護理長行政管理核心能力及評量指標之建立

Establishment of Administrative Core Competencies and Evaluation Indicators for Head Nurses

10.6224/JN.202404_71(2).06

郭雪敏(Hsueh-Ming KUO)；岳芳如(Fang-Ru YUEH)；詹培梅(Pei-Mei CHAN)；梁詩欣(Shih-Hsin LIANG)；張瑩如(Ying-Ju CHANG)

護理長 ； 行政管理核心能力 ； 行為指標 ； 能力評量 ； head nurse ； core competencies of administrative management ； behavioral indicators ； performance evaluation

護理雜誌

71卷2期（2024 / 04 / 01）

34 - 45

繁體中文;英文

背景：近年來醫療照護環境的複雜，凸顯了培養具備領導與管理能力，有效能處理複雜行政業務及領導病房護理團隊面對挑戰之護理長的重要性。而護理長行政管理核心能力的確認及行為指標評量，是培育人才與評量訓練成效的重要依據。目的：確認護理長行政管理核心能力、相對應工作職責、任務、行為評量指標及所需的知識及技能。方法：本研究分二階段進行，均採質性研究法；第一階段確認護理長行政管理核心能力及行為定義，第二階段建立與護理長行政管理核心能力相關的工作職責、任務、行為評量指標、工作產出及所需的知識及技能。每個階段均以（一）質性訪談（第一階段）或專家焦點團體（第二階段）建置雛形內容、（二）舉辦護理長工作坊取得多元觀點，據以修改雛形內容及（三）進行專家焦點團體達成內容共識等三個步驟來進行。結果：本研究共確認護理長行政管理九大核心能力，包括策略規劃力、照護督導力、品質促進力、溝通表達力、危機管理力、當責領導力、實證研究力、數位應用力及簡報說服力；對應護理長管理能力，建立了護理長四大職責及其工作任務，並確認相關的行為評量指標、工作產出及所需的知識技能。結論／實務應用：本研究結果可作為護理長行政管理培訓計畫之依據，並可運用行為評量指標評核護理長工作表現及訓練成效之評核，建議各醫療院所可參考此行政管理能力指標及建構脈絡，發展具個別性之護理長行政管理能力評核標準。

Background: The increasing complexity of the healthcare environment in recent years highlights the importance of cultivating in head nurses the leadership and management competencies necessary to effectively handle complicated administrative tasks and lead nurses in facing various challenges. Identifying the core administrative management competencies required of head nurses and evaluating competency level using behavioral indicators are fundamental to evaluating related training outcomes. Purposes: This study was designed to identify the core administrative management competencies required of head nurses as well as the associated job responsibilities, tasks, behavioral evaluation indicators, work outputs, and requisite knowledge and skills. Methods: This study was conducted in two phases using a qualitative method. The first phase identified the core administrative management competencies and their behavioral definitions. The second phase established competency-related job responsibilities, tasks, behavioral evaluation indicators, work outputs, and requisite knowledge and skills. Each phase consisted of (1) a qualitative interview (first stage) or focus group discussion (second stage) to establish the prototype content; (2) a head nurse workshop to obtain multiple perspectives to modify the prototype content; and (3) a focus group discussion to achieve consensus regarding the content. Results: Nine core competencies related to head nurse administration were identified, including: strategic planning, care supervision, quality improvement, communication, crisis management, responsible leadership, evidence-based practice, digital technology application, and presentation persuasion. Corresponding to these competencies, four responsibilities and associated work tasks were identified. Finally, the related behavioral evaluation indicators, work outputs, and requisite knowledge and skills were confirmed. Conclusion/ Implications for Practice: The results of this study may be used as the basis for head nurse administrative management training programs, while the identified behavioral evaluation indicators may be used to evaluate head nurse work performance and training outcomes. We recommend other institutions apply the results of this study and develop their own administrative core competencies and evaluation indicators for head nurses.

