發展病患服務員與居家服務員整合性課程及配套措施

Development of an Integrating Program and Associated Interventions for Institutional Nurse Aides and Home Care Helpers

本研究目的在探討病患服務員與居家服務員之整合性課程及相關配套措施，以台灣各界產、官、學的長期照護及老人護理專家52人為對象，經七次焦點座談會的討論方式收集資料。研究的討論指引如下：(1)病患服務員與居家服務員整合課程及所需之相關配套措施；(2)病患服務員與居家服務員之資格認定差別與共通的認證原則；(3)病患服務員與居家服務員之師資和人力流通原則。將焦點團體進行的過程給予錄音，做內容的歸納分析。研究結果發現兩制課程整合之方向有兩大主軸：一、職前訓練：包括基礎核心課程50～60小時，內容涵蓋日常生活照顧部分：清潔與舒適、基本生活需求、營養及膳食療法、活動與運動等單元；異常及疾病照顧部分：身體結構與功能、基本生命徵象、疾病徵兆之認識與處理、急救概念、急症處置、臨終關懷、認識安寧照顧及失能者特質之基本認知；其他如：社會福利資源、人際關係與溝通技巧、家庭關係與危機處理、家務處理、意外災害的緊急處理、工作壓力與調適、綜合討論與課程評量。加上回覆示教10小時及實習30小時，總共90～100小時；二、在職教育由用人機構視病人特性及機構的實際需要設計課程，以促進品質監測的發展。藉由本研究課程的整合，期望能使人員之培育與訓練達到一定水準，且促進雙方人力市場之流通，避免政府資源之重複與浪費。

The study was conducted to develop a core-training program and the associated interventions for both institutional nurse aides and home care helpers. A total of fifty-two experts in long-term care and gerontological nursing practice, administration, and education in Taiwan were recruited to discuss the integrating program. Data was collected through seven focus group discussions. The guidelines for the discussion of the core-training program included: 1.the related policies and preparations for the integrations of the training program; 2.the consensus and discrepancy of certified qualifications and policies in the two different programs; 3.the consensus and communication of the integrated resources of instructors and certified nurse aides between these two programs. The conferences were tape-recorded during the group discussions and then analyzed into category. The experts agreed to integrate the training program into two axes: Axis 1 was a total of 90-100 hours of pre-job training, including 50-60 hours of the basic core course, 10 hours of instructing demonstration, and 30 hours of clinical practice. Axis 2 was the in-service education, which could be designed based on the specific needs and characteristics of the facilities and their patients to facilitate the development of quality assurance. Results from the integrated discussion and evaluation could be a welcome beginning for the core-training program for the institutional nurse aides and home care helpers. Moreover, the integrated nursing instruction system and documentation certifying system would provide an economic advantage regarding official training resources and quality control, and promote the mutual personnel communication between both systems.