教育訓練介入對護理長管理技能成效之探討
The Effectiveness of Education Training Programs Upon the Management Skill for Head Nurse
中文摘要
本研究旨在探討教育訓練介入對護理長管理技能之成效。藉由護理行政相關課程 學習前、後，以護理長管理技能量表瞭解護理長於接受教育訓練課程後，其管理 技能是否提昇。採前測-後測之研究法設計，收案對象為台北縣某區域教學醫院 及其附設分院之護理長，共 34 人。本研究收集資料之工具為「護理長管理技能 量表」，採專家效度檢定，取內容重要性之 CVI 達 0.86 之項目共十一類 87 題，
信度檢定採折半信度，Chronbach’s Alpha 值為 0.941。在教育訓練介入前，研 究對象以「護理長管理技能量表」進行前測，之後立即統計分析施測結果，針對 管理技能較差部分，設計實務管理教育訓練課程，透過督導以上組成之 6 人專家 焦點團體座談會後定案。之後隨即施行教育訓練介入，教育訓練時間為期二個 月，在教育訓練結束後採護理長自評方式，立即進行第一次後測，三個月再進行 第二次後測。
資料收集後以次數分配、百分比、平均值、標準差、獨立樣本 t 檢定、配對 t 檢 定進行分析處理，研究結果顯示：
一、護理長應具備之管理技能包括業務創新、品質管理、資訊應用、領導統御、
策略規劃、財務管理、資材管理、行銷管理、環境管理、人力資源管理及人際關 係等十一類八十七小項。
二、教育訓練介入前，護理長管理技能總平均值為 3.46(SD=1.0)，屬中下程度。
教育訓練介入後第一次後測為 4.28(SD=0.64)，第二次後測為 4.42(SD=0.35)
，有明顯進步，並達統計學上之顯著差異（P<0.001）。
三、護理長的年齡、教育程度、醫院屬性、工作科別、是否受過管理訓練以及擔 任護理長年資均與各類管理技能無顯著差異，但在教育訓練介入前護理長的工作 年資則除了資訊應用管理技能無顯著差異外，與其他十類管理技能均有顯著差 異，其中尤以 11-15 年者，其各類管理技能均有顯著偏低現象。不過在教育訓練 介入後之第一次與第二次護理長管理技能後測結果，則無顯著差異，顯示教育訓 練介入已展現成效。
綜合以上結論，顯示教育訓練對於護理長管理技能之提升確實有成
效，其管理技能平均得分由教育訓練介入課前之 3.46 分提升至 4.42 分，故為臨 床上值得推行之訓練方式，因此本研究結果可提供給醫院臨床護理行政管理者在 護理主管培育之參考。
關鍵詞：教育訓練、護理長、管理技能 英文摘要
The purpose of this study was to investigate the effectiveness of educational training on the management skills for head nurses. By the use of related courses on
administration training, A management skill rating scale for head nurse was designed for assessment before and after the training in order to identify any improvement on management skills of head nurses. This study was a pre-post test research design. The research sample group was the head nurses of a district teaching hospital in Taipei county and its branch hospitals, totally 34 head nurses were included. The tools of this research collected data was from “ Head Nurse Management Skill Rating Scale (HNMSRS)”. The validity of this Rating Scale was verified by specialist. There were 11 categories with 87 items with CVI more than 0.86 were chosen. The reliability was assessed with half reliability and the Chronbach’s Alpha was 0.941. Before the
education training, the research samples were pre-tested with Head Nurse
Management Skill Rating Scale. The obtained data were analyzed statistically, the weakness of management skills was concerned and an educational training course on practical management was designed. The course was refined and settled by focus group which was formed with 6 specialist of whom the least rank was nursing
supervisor. Educational trainings were then initiated and lasted for 2 months. The first post-test was performed with self-assessment of the trained head nurses shortly after the educational training and a second post-test was done 3 months after.
The questionnaire data were collected and analyzed with times of distribution,
percentile, average score, standard deviation, t-test and paired t-test. The results of the study revealed:
1. Head nurses should possess management skills including job innovation, quality management, uses of information, leadership, strategic management, financial management, material management, marketing management, environmental management, human resources management and personal relationship, totally 11 categories and 87 items.
2. Before educational training, the average score on management skill was 3.46 (SD=1.0), and was rated middle-low level. However, after training, the score of the first post test was 4.28 (SD=0.64), the 2nd post-test was 4.42 (SD=0.35), which were improved markedly and were statistically significant (p<0.001).
3. The age, educational level, hospital class, department of working and previous management training and seniority of the head nurses were insignificant on all of the management skill. Before the educational training, the seniority of working of head nurses, 10 out of 11 categories of management skill, except the information
management, all were having significant difference, especially those with working seniority 10-15 years. All management skills were remarkably low. However, after educational training, there was no significant difference among the results of 1st and
2nd post test on management skills. This signified that the implementation of educational training was effective.
In conclusion, educational training for improvement on management skill is virtually effective for head nurses. The average score before the educational training was 3.46 and improved to 4.42 after the training. Therefore, it is worthwhile to implement such education for training in clinical practice. This study provides a invaluable reference for hospital nursing administrator for the education of nursing managers.
Keyword: Educational training, Head nurse, Management skills
