英文摘要 |
Background: In 2000, Taiwan’s legislature approved the legal title “nurse practitioner”, and consequently, certification examinations for nurse practitioners began in 2006. The scope of practice is based on Article 24 of the Nursing Personnel Act. However, since the work responsibilities involved in the provision of medical assistance are not clearly established, the professional duties of nurse practitioners often fall into a grey area. The aim of this study is to investigate the scope of work of nurse practitioners in an acute care hospital. Method: Qualitative research was carried out between January to December, 2009. Purposive sampling was used to select 18 nurse practitioners with either surgical or medical nursing practitioner certification. We produced an interview guide to carry out one-on-one in-depth interviews, and used content analysis to analyze the data. Results: The views of nurse practitioners toward the scope of their work were separated into three themes and nine categories. The first category is the scope of work under existing regulations, including: (1) The initial physical examination, asking the patient about his or her illness; (2) Recording the patient’s medical condition and the results of each medical examination and test; (3) Responding to questions from the patient and his or her family, and explaining the patient’s medical condition; (4) Applying for medical tests and examinations under the direction of the physician; and (5) Prescribing medicines under the direction of the physician. The second category is additional assistance given to the care team when needed, which may fall into a professional grey area, including: (1) Medical duties are greater than nursing duties; (2) Lack of clear understanding of the role and scope of work; and (3) Assisting with invasive medical procedures when required. The third category is challenges to the professional competence of nurse practitioners, primarily clinical studies, visual image interpretation, differential diagnosis, and pharmacological capabilities. Conclusions and practical application: The medical assistance provided by nurse practitioners exceeds the scope of existing regulations. The results of this study can be used as a basis for designing training for nurse practitioners, and establishing the scope of medical assistance and advanced clinical nursing care provided by nurse practitioners. |