醫學中心護理人員工作環境之研究

1981年始美國學者研究磁性醫院，是在人力短缺的職場中吸引並留任護理人員，評估護理工作環境是磁性醫院認證之重要指標之一。本研究以美國Lake博士發展之護理工作環境量表，探討台北某醫學中心各病房護理人員之工作環境。係描述性調查型研究，採立意取樣，以該醫學中心基層護理人員為母群體，採無記名網路填答方式。護理工作環境量表為31題四分量表之結構式問卷，統計分析採變異數分析、差異檢定、因素分析及集群分析等。本研究共收案1,367份，共計88個單位。主要結果：(1)護理工作環境量表各項得分以「行政主管期待高品質的護理照護水準」最高，「有足夠的護理人員以提供高品質病人照護」得分較低；(2)工作環境量表總分以「契約或約僱護理」最高，「護士」最低；(3)磁性病房單位其護理工作環境量表得分較非磁性病房單位者高，差異達顯著(p=.000)。本研究結果顯示護理人員對工作環境的感受，可以作為行政者建立注重病人安全優質工作環境及提供高品質醫療照護之參考。

The practice environment scale of the nursing work index (PES-NWI) was derived from the Nursing Work Index (NWI) by Dr. Lake to measure how the practice environment influences nurse and patient outcomes. In 1981, the American Academy of Nursing began a national study to identify and evaluate ''magnet'' hospitals. They were so called due to being able to attract and retain staff nurses despite shortages in their market areas. The purpose of this study was to understand and measure the practice environment of hospital care in a medical center in Taiwan. A convenience sample of totally 88 units including 1367 staff nurses was invited from a medical center via intranet data collecting. Research instruments used the 31-item PES-NWI.ANOVA, t-test, factor analysis, and cluster analysis were performed for data analysis. The important findings were as the following: (1) The score of ''high standards of nursing care expected by the administration'' was the highest, and the score of ''enough registered nurses to provide quality patient care'' was the lowest; (2) The contract nurses had higher composite PES-NWI scores; (3) Staff nurses working at magnet units had higher PES-NWI scores (p=.000). These results might provide administrators with actionable recommendations that can be used to understand and improve the nurse work environment, to ensure patient care safety, and to determine the need for nursing staff.