Mick D J, Ackerman M H
University of Pittsburgh School of Nursing, and the Center for Research and Evidence-based Practice, University of Rochester, Rochester, NY, USA.
Heart Lung. 2000 May-Jun;29(3):210-21. doi: 10.1067/mhl.2000.106936.
This purpose of this study was to differentiate between the roles of clinical nurse specialists and acute care nurse practitioners.
Hypothesized blending of the clinical nurse specialist and acute care nurse practitioner roles is thought to result in an acute care clinician who integrates the clinical skills of the nurse practitioner with the systems knowledge, educational commitment, and leadership ability of the clinical nurse specialist. Ideally, this role blending would facilitate excellence in both direct and indirect patient care. The Strong Model of Advanced Practice, which incorporates practice domains of direct comprehensive care, support of systems, education, research, and publication and professional leadership, was tested to search for practical evidence of role blending.
This descriptive, exploratory, pilot study included subjects (N = 18) solicited from an academic medical center and from an Internet advanced practice listserv. Questionnaires included self-ranking of expertise in practice domains, as well as valuing of role-related tasks. Content validity was judged by an expert panel of advanced practice nurses.
Analyses of descriptive statistics revealed that clinical nurse specialists, who had more experience both as registered nurses and in the advanced practice nurse role, self-ranked their expertise higher in all practice domains. Acute care nurse practitioners placed higher importance on tasks related to direct comprehensive care, including conducting histories and physicals, diagnosing, and performing diagnostic procedures, whereas clinical nurse specialists assigned greater importance to tasks related to education, research, and leadership.
Levels of self-assessed clinical expertise as well as valuing of role-related tasks differed among this sample of clinical nurse specialists and acute care nurse practitioners. Groundwork has been laid for continuing exploration into differentiation in advanced practice nursing roles.
As the clinical nurse specialist role changes and the acute care nurse practitioner role emerges, it is imperative that advanced practice nurses describe their contribution to health care. Associating advanced practice nursing activities with outcomes will help further characterize these 2 advanced practice roles.
本研究旨在区分临床护理专家和急性护理执业护士的角色。
临床护理专家和急性护理执业护士角色的假设融合被认为会产生一名急性护理临床医生，他将执业护士的临床技能与临床护理专家的系统知识、教育投入和领导能力相结合。理想情况下，这种角色融合将促进直接和间接患者护理的卓越表现。对包含直接综合护理、系统支持、教育、研究、出版和专业领导等实践领域的高级实践强模型进行了测试，以寻找角色融合的实际证据。
这项描述性、探索性的试点研究纳入了从学术医疗中心和互联网高级实践邮件列表中招募的受试者（N = 18）。问卷包括在实践领域的专业自我排名以及对与角色相关任务的重视程度。内容效度由高级实践护士专家小组进行判断。
描述性统计分析显示，临床护理专家作为注册护士和高级实践护士都有更多经验，他们在所有实践领域的专业自我排名更高。急性护理执业护士更重视与直接综合护理相关的任务，包括进行病史采集和体格检查、诊断以及执行诊断程序，而临床护理专家则更重视与教育、研究和领导相关的任务。
在这个临床护理专家和急性护理执业护士样本中，自我评估的临床专业水平以及对与角色相关任务的重视程度存在差异。为继续探索高级实践护理角色的差异奠定了基础。
随着临床护理专家角色的变化和急性护理执业护士角色的出现，高级实践护士必须描述他们对医疗保健的贡献。将高级实践护理活动与结果联系起来将有助于进一步明确这两个高级实践角色。
