Building an Indigenous Skill-Mixed Nursing Care Model in Taiwan

Background

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.

Purpose

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

Method

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.

Results

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.

Conclusion

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.