Dunn S V, Lawson D, Robertson S, Underwood M, Clark R, Valentine T, Walker N, Wilson-Row C, Crowder K, Herewane D
Flinders University of South Australia/Flinders Medical Centre, Adelaide, Australia.
J Adv Nurs. 2000 Feb;31(2):339-46. doi: 10.1046/j.1365-2648.2000.01292.x.
In defining the contemporary role of the specialist nurse it is necessary to challenge the concept of nursing as merely a combination of skills and knowledge. Nursing must be demonstrated and defined in the context of client care and include the broader notions of professional development and competence. This qualitative study sought to identify the competency standards for nurse specialists in critical care and to articulate the differences between entry-to-practice standards and the advanced practice of specialist nurses. Over 800 hours of specialist critical care nursing practice were observed and grouped into 'domains' or major themes of specialist practice using a constant comparison qualitative technique. These domains were further refined to describe attributes of the registered nurses which resulted in effective and/or superior performance (competency standards) and to provide examples of performance (performance criteria) which met the defined standard. Constant comparison of the emerging domains, competency standards and performance criteria to observations of specialist critical care practice, ensured the results provided a true reflection of the specialist nursing role. Data analysis resulted in 20 competency standards grouped into six domains: professional practice, reflective practice, enabling, clinical problem solving, teamwork, and leadership. Each of these domains is comprised of between two and seven competency standards. Each standard is further divided into component parts or 'elements' and the elements are illustrated with performance criteria. The competency standards are currently being used in several Australian critical care educational programmes and are the foundation for an emerging critical care credentialling process. They have been viewed with interest by a variety of non-critical care specialty groups and may form a common precursor from which further specialist nursing practice assessment will evolve.
在界定专科护士的当代角色时，有必要对护理仅仅是技能与知识组合的概念提出质疑。护理必须在客户护理的背景下得到展现和界定，并且要涵盖专业发展和能力等更广泛的概念。这项定性研究旨在确定重症护理专科护士的能力标准，并阐明入职实践标准与专科护士高级实践之间的差异。研究观察了超过800小时的专科重症护理实践，并采用持续比较定性技术将其归类为专科实践的“领域”或主要主题。这些领域进一步细化，以描述注册护士的特质，这些特质会带来有效和/或卓越的表现（能力标准），并提供符合既定标准的表现示例（表现标准）。将新出现的领域、能力标准和表现标准与专科重症护理实践的观察结果进行持续比较，确保了研究结果真实反映了专科护士的角色。数据分析得出了20项能力标准，分为六个领域：专业实践、反思性实践、赋能、临床问题解决、团队合作和领导力。每个领域由两到七项能力标准组成。每项标准进一步细分为组成部分或“要素”，并通过表现标准对要素进行说明。这些能力标准目前正用于澳大利亚的几个重症护理教育项目，并且是一个新兴的重症护理认证过程的基础。它们受到了各种非重症护理专科团体的关注，可能会成为进一步专科护理实践评估发展的共同前身。