1. 李俊儀、李佳蓉（2022）．師資生教學專業素養之培力與實踐—以教學簡報設計與實作課程為例．中等教育，73（3），28–54。[Lee, C.-Y., & Lee, C.-R. (2022). Cultivation and practice of teaching professional competencies of student teachers - The course of instructional presentation design and practice. Secondary Education, 73(3), 28–54.] https://doi.org/10.6249/SE.202209_73(3).0019
   連結：
2. 林秋芬、張元玫、楊勤熒、高靖秋、盧美秀（2006）．以護理人員角度，評價護理長決策能力．新臺北護理期刊，8（1），57–68。[Lin, C.-F., Chang, Y.-M., Yang, C.-Y., Kao, C.-C., & Lu, M.-S. (2006). Evaluating head nurses’ decision making competence from nurses’ viewpoints. New Taipei Journal of Nursing, 8(1), 57–68.] https://doi.org/10.6540/NTJN.2006.1.006
   連結：
3. 張元玫、黃美荏、陳嘉珮、吳淑珍、陳淑娟（2009）．某醫學中心儲備護理長行政能力之初探．領導護理，10（3），14–25。[Chang, Y.-M., Huang, M.-Z., Chen, C.-P., Wu, S.-C., & Chen, S.-C. (2009). The effect of a management development program to promote senior nurses’ competency in administration. Leadership Nursing, 10(3), 14–25.] https://doi.org/10.29494/LN.200912.0003
   連結：
4. 張議文、戴宏達、孫秀卿、莊雯如、邱美琪、尹祚芊（2003）．某醫學中心護理長角色功能之調查研究．榮總護理，20（4），401–410。[Chang, I.-W., Dai, H.-D., Shun, S.-C., Chuang, W.-R., Chiou, M.-C., & Yin, T. J. C. (2003). An investigation of head nurses’ role function at a medical center in Taiwan. VGH Nursing, 20(4), 401–410.] https://doi.org/10.6142/VGHN.20.4.401
   連結：
5. 郭俐蘭、劉翠瑤、馮容莊（2020）．護理主管接班人計劃之推動與成效．源遠護理，14（3），40–46。[Kuo, L.-L., Liu, T.-Y., & Feng, R.-C. (2020). Implementation and effectiveness of a succession planning for nurse leaders. Yuan-Yuan Nursing, 14(3), 40–46.] https://doi.org/10.6530/YYN.202011_14(3).0005
   連結：
6. 郭素真、楊易宏、周幸生（2019）．建構護理引領實證照護品質促進的未來．源遠護理，13（3），24–30。[Kuo, S.-C., Yang, Y.-H., & Chou, S.-S. (2019). Nurse leads the future of evidence based quality improvement. Yuan-Yuan Nursing, 13(3), 24–30.] https://doi.org/10.6530/YYN.201911_13(3).0004
   連結：
7. 陳玉枝（2011）．護理行政與管理之變革．護理雜誌，58（3），21–26。[Chen, Y.-C. (2011). Reformation of the nursing administration and management system. The Journal of Nursing, 58(3), 21–26.] https://doi.org/10.6224/JN.58.3.21
   連結：
8. 鈕則誠（2005）．護理管理哲學的概念分析．護理雜誌，52（5），5–9。[Niu, T.-C. (2005). The philosophy of nursing management: A conceptual analysis. The Journal of Nursing, 52(5), 5–9.] https://doi.org/10.6224/JN.52.5.5
   連結：
9. 黃嘉立、鄧雅婷、洪聖惠（2022）．醫療科技問題與病人安全風險學習平台成果與展望．醫療品質雜誌，16（4），6–11。[Huang, J.-L., Deng, Y.-T., & Hung, S.-H. (2022). The achievements and future of information technology related patient safety. Journal of Healthcare Quality, 16(4), 6–11.] https://doi.org/10.53106/199457952022071604001
   連結：
10. 劉翠瑤、孫嘉璟、蕭君婷（2021）．新冠肺炎疫情下—引領護理戰疫的轉換型領導力．護理雜誌，68（2），92–98。[Liu, T.-Y., Sun, J.-J., & Hsiao, C.-T. (2021). Novel coronavirus: Applying transformational leadership to the combat of COVID-19 in nursing practice. The Journal of Nursing, 68(2), 92–98.] https://doi.org/10.6224/JN.202104_68(2).12
    連結：
11. Abd El-Fattah Mohamed Aly, N., Moustafa El-Shanawany, S., Ghanem, M., Abd El Kader, E., & Lotfy, W. M. (2023). Impact of competency-based intervention on leadership effectiveness of head nurses in teaching hospitals. Egyptian Journal of Health Care, 14(2), 1042–1053. https://doi.org/10.21608/EJHC.2023.311249
    連結：
12. Ahmed, H. E.-D., Sleem, W. F., & El-Sayed, R. I. (2021). Core competencies elements among first line nurse managers at port-said governmental hospitals. Port Said Scientific Journal of Nursing, 8(3), 303–326. https://doi.org/10.21608/pssjn.2021.81317.1117
