合作性護理計劃－－一個結合傳統護理計劃與臨床路徑的照護計劃

The Collaborative Nursing Care Plan: Integration of the Clinical Pathway With the Traditional Nursing Care Plan

護理計劃是一個在護理教育中廣泛使用的教學工具。由製作個別化的護理計劃，學生練習應用護理過程作臨床判斷與抉擇。但在臨床實務界，受管理性照護（managed care）制度的衝擊，許多健康醫療機構已由要求傳統分欄式護理計劃轉向使用臨床路徑及常規照護標準。在此趨勢下，護理教育者面臨的問題是如何應變以促進學生畢業後適應今日的臨床要求。針對這個問題，本文重新檢視傳統護理計劃教學上的實用性，並介紹一個結合傳統護理計劃與臨床路徑的“合作性護理計劃”及其在教學上之應用。

The nursing care plan is a commonly used teaching tool in nursing education. By developing individualized nursing care plans for specific clients, students practice use of nursing process and making clinical judgments and decisions. However, the system of managed care has impacted current clinical practice, and many health care agencies have shifted their emphasis from requiring the traditional columnar nursing care plans to use of clinical pathways and standards of care. As result of this trend, nursing educators are faced with the problem of preparing students to cope with today’s reality in clinical practice. In response to this problem, this article reexamines the practical utility of the traditional nursing care plan in nursing education. The article also introduces a collaborative nursing care plan, the integration of the clinical pathway with the traditional nursing care plan, and its application in teaching.