提升某內科病房N2護理人員比率之專案

A Project of Promoting the Percentage of Clinical Ladder-2 Nurses in An Medicine Ward

李佳倫(Chia-Lun Lee) ； 任淑玲(Shu-Ling Jen) ； 陳淨棋(Ching-Chi Chen) ； 陳美杏(Mei-Hsing Chen)

《馬偕護理雜誌》 7卷1期 (2013/01) Pp. 52-62

https://doi.org/10.29415/JMKN.201301_7(1).0006

摘要

本單位為醫學中心內科病房，病人嚴重度及複雜性高，但具重症照護能力之N2護理人員比率僅26.3%，申請進階N2比率也只有0~37.5%，遠低於全院N2護理人員比率（47.7%），故引發改善動機，期望藉由專案手法提升N2護理人員比率達50%，申請進階N2護理人員比率達80%。單位成立專案小組，透過會談、問卷填寫、小組討論後確認主要且可改進之原因為：筆試準備困難、案例分析書寫技巧不足、不易完成N2規定課程及無持續獎勵制度。利用決策矩陣分析擬定之對策包含：給予休假準備筆試、安排進階導師制定個人化進度表及個別指導、指派專人指導使用數位學習完成規定課程及公告獎勵制度等，並持續追蹤成效及檢討改進。專案推行後單位N2護理人員比率提高至84.2%，申請進階N2護理人員比率提高至83.3%，顯示本專案能有效提升N2及申請進階N2之護理人員比率，專案推行過程除了能減少人員排斥進階制度，也能提升成就感及專業能力之自我肯定。

關鍵字

護理能力進階 ； 醫療照護品質

並列摘要

The patients in this internal medicine ward of medical center usually have severe and complex diseases. But the percentage of clinical ladder-2 nurses in this ward was only 26.3%, the percentage of applying for the certification of clinical ladder-2 nurses was 0~37.5%. It is much lower than the percentage of clinical ladder-2 nurses in the hospital (47.7%). The motives of this project were induced. The aims of this project were to of promote the percentage of clinical ladder-2 nurses to 50%, and adjust the percentage applying for the certification of clinical ladder-2 nurses to 80%. The causes identified by the project team from interview and questionnaire were the difficulties of preparing the examination, incapability of writing the case report, the difficulties of attending the required education courses and uncertain enforcement incentives. Strategies of this project included providing vacation for examination preparing; delegated mentor for individualized instruction and scheduling for preparing the certification of clinical ladder; incorporating e-learning in the required education courses, and posting the enforcement ways. Moreover, the project team evaluated the effectiveness of the strategies and made the improvement continuously. After this project, the percentage of clinical ladder-2 nurses was promoted to 84.2% and the percentage of applying for the certification of clinical ladder-2 nurses was advanced to 83.3%. These results indicate the interventions of this project can promote both the percentages of clinical ladder-2 nurses and applying for the certification of clinical ladder-2 nurses effectively. During the process, nurses reduce the sense of exclusion of nursing clinical ladder and increase the sense of achievement and professional competence.

並列關鍵字

nursing clinical ladder ； quality of nursing care