全球性護理人力短缺：文獻回顧

Global Nursing Shortage: A Literature Review

在21世紀，由於社會大眾對延長生命的期盼，再加上慢性疾病種類的增加，住院病患複雜多變的急性病徵，在在使得健康照護服務的迫切需求面臨嚴峻的挑戰，但若要全面性地提供高品質的健康照護服務，這意味著需要更多護理人員投身於健康照護服務的行列，然而許多不好的認知，例如工作負擔過重，工作壓力太大，工作挫折感及得不到足夠的後援支持，在在對提供第一線照護的護理人員工作造成嚴重衝擊，導致全球性護理人力短缺未來將益形嚴重。許多已開發國家已積極著手規劃處置全球性護理人力短缺問題，經由文獻回顧並綜合各類研究報告，我們發現影響護理人員離職的意願和行動主要歸類成三大因素：個人因素，社會影響因素和健康組織機構因素。當然影響護理人力短缺的因素，也不單單只是護理專業和健康組織機構的因素，病患對提供健康照護服務的滿意度也是一項不可輕忽的因素。因此，為了留住優質的護理人員，以期在激烈競爭的健康照護服務能提供具有經濟效益之高品質臨床照護，我們在發展招募和留任護理人員計畫時，應一併考量各種影響護理人員離職的潛在性因素和動機之間的關連，並做深入的釐清和探討，才能提供優質的工作環境，留住優質的護理人員，消彌護理人力短缺對健康照護服務的衝擊。

A 21st century phenomena, the impending needs of the health care service are the epidemiological challenge posed by improved life expectancy, more chronic diseases and an increase in the number of acuity and complexity of hospitalised patients as well as the extension of health services in the community sector. It seems reasonable to expect that adequate numbers of nurses will be needed to participate in health care service. However, adverse perceptions such as excessive workload, intolerance stress, frustration and poor support challenge clinical nurses who are working at the frontline of health care delivery. Recently, the influences of a nursing shortage are predicted to become worse worldwide and many developed countries have tried to deal with this situation. Through the literature review, this paper has synthesized the prior research and classified the major determinants which dominate the nurses’ intentions and actions to leave the professional career into three catalogues: individual factors, social influences and organizational factors. When considering the nursing shortage, the impacts of the shortage are not only on the nursing profession and health organizations, patient’s satisfaction towards the health care service will be compromised as well. To retain qualifiedstaff in a competitive health care industry and to provide cost-effective care with quality clinical outcomes, the relationship between possible factors and staff’s intention to quit has to be taken into account before the development of retention and recruitment programs.