蛻變的白衣天使－－進階護理師的發展與突破

Metamorphosis of Nurses: The Development and Breakthroughs of Advanced Practice Registered Nurses

背景：發展進階護理師制度為全球趨勢，然而台灣進階護理制度的發展仍處於妾身未明階段，亟需凝聚護理界共識。目的：本研究旨在探討產官學界護理專家對台灣發展進階護理師（臨床護理專家、個案管理師、註冊麻醉護理師、註冊助產護理師）的看法與建言。方法：資料收集時間為2017年3月至8月。總計64位專家分別參與北、中、南6場的焦點團體討論，所有內容皆經研究對象同意錄音與繕打成逐字稿後轉製成文本，並以內容分析法進行資料分析。結果：產官學界之護理專家對台灣發展進階護理師的意見與建議可歸納為四項主題：發展需求、核心能力、認證與未來推動相關議題，每一主題皆區分出數個次主題。結論／實務應用：本研究結果彙整護理產官學專家對台灣發展各類進階護理角色功能、執業範疇與管理之現況意見，以及對台灣未來發展各類進階護理角色在教育、核心能力、證照與執業範疇等之建議，可作為建立護理共識模式的視窗及未來推動進階護理師制度的依據。

Background: The introduction and development of the advanced practice registered nurse (APRN) is a global trend in nursing. However, the development of APRNs in Taiwan remains uncertain and lacks necessary consensus. Purpose: This research study aimed to explore the views and suggestions of nursing experts in industry, government, and academia regarding the development of APRNs (clinical nurse specialists, case managers, certified clinical registered nurse anesthetists, and certified nurse-midwives) in Taiwan. Methods: Data were collected from March to August 2017. Sixty-four experts participated in one of six focus group discussions held in northern, central, and southern Taiwan. These group discussions were recorded and transcribed verbatim with the consent of the participants. Content analysis was used to analyze the transcribed data. Results: The comments and suggestions raised during the discussions were categorized into four major themes: professional development of necessity, core competencies, accreditation, and future promotion-related issues. Each theme was further divided into several subthemes. Conclusions/Implications for Practice: The opinions of relevant experts regarding the current status of development of the roles, practical scope, and management and suggestions for APRNs were summarized to facilitate the future development of APRNs in Taiwan in terms of education, core competencies, certification, and practical scope. Furthermore, the results may be referenced in the establishment of a nursing consensus model and as a basis for promoting APRNs.