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  • 學位論文

護理人力資源管理策略:東部醫學中心個案研究

Strategies of Human Resource Management in Nursing: A Case Study of the Medical Center in Eastern Taiwan

指導教授 : 郭瑞祥

摘要


護理是高風險、高壓力、高工作量的工作,但卻是醫院中維繫病人安全與照護品質的重要專業人員,護理人力短缺已是全球性的問題,而台灣護理人員也嚴重短缺,許多醫院因為護理人力不足而縮減病床,造成民眾就醫困擾以及醫院的損失。本研究探討地處偏遠東部地區的醫學中心,如何在全台護理人力短缺的競爭環境下發展出成功的護理人力資源管理策略。研究方法採個案分析法,分析台灣護理人力發展現況對照個案醫院狀況,收集個案醫院近十年的人力資源管理資料配合文獻加以分析,選取留任和招募兩個面向,以SWOT分析東部醫學中心之內在環境的優勢和劣勢以及外在環境的機會和威脅,整理出優勢和機會,減低劣勢和威脅的影響,發展出六項策略規劃,並分析策略規劃執行成果。 六項策略規劃如下: 一、「優勢」醫學中心個案急重難症個案多可以提供多元學習與「劣勢」護理人員素質參差不齊,發展出規劃完整的護理教育和專業訓練計劃。 二、「優勢」--慈濟理念和護理利他理念接近與「劣勢」--民眾對慈濟期望高,成為沈重的壓力,發展出運用護理和慈濟的利他理念強化護理價值感,並且以榮耀護理的價值來提升利他的理念承諾。 三、「優勢」--慈濟四大志業資源豐富、醫院志工多可提供協助和支持與「劣勢」--地處偏遠離家遠且生活單調,因此規劃應用志工對護理人員的關懷支持系統,提供有意義的生活以助留任。 四、「優勢」--臨近慈濟技術學院和慈濟大學,有利進修和學術發展結合「機會」--東部地區醫療人才缺乏,護理專業有機會發展,規劃校院產學合作,培育護理人才。 五、「優勢」--財團法人機構非公家機構,管理制度彈性大與「劣勢」--歷史包袱:護理工作複雜、包羅萬象,因此協調各相關部門,應用管理彈性,改善護理人員工作的複雜性和工作負荷。 六、護理人員離家遠缺少家人支持,無法留任輪三班工作,彈性的管理制度可以改善此劣勢。 研究結果以招募、留任、人才培育、研究發展顯現策略規劃的成果,招募方面,履歷表增加和進用人數穩定,留任方面發現試用期離職率大幅降低、正用離職率逐漸降低,顯現六大策略規劃對招募和留任的成效,不但度過全台護理人力最短缺的黑暗期,並培育出許多護理人才在臨床、教學和研究上充分發揮,使護理人員自己產生成就感和幸福感,也提升護理品質,加添了醫院的榮譽和聲望,造福花東民眾健康的照護。

並列摘要


Nursing is a high risk, pressure, and high loading work. Nurse is the most important professional that affiliated with patient safety and quality of care in hospitals. Nursing shortage has been a universal problem, and Taiwan is not an exception in this regard. Many hospitals have decrease number of beds for the sake of the shortage. The problem has been impacted patients and hospitals. This case study was to explore how the medical center in eastern Taiwan survived and developed the successful human resource management for nursing in this era. The research method was case analysis. The study examined Taiwan nursing shortage and SWOT analysis and strategic planning for nursing human resource management in the medical center with respect of recruitment and retention. SWOT analysis was used to evaluate the strengths and weaknesses of the hospital, and the opportunities and threats from the external environment. We developed six strategies to strengthen the weakness and prevent threats by using the strength and opportunities. The six strategies are as follow: 1. The “Strength” --many critical and difficult cases that can be for multiple learning; the “Weakness” --jagged competence level among nurses. The complete system of continuous education for nurses was developed. 2. The “Strength”—the philosophy of Tzu Chi is closed to that of nursing; the “Weakness”—high expectation on Tzu Chi is a heavy stress to nurses. Therefore, developing strategies of integration of philosophy of Tzu Chi and nursing, and honoring nursing value is conducted to lift commitment to altruism. 3. The “Strength”— Tzu Chi foundation is resourceful and filled of volunteers that can provide assistance and support; the “Weakness” --most of nurses live faraway from home and their monotonous life was boring in the remote area. Volunteers are arranged to lead significant living and give support in nurse retention. 4. The “Strength”—being closed to Tzu Chi University and Tzu Chi College of Technology is advantage for integrating academic and staff development; the “Opportunity” –expansion of nursing role and function due to lack of medical professionals. The matched strategy is the university (college)- hospital collaboration projects to nurture nursing workforce and career development. 5. The “Strength” –the regulation of private institute is more flexible than public institute; the “Weakness” –historical burden: complicated, overarching nursing work. Therefore, flexible management can improve nursing workload and complexity. 6. Nurses are far away from home and lack of family support, unable to retain in the three-shift clinical nursing work, flexible staffing system can improve the weakness. The results showed the effects of the six strategic planning on recruitment, retention, nurturing talent, and research/ development. In the recruitment, number of resume increased and enrolling nurses is stable. In the retention, the new nurses turnover rate has been markedly decreased, senior nurses retained likewise. All showed the six strategic planning help the medical center out of the nursing shortage chaos. Many nurses had been fostered and they utilized their talent and skills in clinical setting, education and research. Nurses were satisfied with achievement and well being, not only improved quality of care, but also lifted reputation for the medical center and benefit to people health in eastern Taiwan.

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