以「市場需求」為導向的健康照護系統，醫護人員被期待提供安全、有效率且符合消費者需求的照護，所以「執業能力」對專業的權威性非常重要。本研究的目的在確認血液透析單位護理情境，以及各護理情境類項之重要性與常見性，並藉由護理情境類項去獲得血液透析單位護理人員執業能力類項及其重要性與常見性，最終目的在確認血液透析單位護理人員之雇用、起始與持續執業能力。研究方法採修正型德懷術。共21位血液透析護理專家（10管理階層人員、11位基層護理人員）參與三回合之問卷調查，問卷回收率達95.5%。經過三回合問卷的分析確認出血液透析單位之護理情境共11類75項，其中重要性常見性均高度者12項，重要性高度常見性中度者39項，重要性高度而常見性低度者20項，重要性常見性均中度者4項。護理執業能力11類97項，其中重要性常見性均高度者8類45項，重要性高度而常見性中度者9類50項，重要性高度而常見性低度者2類2項，確認出的血液透析單位之雇用能力27項、起始能力58項、後續能力6項，6項尚未達50%專家的共識。研究結果可提供護理模組課程設計之基礎，並建構血液透析照護之工作標準、以及作為臨床發展血液透析護理訓練班課程以及評值教學成效之參考。

In the more and more market’s need-centered health caring system, The Medical team is expected to provide a safe and efficient care which can also meet the need of consumers, so competence is very important to a professional authority。The study is to explore the nursing situation of hemodialysis unit and the importance, occurrence of the practicing competency, and by all those nursing situations, we can defined the item, category, importance and occurrence of hemodialysis nursing competence. Research method with Modified Delphi technique , Twenty one hemodialysis nursing experts had（10 manager，11 senior nurses involved ） participated in a 3-rounded questionnaires , and the rate of questinnaire returning have reached 95.5﹪. In these 3-round questionnaires, we confirmed all together 11 categories and 75 items, The situations which valued highly in both importance and among all have 12 items, while the ones which valued highly in importance and moderate occurring situations have 39 items. The ones valued highly in importance but low occurring situations have 20 items, while the ones which valued moderate in importance and occurring situations have 4 items. The practicing competence of hemodialysisunit has 11 categories and 97 items, The situations which valued highly in both importance and occurring situations among all have 8 categories and 45 items, while the the ones which valued highly in importance and moderate occurrence have 9 categories 50 items. The ones valued highly in importance but low occurring situations have 2 items. We confirmed all together 27 items of hire competence, 58 items of initial competence, and 6 items of ongoing competence, and the other 6 of it can’t be categorize due to the lack of 50%. The result can be provide as the foundation to design Nursing Modular Curriculum, to construct the nursing standard of hemodialysis unit, the design of clinical development for hemodialysis training program and the reference of the teaching evaluation.
keyword：hemodialysis nurse. Delphi Technique. nursing situation. nursing practicing competence . Nursing Modules