面對醫療環境之巨變，護理行政管理者須具有預測及變革管理能力，使組織衝擊程度降到最低。護理領導者須了解變革的過程，引導創新策略改善護理工作環境進而確保病人照護品質。本文旨在介紹當前護理行政與管理面臨之挑戰，護理變革管理的概念與策略，變革的步驟及管理工具。並陳述美國醫學會研究院 ( Institute of Medicine, IOM) 提出的五大核心能力作為改善方向，舉例說明國內外護理行政管理變革的經驗，提供行政及臨床實務管理的參考。

In today’s rapidly changing healthcare environment, nursing administrators and managers must enhance their abilities to anticipate and manage change in order to minimize the impact of such on healthcare delivery systems. To maintain patient care quality, nursing leaders should be familiar with change trends and implement innovative strategies that improve the work environment for nurses. This paper describes current major challenges faced by nursing administrators and introduces the concept of change and related strategies and available change management tools. This paper used five core competencies proposed by the Institute of Medicine (IOM) to illustrate and share experiences of managing change in clinical settings.