Building an Indigenous Skill-Mixed Nursing Care Model in Taiwan

Saturday, 7 November 2015: 3:35 PM

Yao-Mei Chen, PhD, RN1
Hsiu-Hung Wang, PhD, RN, FAAN2
Ching-Chiu Kao, MSN, RN3
Shu-Chen Chang, PhD, RN4
Tse-Yun Chang, MSN5
Hui-Chen Tseng, RN, PhD2
I-Chin Huang, MSN, RN2
(1)Department of Nursing/ College of Nursing, Kaohsiung Medical University Hospital (KMUH)/Kaohsiung Medical University, Kaohsiung, Taiwan
(2)College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
(3)Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipie, Taiwan
(4)Department of Nursing, Changhua Christian Hospital, Changhua, Taiwan
(5)Center of Quality Management, Mackay Memorial Hospital, Taipei, Taiwan


Nurses in Taiwan have been responsible for many logistic functions for patient’s hospitalization. Along with the societal changes, the patients’ healthcare needs are evolving and have caused heavy nursing workload and serious nursing shortage in Taiwan.


The purpose of this study is to establish, at the national level, an innovative model of nursing care for clinical practice in Taiwan.


To establish a national nursing care model, the study was conducted in several steps. Step 1, a core team was assembled by 15 national experts from healthcare systems and universities across the country. The core team drafted a basic model for nursing care, including personnel, qualification, education and training, scope of practice, and staffing allocation. Step 2, three regional focus groups were held to interview 4 scholars, 35 nursing administrators, and 22 clinical nurses. The officials were invited to participate in each focus group. The interviews developed several practice-based nursing care issues and have reached preliminary consensus on the model structure. Step 3, a symposium was held with 24 experts participated to establish the reliability and validity of the model structure and the model system. Step 4, three regional conferences were held to communicate with 407 nursing representatives in the areas of clinical practice, associations and unions, and nursing schools and universities. Step 5, the indigenous nursing care model was organized and submitted to the Ministry of Health and Welfare (MHW) for policy development.


For the current healthcare systems in Taiwan, skill-mixed collaborative team for nursing care is suggested. Healthcare personnel should include nurse aides, registered nurses, and advanced practice nurses. While national guidelines are not established, this study collects typical consensus from multiple areas. Two nursing care models were illustrated and each has the weakness and strength discussed.


MHW has to publicize and legitimize the role functions, qualification, education and training, scope of practice, certification, and staffing allocation. An indigenous model of nursing care is crucial for resolving the dilemma of nursing shortage and heavy workload.