提升外科加護病房護理人員N3能力進階比率

Increasing the Ratio of Participation in N3 Nursing Clinical Ladder Program for Nurses in Surgical Intensive Care Unit (SICU)

護理專業能力分級及相關訓練，可激發護理人員思考能力及創造力，以提升人員素質及照護品質。本單位為外科加護病房，屬於重症單位，分析單位護理人力發現N2比率佔47.4%，而N3僅佔5.3%，且近兩年本單位無N2晉升N3之申請，故引發動機成立專案小組，進行原因分析與改善。經過分析發現問題有：個案報告缺乏專人輔導導致寫作能力不足、未具備護理臨床教師合格證書、能力進階資訊系統缺乏再進一級階提示、缺乏N3能力進階資格項目相關參考資料。本專案目的在提升本單位護理人員完成進階N3臨床專業能力訓練、輔導個案報告通過台灣護理學會審查合格比率至7.9%。執行改善措施：舉辦個案報告寫作工作坊、師資培育訓練營及跨領域團隊合作演練；增設級階提醒機制及N3能力進階教學專區。經專案實施後提升N2完成晉升N3申請之意願，且單位護理人員N3佔比由5.3%提升至29%，顯示本專案介入有助於提升護理人員專業能力。

Professional nursing clinical ladder program and related training courses are beneficial to inspire nursing professionals' thinking ability and creativity, and enhance the quality of medical care. The percentage of nurses of SICU participating in N3 nursing clinical ladder program was 5.3% in this study, yet there were 47.4% of SICU nurses certified in N2 clinical ladder program. This study aims to explore the factors influencing the willingness to participate in the N3 nursing clinical ladder program, and to increase the N3 ratio to 7.9%. Based on situation analysis, the findings include: insufficient case report writing skills due to the lack of personal guidance, shortage of nursing clinical teachers with qualified certificates, lack of reminder/ alarm in clinical ladder system, and inadequate information and references to advance to N3. The improvement measures include: holding case report writing workshops, conducting teacher training camps and transdisciplinary team practice, and adding a reminder/alarm system and N3 teaching platform. After implementation, the ratio of the SICU nurses certified with N3 in clinical ladder program increased from 5.3% to 29%, indicating this project is beneficial in enhancing the professional ability of nursing staff.