比較護理進階制度實施前後護理能力及影響因素分析

The Comparison of Pre and Post Nursing Competence and Influencing Factor in Implementing Clinical Ladder Systems

10.6974/TCNJ.200201.0076

徐南麗(Nanly Hsu)；林碧珠(Pi-Chu Lin)；徐曼瑩(Man-Ying Hsu)；楊克平(Ke-Ping Yang)

臨床進階制度 ； 護理能力 ； 評值 ； Clinical Ladder Systems ； nursing competence ； evaluation

志為護理-慈濟護理雜誌

1卷1期（2002 / 01 / 01）

76 - 85

繁體中文

本研究目的在：(1)了解分級後護理人員之護理能力，並與未實施分級制度時之能力做比較；(2)分析影響護理能力分數之有關因素。研究對象為某醫學中心護理人員，實施進階制度前調查時間為88年12月，樣本數為321人，實施進階制度後調查時間為90年7月，樣本數為222人，以Likert 5分法測護理能力。研究結果顯示(1)實施進階制度前與實施進階制度後護理人員總能力平均分數分別為3.77，3.78，表示大部分能完成各項護理工作。(2)實施前後六大能力，合照護、溝通、教學、管理，研究及自我成長能力分別為4.04，4.03；3.95，3.95；3.83，3.78；3.39，3.71；2.85，2.98；3.60，3.68。(3)比較前後測在六大能力分數上均無顯著差異，(4)以變異數分析進階制度實施後在年齡、職稱、婚姻、子女狀況、服務年資、參加訓練、工作重要性、進階意願、主觀分級客觀分級上皆有顯著差異。(5)迴歸分析顯示主觀分級、上司領導、家人支持、個人意願及年資分組可解釋影響護理能力變數之21.7%，仍有78.3%影響因素尚未發現。故建議二年後再評值N1，N2，N3，N4之護理能力，研究結果做為改善教學訓練及提昇護理品質之參考。

The purposes of this study were to (1) understand and compared pre and post nursing competence (2) analyze the factors impacting nursing competence. The study was conducted from Dec 1, 1999 and ended on Jul. 31, 2001. A total of 321 nurses participated in pre implementation clinical ladder system and 222 nurses took the posttest in a medical center. A 5-point Likert scale was used to test nursing competence. The results showed that (1) the average pre and post nursing competence mean scores were 3.77 and 3.78; (2) the mean pre and post -test scores of six nursing competence areas including caring, communicating, teaching, managing, research, self-growth and professional development ability were 4.04, 4.03; 3.95, 3.95; 3.83 3.78; 3.69, 3.71; 2.85, 2.98; 3.60, and 3.68; (3) there were no significant differences between these two groups in the six nursing competence areas; (4) there were significant differences in age, working position marital status, number of children, years of service, attending training, motivation to attend clinicalladder systems, subjective nursing competence classification, objective nursing competence classification (N1, N2, N3, and N4), and importance of work by using ANOVA. Subjective nursing competence classification, boss's leadership, family support, personal motivation, and working years could explain 21.7% of the variance by using stepwise regression. There were 78.3% impact factors not found in this study. The researchers suggested evaluating nursing competence 2 years later continuously in order to use this data to improve teaching and evaluate the quality of nursing care.