本研究之目的在探討某醫學中心實施能力進階度後之成效及其影響因素。本研究 係採問卷調查法，研究對象以某醫學中心服務滿三年以上之護理人員為母群體，系統性抽樣 125 位，以護理人員能力評估表（採專家效度及內在一致信度測試 Cronbach Alpha 值護理 、行政、教學與研究技能分別為.97、.94 及.94， 再測信度 r 值為.75 ）及護理人員能力 進階度實施成效問卷表（專家效度及，認知部份之再測試度 r 值為.79、看法及感受部份之 內在一致信度測試 Cronobock Alpha 值分別為.85 及.87 ）作護理能力進階制度實施後之 評值。所得結果護理人員之護理能力兩年平均值之比較有顯著性提升，護理人員之能力與年 齡、工作年資、教育程度及護理人員對能力進階制度之瞭解、看法、感受無顯著性差異，但 與工作場所、培訓階層及輪調原因均呈顯著性差異。

　　　　　The prupose of this study is to understand the effectiveness and influe ntial factors of the implementation of the clinical nursing ladder program. A self-administered questionnaire was used to evaluate 125 nurses in a mdeical center. The results show that nurse's competence have signifcant improvement after the implementation of the clinical nursing ladder program. There is no singificant difference between nruse's competence and their age, education, years of nursing experience, recognition, feeling and view of the program. There are significant differences between work field, clinical ladder, rotation reasons and the nurse's competence.