心臟外科加護病房護理工作情境與工作能力︰ 就業模組課程之初期研究
Work Situation and Competencies for Nurses Working in Intensive Care Units for Cardiac Surgery：  A

Preliminary Study on Modular Curriculum of Employability

心臟外科加護病房護理人員提供心臟手術後病人急性期的重症照護工作，是醫療團隊中接觸病人時間最長的成員。有鑑於該重症單位護理人員的養成與在職 教育訓練課程尚缺乏該單位有關的工作分析實證性資料；因此，本研究以修正型 德懷術描述心臟外科加護病房護理人員工作情境與工作能力，交叉分析二者的常 見性與重要性，確認該單位護理人員於雇用時、起始期與後續發展期應具備的工 作能力。研究採用深度訪談結果進行德懷問卷編製之依據，再邀請某醫學中心分 佈在北部及南部心臟外科加護病房的 20 位德懷專家參加德懷問卷的填答。20 位 德懷專家提供三回合 60 份問卷，扣除 2 位 6 份無效問卷之後，最後統計三回合共 54 份有效問卷(90％)，以 SPSS 22 版統計軟體進行問卷資料之統計分析。 研究結果包括：(一)心臟外科加護病房工作情境五類 65 項、工作能力 87 項。(二)心臟外科加護病房工作情境的常見性高度者有五類 27 項、中度者有四類 22 項、低度者有四類 16 項；重要性高度者為 100%。(三)心臟外科加護病房護理人 員工作能力的常見性高度者有五類 83 項、中度者有一類 4 項；重要性高度者為100%。(四)工作能力被期待於雇用時即具備的有三類 10 項(11.5％)、起始期有五類 75 項(86.2％)、後續發展期有二類 2 項(2.3％)。 本研究結果可作為醫院及學校未來規劃就業課程和教育訓練進行需求評估、設計與發展課程、選擇教材、安排學習經驗等之實證性參考資料。 關鍵字：工作分析、心臟外科加護病房、德懷術、就業課程

Paramedics in Intensive Care Units (ICU) for Cardiac Surgery provide critical care for patients in acute phase after cardiac surgery, and they have the longest contact time with patient among the medical team. Since the cultivation and in-service training curriculums for paramedics of ICU are lacking of empirical data on work analysis related to the unit, this research used modified Delphi method to describe the work situation and work competencies of Paramedics in ICU for Cardiac Surgery and cross analyzed the frequency and importance of the two, ensuring the work competencies which shall be equipped by paramedics of the unit at probation stage, starting stage, and subsequent development stage. The research developed Delphi questionnaires in accordance with the result of in-depth interview, and invited 20 Delphi experts of Cardiovascular Surgery Intensive Care Units of a medical center distributing in the north and south district to participate in conducting the questionnaire. 60 questionnaires for three rounds were retrieved from 20 Delphi experts. The final result was 54 valid questionnaires for three rounds (90%) without 6 invalid questionnaires of two Delphi experts, and data of the questionnaires was conducted statistical analysis with SPSS 22 statistical software. Research results includes: 1. 5 categories and 65 items in work situation in ICU for Cardiac Surgery; 87 items in work competencies. 2. High frequency in work situation in ICU for Cardiac Surgery has 5 categories and 27 items, medium frequency 4 categories and 22 items, low frequency 4 categories and 16 items; high importance is 100%. 3. High frequency in work competencies of paramedics of ICU for Cardiac Surgery has 5 categories and 18 items, medium frequency 1 categories and 4 items; high importance is 100%. 4. Work competencies is expected to be equipped with when hiring has 3 categories and 10 items (11.5%), at starting stage has 5 categories and 75 items (86.2%), and at subsequent development stage has 2 categories and 2 items (2.3%). This research result can be taken as the empirical reference of requirement evaluation, designing and developing curriculums, selecting teaching materials, arranging learning experience for curriculum of future employability and educational training in hospitals and schools.

Keywords ： work analysis, Intensive Care Units for Cardiac Surgery, Delphi method, curriculum of employability