台北榮民總醫院婦產科專科護理師制度實施概況

The Implementation Status of Obstetric and Gynecological Nursing Specialists (NSP) in Taipei VGH

全民健保給付制度與教改制度的改變，加上住院醫師人力的不足，刺激了專科護理師制度之興起。台北榮總在民國八十九年成立婦產科專科護理師制度，實施一年至今以來，評值其工作內容與工作考核；一、在婦科專科護理師工作內容分析，醫療服務為21.95％，醫療行政業務為64.43％，護理服務為13.57％；二、在產科專科護理師工作內容分析，醫療服務為13.23％，醫療行政業務為63.37％，護理服務類為23.37％；三、專科護理師工作考核方面，以婦產部醫師之評值分數為最高。藉由工作內容分析的結果，明顯可見專科護理師在住院醫師與實習醫師人力不足，所產生之醫療服務與醫療行政業務方面，確實發揮極大輔助功能，但在，護理服務方面的角色功能尚須努力，分析其原因，或許與該專科護理師人力配置不足有關，期望能再增設專科護理師員額，減少人力不足之問題，以能發揮護理專業的獨特功能，拓展護理領域，共同提升醫療照護品質。

The alteration of the enrollment allowance of health insurance and innovation in the educational system; as well as, the overarching lack of residents as resource personnel all contribute to an establishment and reinforcing of the Nursing Specialist (NSP) system. The NSP system has been in place at the Department of Obstetrics and Gynecology in Taipei VGH since 2000.The evaluation of practice consistency and merit system of performance was conducted after the first year's adaptation. The results show as follows: (1) Analyzing the evaluation of consistency in performance for gynecologic NSPs, the percentages of components are 21.95％ in medical services, 64.43% in medicine administration, and 13.57% in nursing services; (2)As the same evaluation for obstetric NSPs, the range of consistency in performance are 13.23% in medical services, 63.37% in medicine administration, and 23.37% in nursing services; (3)The quality of performance is scored the highest by the physicians of obstetrics and gynecology among all the evaluators of interpretation. Based on the analysis of consistency in performance, it prominently reveals the help and support from three NSPs who buffered the problems arising from a insufficient numbers of residents and interns. However, the roles for NSP still require more effort to achieve. In addition, more NSP staff need to be recruited in order to diminish the lack of adequate manpower resource and to improve the quality of medical care simultaneously.