台灣專科護理師培訓及進階制度

Nurses Practitioner Training and Ladder System in Taiwan

蔡秀鸞(Shiow-Luan Tsay)；童恒新(Heng-Hsin Tung)

台灣 ； 專科護理師 ； 培訓 ； 進階制度 ； Taiwan ； Nurses practitioner ； Training ； Ladder system

醫學與健康期刊

10卷3期（2021 / 11 / 01）

111 - 121

繁體中文

專科護理師訓練目前主要仍在醫療機構中進行，醫院訓練其優點為時效性，相對的其訓練品質標準較難統一。然而專科護理師研究所之培育包含國家考試所需的學科及臨床訓練時數外，亦有研究方法、統計或實證等課程；提供更具系統性的基礎訓練但需要較長時間的養成。惟目前專科護理師具備研究所學歷僅佔19.3%，且國內研究所培育碩士級專科護理師量能仍有限。因此，專科護理師進階制度亦是維持照護品質重要的一環，目前每年專科護理師申請進階通過率約為36～44%。本文介紹分成兩大面向，首先以目前專科護理師之培訓為起點，含括訓練醫院認定執行過程。再闡述專科護理師之執業範疇及其進階制度成效以提升專科護理師之專業發展。最後，專科護理師需長遠規劃，期能在未來10年內所有的專科護理師培訓在護理研究所進行，基礎門檻提升至碩士學歷以利優化一致性的專業訓練達到國際標準；此外，持續推動專科護理師進階制度，多方面開設相關課程以協助持續精進其專業成長，以利全民福祉。

Nursing practitioners (NPs) were mainly cultivated in hospitals, the positive side of hospital training is efficient but lack of standardize quality. NP program in graduate level from school provide not only lecture and practicum to meet national examination criteria but also research course, statistical analysis course or evidence based practice, thus, offer systematic fundamental training but need more time to complete the program compare to hospital training. Only 19.3% of NPs received training from school and there are limited school-based NP program in Taiwan. Thus, nursing practitioner ladder is one of the key to ensure quality of care, the passing rate of the ladder is 36-44% for each year. This paper described two main sections, one is concerning nursing practitioner training including hospital accreditation process enable to train nurse practitioner. In addition, the other section is to illustrate scope of nurse practitioner practice and effectiveness of NP promoting ladder to optimize nurse practitioner professional growth. Lastly, long term strategy for NP development is needed. NPs should be trained in graduate school-based with master degree to achieve the same and high stander at international requirement for advanced practice nurse, as such, enhancing well-being for all.

1. 姚鳳秀,劉紋妙,沈慧萍,鍾淑英(2016)。專科護理師護理能力及其相關因素之探討。台灣專科護理師學刊，2，22-34。
   連結：
2. 陳小蓮, HL(2016)。臺灣專科護理師進階制度的規劃。台灣專科護理師期刊，2，13-18。
   連結：
3. 陳齡芳, LF,陳小蓮, HL(2019)。臺灣專科護理師進階制度推動現況與未來。源遠護理，13，22-28。
   連結：
4. 章瓊慧, CH,唐婉如, WR(2016)。臺灣專科護理師工作項目及時間分配之探討。台灣專科護理師學刊，2，35-45。
   連結：
5. American Association of Nurse Practitioners. NP Fact Sheet. Available at https://www.aanp.org/all-about-nps/np-fact-sheet. Accessed June 1, 2021.
6. Benner, PE(2001).From novice to expert: Excellence and power in clinical nursing practice.Upper Saddle River:Prentice Hall.
7. Evans, A,Loera, K,Harris, D,Carson, S,Boutros, L,Kuhara, C(2019).Development, implementation, and satisfaction with a nurse practitioner professional ladder: A Children’s Hospital Experience.J Pediatric Health Care,33,111-116.
8. International Council of Nurse.Definition and Characteristics of the Role. Available from https://international.aanp.org/practice/apnroles. Accessed September 7, 2021.
9. Kaiser P: Nurse practitioner III initial application packet. Available from: http://kpnursing.org/_NCAL/professionaldevelopment/careermobility/clinicalladders/docs/NP3_Renewal_Packet_%20FINAL.pdf. Accessed 2013.
10. Luo, PY,Tung, HH,Huang, SS(2021).Organizational empowerment and practice outcomes of acute care nurse practitioners in Taiwan. A national survey.Am Assoc Nurse Pract
11. National Organization of Nurse Practitioner Faculties. The Doctor of Nursing Practice Degree: Entry to Nurse Practitioner Practice by 2025. Available from: https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/dnp/v3_05.2018_NONPF_DNP_Stateme.pdf. Accessed September 7, 2021.
12. Tsay, SL,Tsay, SF,Ke, CY,Chen, CM,Tung, HH(2019).Analysis of nurse practitioner scope of practice in Taiwan using the Longest policy cycle model.J Am Assoc Nurse Pract,31,198-205.
13. Williams, BW,Byrne, PD,Williams, NV,Williams, MV(2017).‘Dreyfus And Dreyfus and indicators of behavioral performance: A study of measurement convergence.Journal of Continuing Education in the Health Professions,37,50-54.
14. 台灣專科護理師學會：2021年全國調查，蔡秀鸞：專科護理師進階制度之成效比較。http:www.tnpa.org.tw/papers/papers_detail2.asp?id=222。引用6/1/2021。Taiwan Association of Nurse Practitionerb: The Comparison of Nurse Practitioner Ladder System Effectiveness: 2021 National Survey. http:www.tnpa.org.tw/papers/papers_detail2.asp?id=222. Accessed June 1, 2021. [In Chinese]
15. 台灣專科護理師學會：專科護理師核心專業能力。http://www.tnpa.org.tw/papers/papers_detail2.asp?id=209。引用6/1/2021。Taiwan Association of Nurse Practitionera: Competence of Nurse Practitioners in Taiwan Available at: http://www.tnpa.org.tw/papers/papers_detail2.asp?id=209. Accessed June 1, 2021. [In Chinese]
16. 衛素蓉,張曉雲,陳淑銘,葉淑惠,楊麗慧(2017)。比較專科護理師自覺重要角色能力與實際執行角色能力之看法：以Q方法探討。護理雜誌，66，33-42。

1. 陳盈如,唐嘉君,李達雅(2022)。疫情危機下的轉機？新冠肺炎大流行下推動專科護理師獨立作業之契機。台灣專科護理師學刊，9(1)，10-15。
2. 蕭思美,黃彥綾,陳貞如,周美吟(2023)。偏鄉醫院專科護理師之執業困境。護理雜誌，70(4)，47-55。
3. (2024)。從國外角度分析國內家庭專科護理師的課程規劃及困境。台灣專科護理師學刊，11(1)，5-13。
4. (2024)。後疫情時代臺灣培訓麻醉專科護理師之挑戰與因應策略。台灣專科護理師學刊，11(1)，23-30。
5. (2024)。家庭專科護理師之賦能與社區健康永續發展。台灣專科護理師學刊，11(1)，14-17。