技術混合照護模式於臨床應用之省思

Reflection on the Application of the Skill-mixed Care Model in Clinical Settings

10.6692/KJN-2013-30-2-1

張秉宜(Bieng-Yi Chang)；王桂芸(Kwua-Yun Wang)

技術混合照護模式 ； 輔助人力 ； 人力配置 ； skill-mixed care model ； assistive personnel ； manpower allocation

高雄護理雜誌

30卷2期（2013 / 08 / 01）

1 - 10

繁體中文

衛生福利部於2012年提出十大改善護理人力不足之策略，並以推動急性醫療機構實施技術混合照護模式（skill-mixed model）為行動方案，希望以輔助人力分擔非專業之護理照護工作，以減輕護理人員工作之負荷。計畫推動迄今已近一年，為初步瞭解國內推動技術混合照護模式之現況，瞭解已推動醫院之經驗顯示，實施技術混合照護模式之問題包括：輔助人力配置標準不一、照護能力不足、異動性過高而增加重複訓練之人事成本及護理人員反映工作指派及溝通時有壓力。為能達到目標，未來應有探討輔助人力不同配置模式實施效益的實證研究，以提供國內醫療機構於推動技術混合照護模式之參考依據；對於護理人員適應合作與監督關係及學習溝通的輔導應再增加，更要思考開拓輔助人力資源以提昇其能力與素質，促進護理人員之回流與留任及照護品質之提升。

In 2012, the Ministry of Health and Welfare has proposed the policy of applying the skill-mixed care model into acute care hospitals to resolve nurse shortage. Based on the information from the hospital adopting this model, major problems and impacts regarding implementing the skill-mixed care model mainly focused on lack of manpower allocation standards, inadequate ability for services, the rapid turnover and repeated training burden, as well as the nurses' perception and adaptation of governance roles. In order to achieve the optimal goal, comprehensive studies on obtaining evidence regarding the benefits of manpower allocation patterns are needed. Learning hours regarding work delegation and governance for nurses needs to be increased, and exploring possible resources for recruiting assistive personnel to improve the nurse retention as well as to provide better care quality.