醫院極重視護理人員臨床專業能力進階，而撰寫個案報告為其中重要依據，專師為進階護理師，提升其專業能力更趨重要。本院外科專師共14位，N2進階層級7人，分析2011至2016年間N2外科專師未送審個案報告的顯著導因為沒有動力書寫（100％）、同儕裡面也有人還沒寫（100％）、想要送審台灣護理學會的同時也送期刊審查（100％）、已經是專師，怎麼好意思開口找人指導個報（85.7％）、不清楚要怎麼寫才會通過（85.7％）、沒寫也不影響工作（85.7％）。專案期間自2016年8月1日至2018年3月31日，採一對一輔導、成立個案報告讀書會、運用通訊軟體建立學習社群、減少送審者照護人數及增加休假、安排個案報告通過者及期刊刊登者分享撰寫及投稿過程、增列個案報告通過為考核加分項目並公告期刊投稿規範。專案目標為送審三篇，專案改善後，共送審5篇，達成率為167%，顯示成效顯著。

Medical institutions emphasized the importance of advancement in professional competency of nurse, including case report writing skill. Nurse practitioners are advanced registered nurses, and improvement of their professional competency is necessary. Our hospital has 14 nurse practitioners in the surgery department, seven of them were on the advanced level of N2. We analyzed why these seven N2 nurse practitioners did not write case reports during 2011-2016. The reasons included lack of motivation(100%); peers did not write case report(100%); simultaneous submissions to the Taiwan Nurses Association and journals(100%); feeling embarrassed to request assistance(85.7%); unfamiliar with writing skill(85.7%); and an assumption that not writing a case report will not affect their job(85.7%). During the project period from August 2016 to March 2018, interventions included one-on-one guidance; holding a case report reading meeting; establishing a learning group on social media; reducing the number of responsible patients, and increasing the leave duration for nurse practitioners who submitted reports; inviting nurse practitioners who had published case reports to share their writing experience; and earning an additional points during promotion for those who had published case reports. Moreover, manuscript submission guidelines for the journals were announced to all nurse practitioners. The goal is to submit three case reports in the end of this project. After introducing such incentives, five papers were submitted. The completion rate was 167% and the effect was great.