The Skill Mix Model: A Preliminary Study of Changing Nurse Role Functions in Taiwan

台灣護理人員在技術混合照護模式中角色功能改變之先驅性研究

10.1097/JNR.0b013e318228cd5d

黃立琪(Li-Chi Huang)；李卓倫(Jwo-Leun Lee)；梁亞文(Yia-Wun Liang)；徐明儀(Ming-Yi Hsu)；鄭睿芬(Jui-Fen Cheng)；梅婷婷(Ting-Ting Mei)

護理角色功能 ； 技術混合照護模式 ； 照顧服務員 ； nurses' role function ； skill mix model ； nurse aide

The Journal of Nursing Research

19卷3期（2011 / 09 / 01）

220 - 229

英文

背景　護理人員短缺是目前全世界所面臨的嚴重問題，因此運用照顧服務員於護理人力中之技術混合照護模式，已被應用在健康照護體系中。目的　研究目的在調查台灣於技術混合照護模式實施後，護理人員自覺其角色功能之改變情形。方法　研究採橫斷式研究設計，以結構式問卷進行調查。研究對象共38位，為試辦計劃的三間醫院，於實施技術混合照護模式六個月後之內科病房護理師。結構式問卷內容包括：人口學基本資料、護理人員自覺其角色功能、角色與工作滿意度、病人照護品質。護理人員角色功能包含獨立性、依賴性及相互依賴性等角色功能。結果　研究結果顯示，護理人員自覺其獨立性與相互依賴性角色功能，於技術混合照護模式實施後有所改變。角色功能明顯改變的有：擔任照顧服務員教育者、病人照護督導者、及護理照護結果之評值者等獨立性角色功能，及護理工作和健康照護團隊之整合者等相互依賴性角色功能。此外護理人員自覺病人被重覆確認及病人照護品質是增加的。結論　研究顯示，護理人員在技術混合照護模式中，需要更多關於分派、教育照顧服務員，及擔任督導和護理照護整合者之角色功能。此研究結果將可作為台灣醫院之護理照護模式的參考。

Background: Nursing shortage is a critical problem worldwide. Using nurse aides (NAs) within a skill mix model has been applied in the healthcare delivery system as a strategy to improve nursing workforce shortages.Purpose: The purpose of this study was to investigate changes in nurse perceptions of their role functions under the skill mix model in Taiwan.Methods: This was a cross-sectional designed study that employed a structured questionnaire. Participants included 38 registered nurses from three medical wards in three hospitals that had implemented the skill mix model for 6 months. The questionnaire gathered data on participant demographics, perceptions on the role functions, role and job satisfaction of nurses, and patient care quality. Nurses' role functions were grouped into independent, dependent, and interdependent categories.Results: Results demonstrate that nurses' perceptions of independent and interdependent role function have changed since the implementation of the skill mix model. The most significant role changes in the independent function category included the nurse as educator of NAs, supervisor for patient care, and evaluator for nursing care outcomes. The most significant role changes in the interdependent function category included the nurse as integrator of nursing work and coordinator of the healthcare team. Nurses' perceived changes increase in repetitive confirmation of patient conditions and patient care quality.Conclusions: This study revealed that nurses working in skill mix model environments need more authority to delegate and educate NAs and to supervise and integrate nursing care. Study results may serve as a reference for hospital nursing practice in Taiwan.

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