| 摘要: | 研究目的： 1.以專家座談規劃離島偏遠衛生所的護理工作模式及各層級護理人員培訓課，具體建議核心課程、課程方式等「離島偏遠衛生所護理人員護理工作模式及培訓規劃草案」。 2.並舉辦四場次的草案說明會以修正本草案。 研究方法： 1.專家座談：邀請二位學者、四位衛生所護理長及四位衛生局/署等相關專家學者，組成10人小組會議，以研議離島偏遠衛生所護理工作模式及護理人員培訓計劃。其討論次數三次。 2.草案說明會：在中部、東部、南部與離島各舉辦一次，邀請偏遠地區衛生所護理人員。共計78名。 3.問卷調查：以南投縣及台東縣之衛生所護理人員共237人為調查對象。包括南投縣123人及台東縣117人，與出席說明會者合計318人。問卷寄回並填寫完整者共有278人（回收率為87.3%） 主要發現： 1.衛生所護理工作模式：衛生所在衛生局指導下，並結合區域內資源，如地區醫療診所或護理診所(專科護理師所開設的)及IDS醫療機構(其護理人員以專科護理師為主)區域外資源如學術/研究機構及學會等提升衛生所護理人員專業能力及衛生所照護品質。而衛生所內護理人員可分為三等級，並分別以個案、團體、社區為重，只是比例上有所不同。 2.原則上大部份偏遠地區衛生所護理人員是贊同此草案的，只有少數須修改，及推動應注意的事項，故經研究小組第二次修訂(p.135)。 3.偏遠地區設置專科護理師是非常可行的，此可與IDS結合或另外設置。最重要的是偏遠地區民眾的就醫權與健康權是否被關心與照護是否具有品質。結論及建議： 1.制定行政命令或修法等要求衛生所護理人員資格及參與在職進修教育。 2.本研究結果，建議進階制度與工作模式可委由有意願之學會與學校一起在某一縣市試辦。 3.遠距學習是必要的，故遠距學習的軟硬體設施應及早設置。 4.培育在地資源，尤其有醫護背景之專業人員培育成師資群。 5.對目前現職人員應有落日條款：建議由同儕(2位)、護理長、主任及衛生局主管等五位組成審核團。 6.建議行政人員以跨衛生所方式兼辦將可提升行政效率與品質。
PURPOSE 1.To develop a public health nursing model and an advanced continuing education program for public health nurses in the remote area. The education program should include core courses, course methods, et al. 2.To develop the public health nursing model and advanced continuing education program by advisory group and conference. METHODS 1.Advisor group: The 15 experts were invited to form an advisor group which included four central governors, five public health administrator, three academics, and three public health practitioners. Their specialty included medical, public health, and nursing. Three focus group meetings were taken place to develop public health nursing model and advanced continuing education program protocol. 2.Conferences: Four conferences were taken place for announcing the protocol to public health nurses. Four conferences were taken place in middle, east, south, and Pon-Ho island. All public health nurses who work in the remote area were invited, but only 78 PHNs attended. 3.Survey: The questionnaire was given to the public health nurses in Non-To County and Tai-Don County. The 237 PHNs received which included 123 in Non-To County ad 117 in Tai-Don County. Also, it plus 78 PHNs from the conference. The total participants were 318, but only 278 PHNs completed the questionnaires. The return rate was 87.3% RESULTS 1.Public health nursing model: public health station has to coordinate intra-community and inter-community resources to develop care model. Senior PHNs can be an advisor to new or junior PHNs in the community or outside of the community. The three-level continuing education program was developed. The three-level PHNs have different-level concerns in clients, family, group, and community. 2.The second revised protocol was presented in the report. 3.It is necessary to have public health nursing specialist in the remote area. This can be developed with nurses who work for IDS. It is importance that we need to concern health rights of people who live in the remote area. CONCLUSION & SUGGESTION 1.It is necessary to develop regulations or standards to encourage PHNs to participate in the education program. Also PHN’s qualification should be asked in the regulation. 2.The model and advanced continuing education program can be tested in a county by a education institution or association. 3.It is necessary to set up e-learning for PHNs who work in the remote area. Therefore, the soft-ware and hard-ware for e-learning should be concerned in the near future. 4.The senior PHNs should be trained to be the tutors in the local area. 5.This protocol developed by this project is for new nurses who will work in public health station in remote area. It is necessary to develop an article for nurses who work in public health stations now. It establish an advisor group to evaluate PHNs who are qualify in which levels of advanced PHNs. The five-people advisor group included two peers, head nurse and director of public health stations, and administrator from health care bureau. 6.It is suggested that administration jobs should do by professional administrators, not do by PHNs. |
