護理教育訓練與臨床實務，在推行實證護理照護上的困難與建議

Obstacles and Advice in Employing Evidence-based Practice by Nurses in Nursing Education Training and Clinical Practice

護理是醫療團隊人員之一，當照護團隊以實證決策照護措施時，護理人員必須具備實證基礎的臨床知識、批判性思考、有效溝通與團隊協同合作的能力。因此，在推動實證照護過程時，需在護理養成教育強化學生實證能力，畢業後更要延續在臨床照護作業中。然而，實證護理的步驟中如資料搜尋、判讀及整合作業部份容易讓實證護理技巧不成熟的學生、護理師產生挫折感，或因臨床工作負荷、未獲醫療端支持等緣由影響實證決策推行。建議各級護理學校在實證課程須長期規劃、為延續各階段需求應加強學校及醫院實證教師的培育，並須爭取醫療團隊及主管的支持才能讓實證護理推行更順暢。

Registered nurses are one of the most trusted staff groups of professionals of the medical team. Nurses necessarily have evidence-based clinical knowledge, critical thinking, effective communication and teamwork to make interventions when the care team makes evidence-based nursing decisions. Therefore, in the promotion of employing evidence-based practice nursing, it is necessary to enhance students' evidence-based skills in nursing education and continuously construct in clinical care practices program after graduation. However, the protocol of evidence-based nursing, such as data search, interpretation and integration, which be difficult for students and nurses as well as immature evidence-based nursing skills, or affect the implementation of evidence-based nursing because of clinical workload and lack of manager support. We advise that schools of nursing at all levels should schedule on long- term program for evidence-based nursing training, so that enhance the training of evidence-based nursing teachers in schools and hospitals to develop the demand at all stages. Even to gain the support of supervisors, so those to smoothly implement evidence-based nursing practice.