運用360度評核二年期護理師護理能力之探討

護理人員為醫療體系內照護病人的第一線人員，此角色在臨床照護上扮演著重要角色，而護理能力更攸關病人安全及護理品質。藉由「360度評核」機制能較客觀、公正的對受評者進行評估，讓受評者更了解自己的優缺點，協助個人成長，以提升護理能力。本研究主要目的為探討醫療人員及非醫療人員對二年期護理師護理能力、自評結果與主管、同儕、部屬、外部顧客及不同基本屬性評核之差異。以醫療人員版及非醫療人員版問卷作為二年期護理師護理能力調查。評估者包含主管、同儕、部屬、外部顧客及自評，共收案210人次。資料收集建檔後以SPSS 18.0統計軟體進行統計分析。結果發現：醫療版護理能力(滿分5分)自評平均分數為4.09 ±.38，在五大能力構面得分最高為資訊技術構面、分數最低為實證專業執行構面。主管評核平均分數為3.87 ±.48、同儕平均評核分數為4.21 ±.49，在五大能力構面得分最高皆為品質改善技術應用構面、分數最低為實證專業執行構面。各組人員對二年期護理師能力評核，p値<.01達顯著差異。非醫療版能力評核(滿分5分)，部屬評核平均分數為4.37±.61、外部顧客平均評核分數為4.51±.48。兩者評核結果未達顯著差異，顯示部屬及外部顧客對二年期護理師能力評核達一致性。服務科別不同在自評、主管及部屬評核結果皆達顯著差異，顯示科別不同，對護理能力表現有差異；教育程度及工作年資不同在各組皆未達顯著差異。本研究透過360度評核方式，醫療團隊及外部顧客即時的回饋、護理師自我評估，讓新進護理師了解護理能力的要求，減少實際表現間的差距，並提供具體資料作為臨床教師教學策略參考及課程內容修訂依據。

關鍵字

二年期護理師； 360度評核；護理能力

並列摘要

Nursing staff stand on the first line of care for patients in medical system. They play an important role in clinical care, and their competency is of critical value to patient safety and quality of care. Through the "360-degree evaluation" mechanism, the trainees can be evaluated objectively and fairly, so that the trainees can better understand their strengths and weaknesses and assist their personal growth to improve their nursing competency. The main purpose of this study was to explore the differences of the nursing competency of the two-year nursing staff evaluated between medical staff, non-medical staff and self-evaluation and to compare the assessments of supervisors, peers, subordinates, external customers and different basic attributes. The medical staff version and the non-medical personnel version of questionnaires were used to survey the two-year nursing staff nursing competency. A total of 210 subjects were recruited. The evaluators included supervisors, peers, subordinates, external customers and the trainees themselves. After data collection and coding, statistical analysis was performed using SPSS 18.0 statistical software. The results showed that the average score of the self-evaluation of the medical care competency was 4.09 ±.38 (out of 5 points), and the highest score was the information technology facet and the lowest scores was the empirical professional facet. The average score of the supervisors was 3.87 ±.48, and the average score of the peers was 4.21 ±.49. The highest score in the five major competencies fell in the quality improvement technology application facet and the lowest score was the empirical professional execution facet. The assessments on the ability of the two-year nurses between the groups of personnel was significantly different (p<.01). To the non-medical version of the competency assessment, the average score of the subordinate assessment was 4.37±.61 (out of 5 points), and the average score of the external customer was 4.51±.48. The results of the two assessments did not reach significant differences, indicating that the subordinate and external customers had a consistent assessment on the ability of the two-year nurses. Self-assessment, supervisory and sub-general assessment results all differed significantly among service divisions, showing that nursing performance differs in different disciplines. Education levels and working years were not significantly different between groups. Through the 360-degree evaluation, this study provided immediate feedback by the medical team and external customers and self-assessment by the nurses, so that the new nurses can understand the requirements of nursing competency, reduce the gap between actual performances. Empirical information can provided as a reference to the clinical teachers for the revision of education strategies and the course contents.