我國公立醫院面對醫療產業環境改變及民營化風潮的雙重挑戰，為降低營運成本，遂發展出護理人員外包策略。本研究係以實證研究方式，針對外包護理人員之護理品質相較於編制內及契約的護理人員是否有差異，作一深入比較及研究。本研究以某公立地區醫院健保病房78位各不同僱用別護理人員所照顧之300位病患為研究對象。護理品質評價方法包含查看病歷、訪問護理人員、觀察病患與訪問病患等四種方式，針對個別護理人員之護理過程與結果實施現況評值。研究發現三組僱用人員各構面護理品質表現均以編制內最佳，其次是契約人員，外包人員品質最低。不同僱用別護理人員之護理品質，包括總體護理品質、護理計畫、護理指導與護理評值等構面都有顯著差異。
To reduce costs, many hospitals are trying to adopt strategies to contract out their nursing workforce. The purpose of this study is to compare the quality of health care among the following three categories of nursing workforces in public hospitals: outsourced nurses, permanently employed nurses and contracted nurses compensated based on hours worked. The research sample included 300 patients cared for by 78 nurses in insurance wards in a local public hospital. Four methods were used to evaluate care quality. They included examining medical records, interviewing nurses, observing, and interviewing patients. The study found the best care quality was delivered by permanently employed nurses followed by that delivered by contracted nurses. The worst care quality was delivered by outsourced nurses employed by agency companies contracted to the public hospital. Care quality dimensions that were statistically significant among three categories of nurses included total quality of nursing care, nursing care planning, nursing instruction, and nursing evaluation.
