*中心館藏網址:http://tulips.ntu.edu.tw/record=b2345652*cht  

[ 摘要 ]
急性照護專科護理師在國內缺乏足夠的住院醫師人力擔任第一線病人照護 背景之下，已成為多家醫院競先採用的專業人員，結合護理專業及部分醫療能力與醫師合作的模式之下，執行第一線病人照顧的角色。多家醫院中由以和信治癌中心醫院的急性照護專科護理師的模式與美國急性照護專科護理師相近，且此專 護理師的定義與定位和國家衛生研究院專科護理師專責小組之定義相同，且此定 很快的被衛生署引用。因此本研究以和信治癌中心醫院為例採先驅研究方式，初 探討實施急性照護專科護理師之狀況。本研究目的有探討急性照護專科護理師執 內容分析，急性照護專科護理師對執業自我效能的狀況，了解護理人員、病人對 性照護專科護理師服務的滿意度，及比較專科護理師與護理人員對專科護理師角色的認知之差異。依據研究目的進行資料收集及問卷調查。資料以SPSS套裝軟體進行描述性分析及以無母數分析之Mann-Whitney U等統計分析。
研究顯示，專科護理師的工作時間主要在病人直接照顧。照顧內容時間以病歷書寫、與病人討論及執行身體評估最高。而以執行技術最少。專科護理師的平均每日工作時間為7.30小時，每日平均照顧病人數為6.06人，平均每位病人照護時間為46.5分鐘。自我效能的分數達中-上程度。此結果在專科護理師的年齡、護士年資及專科護理師年資無顯著差異（ p＜.0.5）。在健康評估史詢問是感到困難的項目為神經學、男性生殖系統及內分泌系統。覺得身體檢查感到困難的項目是神經學、心臟檢查及男性生殖系統檢查。在病人、護理人員的滿意度皆為正向。比較專科護理師與護士對專科護理師角色的認知，共同認為專科護理師的角色主要在病人的臨床照顧，但在以專科護理師為護理領導者的角色此項則有顯著的差異（p＜.0.5）。在專科護理師角色發展成功的因素在行政支持、護理領導者的支持、醫療部門的支持具有顯著的差異（p＜.0.5）；專科護理師較色發展的阻礙因素也以缺乏行政支持、缺乏護理領導者的支持、缺乏醫療部門的支持有顯著差異（p＜.0.5）。
結論，專科護理師執業效能的初步探討，顯示其結果是正向的。專科護理師執業模式是以進階護理-醫療照顧模式提供病人連續性及整合性的照顧。在醫院課程訓練及實務訓練下，專科護理師具有相當高的自我效能。此結果將可提供我國實施專科護理師制度的重要參考。

[ 英文摘要 ]
The porpose of this study was to explore the efficacy of acute care nurse practitioners in the hospital setting in Taiwan. The study is a descriptive ,correlational design.Data of 30 acute care nurse practitioners, 51 nurses and 100 patients were collected.The study instruments included the Nurse Practitioner Self-efficacy scale,Nurse satisfaction Scale and Patient Satisfaction Scale.Data were analyses by using the SPSS 10.0 software . Statistic methods included mean, standard deviation, t-test,Pearson’s correlation,Mann-Whitney U and Kruskal-Wallis test.
The result showed that acute care nurse practitioners spect their majority of time in applying direct patient care. They denoted their time in charting, discussion with patients and performing routine physical assessment. Generally , they were taking care of 6.06 patients daily , and specd averaged of 46.5 minutes per patient. Nurse practitioner showed a moderate high level of self-efficacy. Self-efficacy was not related to age,previous years of nursing experience and years of being an acute nurse practitioner (p<.05). Overall, nurse practitioners had difficulty in performing physical assessment in neurological, cardiovascular and reproductive systems. Both patient and staff nurse demonstrated high levels of satisfaction toward clinical competence of nurse practitioner. Nurse practitioners indicated the importance in physical and mental supports from hospital administration, nursing leaders, and physicians for implementing their roles. Study results provide vital information for policy makers in building practice model for nurse practitioners in Taiwan.
Key Words: Acute care nurse practitioner, self-efficacy, satisfaction.