An Investigation on the Nursing Competence of Southern Taiwan Nurses Who Have Passed N3 Case Report Accreditation

嘉南地區通過「N3個案報告」護理人員之護理能力探討

林明珍(Ming-Chen Lin) ； 陳清惠(Ching-Huey Chen)

《The Journal of Nursing Research》 12卷3期 (2004/09) Pp. 203-212

摘要

本研究以嘉南地區通過N3 (clinical nurse level III) 個案報告之239位護理人員為對象，目的在探討撰寫個案報告前後能力之改進及其影響因素。採橫斷式研究調查，91年7月至10月間於13所醫院進行資料收集，結果顯示：(1)通過N3個案報告之護理人員自評具有相當好之整體護理能力 (5.57  0.74)，與其護理主管之客觀評量無顯著差異 (5.57  0.74 vs 5.55  0.89; t = 0.162, p = .871)。(2)護理人員自評撰寫N3個案報告前後護理能力有中等以上的改進程度，與其護理主管及同事之客觀評量無顯著差異 (4.89  1.35 vs 4.84  1.57 vs 4.84  1.26; F = 0.096, p = .909)，呈現出撰寫報告的正面意義。(3)護理人員撰寫N3個案報告前後能力改進之預測因子為：「對撰寫N3個案報告之態度」、「撰寫N3個案報告之困難度」及「撰寫N3個案報告之準備行為」，三個因素共可解釋護理能力改進之26.2%的變異量。由本研究結果建議N3進階教育應包含輔導降低報告撰寫困難、督促加強個案報告撰寫各項行為，以有效促進其能力改善程度。

關鍵字

個案報告 ； 護理能力 ； 能力進階 ； 護理人員

並列摘要

The purpose of this study was to examine factors affecting the development of nursing competence in the writing of N3 (clinical nurse level III) case reports. A cross-sectional survey was conducted in 13 hospitals in southern Taiwan from July to October, 2002. The subjects included 239 nurses who had passed N3 case report accreditation. The results show that (1) nurses rated their current competence at a fairly good level (5.57  0.74). There was no significant difference between nurses’ subjective self-evaluation and supervisors’ objective evaluation (5.57 0.74 vs 5.55  0.89; t = 0.162, p = .871). (2) The nurses’ self-rating, supervisors’, and colleagues’ evaluation all indicated moderate progress in nursing competence after writing N3 case reports. The progress scores rated by nurses themselves, supervisors and colleagues were not significantly different (4.89  1.35 vs. 4.84  1.57 vs. 4.84  1.26; F = 0.096, p = .909). This finding reveals that writing N3 case reports has a positive effect on nursing competence. (3) The results also indicate that ‘Attitude toward N3 case report’, ‘Writing difficulty’, ‘Preparation for writing case report’ were the three predicting factors of progress in nursing competence, which accounted for 26.2% of the total variance. Therefore we recommend that N3 advancement education should include guidance in alleviating writing difficulty and emphasis on implementing various types of preparation for writing case reports, as effective ways to improve nursing competence.

並列關鍵字

case report ； nursing competence ； clinical ladder ； nurse

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