    連結：
13. Clark, J. S. (2012). The system chief nurse executive role: Sign of the changing times? Nursing Administration Quarterly, 36(4), 299–305. https://doi.org/10.1097/NAQ.0b013e3182669440
    連結：
14. Elhadad, A, E., Sleem, W. F., & Ahmed, M. F. (2022). Association between leadership competency, quality of work and readiness for change among head nurses. Mansoura Nursing Journal, 9(1), 189–200. https://doi.org/10.21608/MNJ.2022.259017
    連結：
15. González-García, A., Pinto-Carral, A., Pérez-González, S., & Marqués-Sánchez, P. (2021). Nurse managers’ competencies: A scoping review. Journal of Nursing Management, 29(6), 1410–1419. https://doi.org/10.1111/jonm.13380
    連結：
16. Kakemam, E., Liang, Z., Janati, A., Arab-Zozani, M., Mohaghegh, B., & Gholizadeh, M. (2020). Leadership and management competencies for hospital managers: A systematic review and best-fit framework synthesis. Journal of Healthcare Leadership, 12, 59–68. https://doi.org/10.2147/JHL.S265825
    連結：
17. Kim, S., & Lim, J.-Y. (2022). Development and evaluation of the “high-up” program for enhancing the nursing-management competency of mid-career hospital nurses: A quasi-experimental study. International Journal of Environmental Research and Public Health, 19(7), Article 4392. https://doi.org/10.3390/ijerph19074392
    連結：
18. McClelland, D. C. (1973). Testing for competence rather than for “intelligence.” American Psychologist, 28(1), 1–14. https://doi.org/10.1037/h0034092
    連結：
19. Penconek, T., Tate, K., Bernardes, A., Lee, S., Micaroni, S. P., Balsanelli, A. P., de Moura, A. A., & Cummings, G. G. (2021). Determinants of nurse manager job satisfaction: A systematic review. International Journal of Nursing Studies, 118, Article 103906. https://doi.org/10.1016/j.ijnurstu.2021.103906
    連結：
20. Valizadeh, L., Zamanzadeh, V., Eskandari, M., & Alizadeh, S. (2019). Professional competence in nursing: A hybrid concept analysis. Medical Surgical Nursing Journal, 8(2), Article e90580. https://doi.org/10.5812/msnj.90580
    連結：
21. Wang, N., Schnipke, D., & Witt, E. A. (2005). Use of knowledge, skill, and ability statements in developing licensure and certification examinations. Educational Measurement: Issues and Practice, 24(1), 15–22. https://doi.org/10.1111/j.1745-3992.2005.00003.x
    連結：
22. 林秋芬（2018）．緒論．於盧美秀總校閱，護理行政（七版，2–3頁）．新文京。[Lin, C.-F. (2018). Introduction. In M.-S. Lu (Ed.), Nursing administration (7th ed., pp. 2–3). New Wun Ching.]
23. 施能傑（2002）．能力模式與人力資源訓練發展．人事月刊，34（3），5–19。[Shin, N.-J. (2002). Capability model and human resources training and development. Personnel Monthly, 34(3), 5–19.]
24. 衛生福利部統計處（2022）．機構執業醫事人員數及每萬人口執業醫事人員數。[Department of Statistics, Ministry of Health and Welfare, Taiwan, ROC. (2022). Number of practicing medical personnel in institutions and number of practicing medical personnel per 10,000 population.] https://www.mohw.gov.tw/dl-73291-c9f551df-f78a-41ab-a554-addf890c8369.html
25. American Organization for Nursing Leadership. (2015). AONL nurse executive competencies: System CNE. https://www.aonl.org/system/files/media/file/2019/06/nec-system-cne.pdf
26. Greiner, A. C., & Knebel, E. (2003). Health professions education: A bridge to quality. The National Academies Press. https://www.ncbi.nlm.nih.gov/books/n/nap10681/pdf/
27. Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. SAGE Publications.