- 學位論文
非典型雇用護理人員運用於一般病房照 護人力可行性之研究
A FEEASIIBILITY STUDY ON HIRING TEMPORARY NURSING STAFF IN A STANDARD ROOM
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摘要
摘 要 本論文研製之目地主要在探討非典型雇用護理人員運用於一般病房照護人力 可行性，以文獻探討為基礎輔以實務之問卷調查結果，經由回收樣本之統計分析 驗證文獻中國內外學者所主張之運用非典型雇用護理人員之觀點於醫療產業中的 可接受度及可行性，並嚐試探討醫療機構對於一般病房運用非典型雇用護理人員 的接受度。 本研究之主要目地瞭解：1.企業之人力資源策略。2.醫療體系對護理人員缺少時，採用之人力彈性應變機制。3.醫療體系對非典型雇用護理人員照護人力的看法。4.醫療體系對於一般病房採用的非典型雇用護理人員照護人力的接受度及可行度評估。5.非典型雇用護理人員對組織績效的影響。 本研究之範圍以醫療機構有運用非典型雇用護理人員照護人力，開放使用床 數一百床(含急性與非急性病床)以上之區域醫院為研究的範圍；本研究之對象以 護理、醫務運用相關單位及行政招募單位為主要對象；研究問卷共200份問卷， 回收之有效問卷總計為152份，有效回收率為76%；經統計分析發現1.本研究結果 顯示醫療機構以行政二級以上主管及醫務部二級以上主管認同透過運用非典型 雇用護理人員可使人力資源指揮調度較為靈活並降低人事成本及可提高整體滿 意度並競爭優勢發揮最認同，但護理部二級以上主管對此看法深表不贊同。普遍 認為非典型雇用護理人員無法對機構產生向心力，影響其他員工對機構的忠誠度 與穩定性不會顯著。2. 一般病房缺少護理人員時，運用非典型雇用護理人員的 機制作法，持肯定的認同態度，尤其對於解決一般病房員工短期進修、產假及育 嬰假等期間(一年以上)之人力調派需求；運用在一般病房，能減輕護理人員工作 量負荷及能減輕護理人員工作時數負荷亦認同。3.一般病房運用非典型雇用護 理人員；在對於非典型雇用護理人員的資格要求上，對於須具備『專科』以上護 理科系畢業及有護理師執照，才能勝任照護工作」認同感高。在工作表現上，仍 認為一般病房運用非典型雇用護理人員，非典型雇用護理人員必須受過一般病房 照護訓練。4.一般病房運用非典型雇用護理人員對組織績效的影響，非典型雇用 護理人員(訂期契約) 得分皆高於非典型雇用護理人員(外包及委任)。因為目前 運用非典型雇用護理人員(勞動派遣、外包及委任)，在國內尚未立法通過且對核 心能力(護理專業) 亦無法有提升。5.不同醫療機構對於運用非典型雇用護理人 員的認知，統計上有顯著差異。6.不同醫療機構對於一般病房缺少護理人員，運 用非典型雇用護理人員的機制，無顯著得交互作用。7.不同權屬別醫療機構之不 同工作職務之受試者，對於一般病房缺少護理人員，運用非典型雇用護理人員整 體機制的可行性，顯著交互作用。8. 護理單位主管之教育程度不同，對於一般 病房缺少護理人員，運用非典型雇用護理人員的整體看法上機制，無顯著差異。 9.不同評鑑等級醫療機構之工作職務對於一般病房非典型雇用護理人員資格整 體的看法，無顯著的交互作用。10.不同評鑑等級醫療機構之工作職務對於一般 病房非典型雇用護理人員對組織績效(工作效能有提升、對服務品質有提升、組 織成本效益有良好的效果及核心能力(護理專業) 有提升)的影響，無顯著得交互 作用。 根據上述研究發現，一般病房運用非典型雇用護理人員在護理人員缺少之 際，確實為醫療機構可接受之人力運用彈性的可行方案之一；而非典型雇用護理 人員的運用亦確實可提供醫療機構評估降低人事成本及增加人員彈性的選擇。
並列摘要
ABSTRACT A procedure is the aim of the thesis is to research hiring temporary nursing staff on a standard room. Extensive research and quantitative research are conducted for this thesis. Feedback is analyzed to reflect feasibility study complied by academics. However, different from previous studies, this thesis intends to reveal the acceptability of temporary nursing staff in the medical field. The primary purpose of this research is to analyze: 1. Human Resource Strategy in an Enterprise. 2. Contingency Plan available during shortage of medical staff. 3. The institute’s attitude towards temporary staff. 4. Acceptability Assessment and Feasibility Assessment of temporary nursing staff in a standard room in a medical institute. 5. The affect of hiring temporary staff on an organization. The area of study has included institutes which facilitate temporary nursing staff, and have capacity above 100 beds (both acute and none-acute). The target surveyee are medical staff, related department and hospital administration staff. 200 surveys are conducted, among them 152 have returned, the feedback rate is 76%. The result obtained revealed: 1. Among Second Grade of Administrative staff and Second Grade of Medical Affair staff, both acknowledge hiring temporary medical staff can effectively lower human resource and add flexibility to manpower control. This attitude is different from Second Grade of Nursing staff who observed lack of loyalty from temporary nursing staff, and this attitude may ultimately affect the loyalty and stability of normal staff. 2. Activating the mechanism of temporary nursing staff during shortage of nursing staff in standard room is deemed acceptable. The same attitude prevails when nursing staff are in training course, on maternity leave or child care leave. In such situation, nursing staff agrees hiring temporary nursing staff can effectively reduce work load and working length. 3. The general consensus among nursing staff is that Temporary Nursing Staff is required to present certificate from nursing college and obtain nursing license to deem competent for the job. Regarding performance, nursing staff all agree that Temporary Nursing Staff must undergo standard training before commencing their role in caring. 4. Performance assessment on temporary nursing staff in an organization have different ranking. Temporary Nursing Staff (contract based) scores higher than Temporary Nursing Staff (out-sourced or delegated) because the core skills (regarding nursing profession) of the latter are yet recognized legally. 5. Different institution has different attitude and perception of temporary nursing staff and the difference will reflect onto statistic result. 6. When institution short of nursing staff, it may implement the mechanism of hiring temporary nursing staff, but there is no obvious complementary effect. 7. Different hospital status may have different implication to temporary nursing staff; therefore the feasibility of hiring temporary nursing staff can be complementary. 8. There is no apparent difference in activating temporary nursing staff among nursing supervisors who has different educational background. 9. There is no apparent difference in attitude towards hiring temporary nursing staff among different hospitals. 10. Different ranking hospitals do not observe to have difference in performance (ie. Work efficiency, service quality, organizational cost structure and core competences) when facilitating temporary nursing staff comparing to normal nursing staff. Base on the research conducted, employing temporary nursing staff during shortage of certified nurses is an acceptable alternative. It is a flexible option that can effectively reduce human resource cost and expands staffing flexibility.
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