, these norms should be included as evaluation benchmarks and inspection items for hospitals. In addition, the attention and support of senior managers in institutions must be secured and a handling protocol for moral dilemma cases and related consultation mechanisms must be established. Nursing supervisors should be guided to develop the ability to address these dilemmas to help foster a positive workplace and a respectful team atmosphere. All professional groups should participate actively in promoting issues related to nursing ethics, organize seminars and continuing education activities, and make the revised Taiwan code of ethics for nurses and learning cases available online for reference by nursing staff nationwide.