臺灣專科護理師進階制度推動現況與未來

Current and Future Development of Nurses Practitioner Ladder System in Taiwan

陳齡芳(Lin-Fang Chen) ； 陳小蓮(Hsiao-Lien Chen)

《源遠護理》 13卷1期 (2019/03) Pp. 22-28

https://doi.org/10.6530/YYN.201903_13(1).0003

摘要

臺灣地區人口年齡老化，醫療服務需求量與日俱增，專科護理師是護理專業的延伸，與臨床醫師合作提供連續性及整合性的護理與醫療照護。國內發展專科護理師制度至今逾20年，於2006年進行第一屆的專科護理師甄審考試。專科護理師學會提升專科護理師的專業能力及病人照護品質。於2017年訂定專科護理師進階認證制度，此制度共分為五階層，NP I-NP V，各階層執業指標包含三個面相：（1）臨床執業與成效、（2）教學能力，（3）領導、行政和研究能力。於2017年10月開始受理NP II至NP V專科護理師進階制度審查，受理案件227件申請案，平均通過率為34%。發現各階層的臨床執業成效報告是成功進階與否的主要關鍵，這與送審者對各階層報告的書寫格式及要求內容的理解、臨床推理能力、邏輯分析能力、實證應用能力等有關，學會除釐清各階層臨床執業成效報告要求、公告範例外，亦請學術委員會針對持續辦理相關研習會及工作坊，至2018年4月第二次進階審查時共收件282件，平均通過率提升至37%。在各階層臨床執業能力報告的書寫仍有相當大的改進空間。制度引導下許多專科護理師已開始進修或取得碩士學位，專業投稿及發表也正向成長，國內相當多的醫療機構也開始使用本制度作為院內專科護理師的能力指標，並與薪資做結合。本制度在推展時會隨時作適當的修正，朝我們的既定方向推動，期望在持續推動下，確能提升台灣專科護理師的臨床能力，提高病患照顧品質，在團隊中發揮領導的角色，贏得醫療團隊、民眾及社會更多的信賴及敬重。

關鍵字

專科護理師 ； 進階制度 ； 核心能力

並列摘要

The aging society in Taiwan increases the demand in healthcare facilities. Nurse practitioners (NPs) are professional clinical nurses who work collaboratively with physicians to provide continuous and integrative care. Development of professional NP started 20 years ago and the board examination for NPs began in 2006. Taiwan Nurse Practitioner Association (TNPA) is devoted to the promotion of the professional competency of NPs and established the career ladder system for NPs in 2017. The system includes five levels, from NP I to NP V, and three facets of practice indicators for each level: (1) clinical practice and outcome, (2) teaching, and (3) leadership, administration and research. In 2017, the TNPA first reviewed 227 ladder advancement applications from NPII to NP V with a passing rate of 34%. Analysis indicated that key factors for success in the career ladder advancement were clinical practices and effects, and were associated with their ability in report documentation, critical thinking, logic analysis, and evidence-based practice. TNPA clarified the required documentation with samples on clinical practice effects. The TNPA Academic Commission also provided relevant seminars and workshops for applicants. A second review in April 2018 had 282 application and the passing rate increased to 37%. The deficit remained in the clinical practice report writing. This career ladder system guides NPs to continue education, either on-the-job or at graduate school, and increases in professional publications. Many healthcare organizations adopted this NP career ladder system for NPs performance evaluation and compensation. The TNPA will continue to modify and promote NP career ladder system toward the improvement on the competency of NPs in clinical practice, quality of patient care, gaining the trust and respect of the healthcare team, the public and the community.

並列關鍵字

nurse practitioner ； career ladder system

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