建構優質護理執業環境改善策略

Purpose of the Study: This descriptive cross-sectional study was to explore the satisfaction of the nursing practice environment and to design improvement strategies for the parts of unsatisfied.Method: This study used a questionnaire and focused group discussion to investigate. The participants came from the nursing staff of an affiliated hospital of a medical university. The psychometric properties of this questionnaire included reliability and validity. This scale is a 5 point Likert scale, from strongly unsatisfied (1) to strongly satisfied (5). There were 450 participants in total and we had 342 effective samples with the return rate 76%.Results: The result of satisfaction of the nursing practice environment was 3.85 (SD=0.66), and the average of satisfaction in six major parts was 3.46 (SD=0.81). Twenty improvement projects summarized by specialists were: 1. To set up preceptor's allowance, 2. to set up instruction reward, 3. to set up clinical competence advanced allowance, 4. to implement cross-training, 5. to enhance the function of communication and coordination in head nurses, 6. to fulfill the reaction and coordination on medical questions, 7. to fulfill the accountability of each department, 8. to create nursing information system, 9. to computerize the nursing plan, 10. to recruit sufficient staff, 11. to improve nurses aid's job function, 12. to set up mail box of caring, 13. to set up complaint channel, 14. to send care cards to new staff, 15. To hold staff symposium, 16. to hold group discussion and telephone within new staff and preceptor, 17. to instruct nurse show to release pressure, 18. to create a careful atmosphere in the working place, 19. to set up supporting groups, and 20. to set up an assessment and promotion system and to reward or promote based on the result of assessment in time.Conclusion: The opinion of specialist can be used a reference to construct a high quality nursing practice environment.