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A Concept Analysis of Expertise Associated With Practicing Clinical Nurses in Hospital Settings
Jonathan D Hecht1, Elizabeth M Heitkemper1, Valerie Danesh1,2
1The University of Texas at Austin, School of Nursing, Austin, Texas, USA.
Journal of Advanced Nursing
|January 3, 2026
Summary
Clinical nursing expertise involves specialized knowledge and skills developed through experience and contextual connections within hospitals. Understanding expertise is crucial due to nurse shortages and increasing patient complexity.
Area of Science:
- Nursing Science
- Healthcare Management
- Clinical Practice
Background:
- Generational loss of expert clinical nurses globally, exacerbated by the COVID-19 pandemic.
- Increasing complexity of hospitalized patients necessitates a deeper understanding of clinical nursing expertise.
- Urgent need to define and cultivate expertise among practicing clinical nurses in hospital settings.
Purpose of the Study:
- To analyze and clarify the concept of expertise among practicing clinical nurses in hospital settings.
- To synthesize existing literature on clinical nursing expertise to address ambiguity.
- To provide insights for nurses and researchers on developing and recognizing expertise.
Main Methods:
- Utilized Walker and Avant's concept analysis method.
- Conducted a comprehensive literature search across PubMed, Medline, CINAHL, and Access Medicine (1982-2025).
- Included research studies and literature reviews published in English focusing on clinical nursing expertise in hospitals.
Main Results:
- Clinical nursing expertise is defined by enculturated knowledge and skills, rapid holistic patient interpretation, and individualized, instinctive actions.
- Key antecedents include deliberate experience accumulation and contextual hospital connections.
- Common consequences involve facilitating improved patient outcomes and care delivery.
Conclusions:
- Expertise attributes, antecedents, and consequences are cross-specialty and complementary.
- Expert actions stem from experience, pattern recognition, and skilled know-how, not intuition.
- Developing expertise requires active engagement, contextual connections, and adaptation to evolving knowledge.
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