單位分享自治模式之建立與實施成效

The Effectiveness of Implementing an Unit-based Shared Governance Model

10.7081/NR.200104.0125

李春蘭(Chen-Lan Lee)；楊克平(Ke-Ping Yang)；吳聖良(Shang-Liang Wu)；李麗傳(Li-Chuan Lee)

單位爲基礎的分享自治模式 ； 專業自治感受 ； 工作滿意度 ； Unit-Based shared governance model ； professional nursing governance ； work satisfaction

護理研究

9卷2期（2001 / 04 / 01）

125 - 136

繁體中文

本類實驗性研究目的為建立一個適用於單位之分離自治管理模式。立意選取某醫院護理部的53名護理人員，以單位專業自治感覺前測平均分數依序分配於實驗（n=29）及對照（n=24）兩組各三個單位，以統計方式控制年齡、年資及教育等變項。用Martin建議的分享自治系統評估法，以（1）管理者及護理人員準備度開放式問卷；（2）護理人員專業自治感受量表（IPNG）與工作滿意度量表（IWS）做組織成效的測量；（3）參與人員實際的執行意願等結構與非結構量表收集。本研究資料由準備期收集前測資料後，經教育期暨執行期進行分享自治概念的強化與實施介入模式，至後測資料收集之評值期後，歷經約四個月。資料以獨立t及x^2雙尾檢定分析差異情形。結果在建立一個本土化、適用於單位的分享自治管理模式後，可提升護理人員專業自治的感覺與工作滿意度，更可凝聚工作團隊之向心力，使護理人員有自主表達、擁有權威的感受；管理者能感受到同仁的表現且發現工作更易推展。本研究建議管理者和護理人員應在組織目標下，重新定位護理實務專業權責的角色，在相互的信任及充分授權下，擴大現行委員會中之基層人員代表與參與權。

The purpose of the nonequivalent control group study was to establish a regional unit-based shared governance model. Fifty-three subjects distributing to experimental (n=29) and control (n=24) groups-age, working years, and education were matched statistically-were selected by “purposeful sampling” of Index of Professional Nurse Governance pretest mean scores from six units at a nursing department. Based on Martin’s “systematic” evaluation model for shared governance, the study collected: (1) managers and staffs perception of existing governance using open-ended questions, (2) measure of organizational efficiency using the IPNG and the Index of Working Satisfaction, and (3) the research teams assessment of the unit’s willingness to continue this model in the future. The reliability and validity of the questionnaires were established. Intervention of the model was approximately four months, including: preparatory and evaluating phase: data was collected; educative phase: empowering managers and staff were educated in the shared governance concepts; implementing phase: shared governance team was built up. Two-tailed t and x^2 tests were used to detect differences between the two groups. Results showed, after establishing the unit-based model, (1) an increase in the nursing professional governance and work satisfaction among nurses; (2) an enhanced partnership between managers and nurses; (3) staff nurses perceived increased autonomy, authority, and more frequently expressed their opinions to managers; (4) managers perceived their staff to have more potential competence, then task pushed effectively. The findings suggest that managers and nurses need to refine their professional roles based on the organizational mission, as well as to expand nurses’ representation and participation in current organization- wide committees by trust and full delegation from their managers.

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