二年期護理人員急救能力指標建構與分析
Construction and Analysis of a First Aid Competence Index for Nurses in the Two-Year Nursing

Postgraduate Training Program

背景：院內心跳停止是世界各國醫療界所注重的病人安全議題，護理人員通常是發現病人狀況改變第一個啟動急救的人。二年期新進護理人員雖然接受衛生福利部「二年期護理師(護士)訓練計劃」，有關急救基本概念及技術課程並擁有BLS證照，但在緊急狀況發生時仍無法立即辨別及處理，嚴重時會影響病人急救成效。因此，瞭解二年期護理人員的急救能力對病人安全是非常重要的。

目的：本研究主要目的為建構二年期護理人員急救能力量表。並檢測量表的信度(reliability)、效度(validity)，驗證量表在臨床及研究的適用性，以建構二年期護理人員急救能力評估工具。主要是經由德菲法及驗證性因素分析，初步發展以急救能力為內涵之評量工具。

方法：本研究共分三階段，包括：問卷內容初擬，專家效度，進行驗證性因素分析（CFA）。

結果：量表經驗證性因素分析包括五個構面，共15題；分別為「批判性思考能力」、「緊急應變能力」、「急救相關技術操作能力」、「醫療團隊合作能力」、「醫療團隊溝通能力」，各構面的建構信度為.812，.744，.833，.887，.874。整體量表的Cronbach’s α係數為.920，各構面α係數為.808，.748，.830，.880，.866；量表絕對適配指標GFI達.896、RMSEA達.87。

結論：研究結果顯示，此量表具有良好信度與效度，將能做為評量二年期護理人員在急救能力成效的客觀性指標。

Background In-hospital cardiac arrest is a patient safety issue which also attracts extensive attention worldwide. Nursing staffsare often the firstline membersto initiate rescue process when discovering unstable hemodynmics of the patients.Although new nursing staffs hadtraining courses in the Two-Year Postgraduate Training Program for Nurses (NPGY2) provided by the Ministry of Health and Welfare—in which basic concepts of first aid are acquired, technical courses are taken, and basic life support certification is obtained—NPGY2 nurses were still incapable of identifying emergency conditionandsolving patient’s problems immediatedly. Their incompetence in first-aid skills may influence the rescue efficacy andalso lead to increase in-hospital morbidity and mortality. For patient safty, itis crucial to evaluatethe first aid competence of NPGY2 nurses.

ObjectiveThe main purpose of this study was to constructNPGY2 nurses’first aid capability scale. We testreliability and validity of the scale in order to knowthe applicability of the verification scale in clinical practiceand research,andconstructa useful tool to assess theNPGY2 nurses’first aid capability. We first developed a scale focusing on the first aid ability by Defi method and confirmatory factor analysis.

MethodsThe study was divided into three phases, including: initial content of the questionnaire, expert validity, and confirmatory factor analysis (CFA).

ResultsThe confirmatory factor analysis consisted of five facets with a total of 15 questions; "critical thinking ability", "emergency response ability", "first aid related technical operation ability", "medical team cooperation ability", "medical team" Communication ability, the construction reliability of each facet is

.812, .744, .833, .887, .874. The Cronbach's α coefficient of the overall scale is .920, and the alpha coefficients of each facet are .808, .748, .830, .880, .866.GFIis .896，RMSEAis .87。

ConclusionOur study showedthat this scale has good reliability and validity.The scale maybe used as an objective indicator for assessing the effectiveness of first aid in theNPGY2nurses.