研究生护士,专科护士和护士执业人员之间的临床决策过程 一项国际合作研究
Rika Levy-Malmberg1,2, Erika Boman1,3, Daniela Lehwaldt4
1University of South-Eastern Norway, Kongsberg, Norway.
International nursing review
|March 7, 2024
概括
执业护士利用批判性思维和临床自主性进行独立的决策,与注册护士和护士专家不同. 这项研究比较了挪威,芬兰和爱尔兰的急诊室护士角色.
科学领域:
- 护理 护理 护理
- 医疗保健管理的管理
- 临床实践 临床实践
背景情况:
- 紧急部门 (ED) 呈现复杂的临床决策场景,通常在危机期间.
- 高质量的患者护理受到有效的ED决策的重大影响.
- 有限的实证研究存在于ED的不同护理角色的决策过程中.
研究的目的:
- 为了比较注册护士,护士专家和ED的护士执业人员之间的临床决策过程.
- 调查经验,日常生活和批判性思维对护理决策的影响.
- 识别护理角色之间的决策自主性和方法的差异.
主要方法:
- 一项符合COREQ指南的定性观察性研究.
- 在挪威,芬兰和爱尔兰的三个医院观察了18名护士 (6名注册护士,6名护士专家,6名护士执业人员).
- 分析了每个地点40小时的观测时间,使用明显和潜在内容分析,并补充了澄清问题.
主要成果:
- 三个主要的决策主题出现了:坚持例行程序/经验/直觉,考虑患者的经验,并为新的替代方案进行批判性思考.
- 注册护士主要依赖于日常工作和经验.
- 护士专家结合了患者的经验,而护士从业人员利用了这三种方法,展示了更大的自主权.
结论:
- 在ED的护士角色之间,临床决策过程存在显著的差异.
- 执业护士通过促进和评估新选择,利用临床自主权进行独立和协作选择来展示先进的决策.
- 调查结果可以为先进实践护理教育的发展和全球实践范围提供信息.
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