護理長行政管理核心能力及評量指標之建立

Establishment of Administrative Core Competencies and Evaluation Indicators for Head Nurses

背景：近年來醫療照護環境的複雜，凸顯了培養具備領導與管理能力，有效能處理複雜行政業務及領導病房護理團隊面對挑戰之護理長的重要性。而護理長行政管理核心能力的確認及行為指標評量，是培育人才與評量訓練成效的重要依據。
目的：確認護理長行政管理核心能力、相對應工作職責、任務、行為評量指標及所需的知識及技能。
方法：本研究分二階段進行，均採質性研究法；第一階段確認護理長行政管理核心能力及行為定義，第二階段建立與護理長行政管理核心能力相關的工作職責、任務、行為評量指標、工作產出及所需的知識及技能。每個階段均以（一）質性訪談（第一階段）或專家焦點團體（第二階段）建置雛形內容、（二）舉辦護理長工作坊取得多元觀點，據以修改雛形內容及（三）進行專家焦點團體達成內容共識等三個步驟來進行。
結果：本研究共確認護理長行政管理九大核心能力，包括策略規劃力、照護督導力、品質促進力、溝通表達力、危機管理力、當責領導力、實證研究力、數位應用力及簡報說服力；對應護理長管理能力，建立了護理長四大職責及其工作任務，並確認相關的行為評量指標、工作產出及所需的知識技能。
結論／實務應用：本研究結果可作為護理長行政管理培訓計畫之依據，並可運用行為評量指標評核護理長工作表現及訓練成效之評核，建議各醫療院所可參考此行政管理能力指標及建構脈絡，發展具個別性之護理長行政管理能力評核標準。

Background: The increasing complexity of the healthcare environment in recent years highlights the importance of cultivating in head nurses the leadership and management competencies necessary to effectively handle complicated administrative tasks and lead nurses in facing various challenges. Identifying the core administrative management competencies required of head nurses and evaluating competency level using behavioral indicators are fundamental to evaluating related training outcomes.
Purposes: This study was designed to identify the core administrative management competencies required of head nurses as well as the associated job responsibilities, tasks, behavioral evaluation indicators, work outputs, and requisite knowledge and skills.
Methods: This study was conducted in two phases using a qualitative method. The first phase identified the core administrative management competencies and their behavioral definitions. The second phase established competency-related job responsibilities, tasks, behavioral evaluation indicators, work outputs, and requisite knowledge and skills. Each phase consisted of (1) a qualitative interview (first stage) or focus group discussion (second stage) to establish the prototype content; (2) a head nurse workshop to obtain multiple perspectives to modify the prototype content; and (3) a focus group discussion to achieve consensus regarding the content.
Results: Nine core competencies related to head nurse administration were identified, including: strategic planning, care supervision, quality improvement, communication, crisis management, responsible leadership, evidence-based practice, digital technology application, and presentation persuasion. Corresponding to these competencies, four responsibilities and associated work tasks were identified. Finally, the related behavioral evaluation indicators, work outputs, and requisite knowledge and skills were confirmed.
Conclusion/ Implications for Practice: The results of this study may be used as the basis for head nurse administrative management training programs, while the identified behavioral evaluation indicators may be used to evaluate head nurse work performance and training outcomes. We recommend other institutions apply the results of this study and develop their own administrative core competencies and evaluation indicators for head nurses.