臨床工程人員制度化情境下之運作效益與護理任務移轉探討

Operational benefits and nursing task shifting under the institutionalization of clinical engineering personnel

近年高階醫療儀器與智慧照護科技快速導入臨床場域，包括導航設備、高階影像系統、機械手臂、智慧監測設備及AI輔助照護裝置等，使醫療儀器於診斷、監測、治療與照護流程中的重要性持續提高。此類設備往往需較長學習時間、專業操作能力、定期校正、品質管制及特殊保養，也增加醫療及護理人員在設備使用、異常排除與跨專業溝通上的工作負擔。設備操作安全、效能維持與跨專業協作，已成為醫療品質與病人安全的重要議題。台灣目前尚無正式法定之臨床工程人員為醫事人員職類，但相關制度化討論已進入政策與立法場域；同時，護理人力亦面臨空缺率、離職率上升及高齡照護需求增加等壓力。本文整合護理人力、任務移轉、臨床工程及醫療設備管理相關文獻，並參照美國與日本制度經驗，分析台灣未來可能之任務分工模式、效益、限制與配套條件。美國模式以設備生命週期管理與技術支援為主，日本模式則於醫師指示下參與特定高風險設備操作。對台灣而言，較可行方向並非全面取代護理人員，而是在明確授權、標準化訓練與責任界面下，逐步承接部分儀器準備、功能確認、操作支援、品質管制及異常通報等技術性任務。整體而言，臨床工程人員制度化具支援任務重整與改善設備治理之潛力，但仍有賴法規、訓練與本土實證研究配合。

Advanced medical devices and smart care technologies, including navigation systems, high-end imaging platforms, robotic systems, intelligent monitoring devices, and AI-assisted care equipment, have been rapidly introduced to clinical settings. Their increasing role in diagnosis, monitoring, treatment, and care processes has increased the importance of safely operating such devices, maintaining them, and encouraging their operators to engage in interdisciplinary collaboration. These technologies often require extended training, specialized operating skills, regular calibration, quality control, and dedicated maintenance, which can increase the workload of medical and nursing staff as they learn to use devices, troubleshoot problems, and communicate with other professionals. In Taiwan, clinical engineering personnel have yet to be formally recognized as a statutory category of health-care professional, although institutional, policy, and legislative discourse has suggested recognizing their contributions to the medical field. In addition, the nursing workforce faces increasing pressure from staff vacancies, turnover, and demand for older-adult care. This article reviewed the literature on nursing workforce problems, task shifting, clinical engineering, and medical equipment management and explored institutional experiences from the United States and Japan to examine models of task division, benefits, limitations, and conditions supporting task shifting and the use of clinical engineering in Taiwan. Institutional models in the United States typically prioritize equipment lifecycle management and technical support, whereas models in Japan typically prioritize nurse and clinical engineer participation in selected high-risk equipment operation under physician instruction. In Taiwan, replacing nursing staff is not currently feasible; instead, Taiwanese hospitals should gradually assign technical tasks such as equipment preparation, functional verification, operational support, quality control, and anomaly reporting to clinical engineering personnel under clear authorization, standardized training, and defined boundaries of responsibility.