推動護理職場正向工作環境

護理人員是醫療照護體系中最直接也是人數最多的照顧提供者；然而在全球醫療環境複雜及醫療資源短缺的情形下，各國健康部門或醫療機構多以刪減所需之護理人力來節省支出，降低成本，造成全球護理人力短缺。護理人力短缺最主要原因是不健康的工作環境，不滿意工作環境而離職或轉業，1/3畢業護生不願進入職場。因此，推動護理人員執業環境改善及增加護理人員留任率為全球議題。推動護理正向工作環境的策略：一、建構「正向工作環境」指標，讓醫院有所依循；二、定期監測護理工作環境，落實「正向工作環境」的推動；三、成立專責機構辦理正向護理工作環境。未來的建議：立法要求一定的護病比、專責組織的設立、健保給付與護病比連動、護理人力持續列入醫院評鑑必要條文、落實勞動基準法、推動彈性護理人力管理、鼓勵民間成立護理人力機構、加強各護理專業人才的培訓、提升各級主管行政管理能力以及護理人員由均衡的生活做起，改善自我照顧計畫以提供他人更好的照護。

關鍵字

正向工作環境；磁吸醫院；護理人力

並列摘要

Nurses are direct care providers that compose the largest number of staff in most health care systems. In recent years, nursing manpower was gradually reduced to meet the fiscal needs under current complicated healthcare environment and reduced medical resources, which resulted in a significant nursing shortage. Compounding the situation was an unhealthy work environment for nurses. One-third of nursing new graduates were unwilling to enter the workforce. Therefore, an improved work environment and increased nurse retention became subjects of importance globally. The strategy to improve work environment included: 1) set up a target of ＂Positive Practice Environments＂, 2) monitor nurses' work environment to ensure adherence to ＂Positive Practice Environments＂ measures, and 3) establish an accreditation agency to approve ＂positive nursing practice hospitals＂. Recommendations included legislation on nursing ratios, establishing an accreditation agency, connect nursing ratio with National Health Insurance payment, add nursing ratios in the hospital accreditation, comply with Labor Standards, promote flexible nursing resource management, improve managers' competency and maintain life balance for nurses.