Department of Nursing, Cardinal Tien Hospital, Taipei, Taiwan, ROC.
J Nurs Res. 2011 Jun;19(2):112-8. doi: 10.1097/JNR.0b013e31821aa0eb.
There is a paucity of published research on clinical or practical nursing knowledge. The ways that nurses acquire, develop, and maintain emergency room (ER) nursing care skills is a research area, in particular, that deserves further investigation.
This study examined clinical setting learning processes to better understand the practical knowledge content of ER nurses.
This study used a phenomenological approach and in-depth interviews of 10 nurses. Each participant had at least 3 years of ER experience. Researchers used Moustakas' method to analyze interview data. Findings were checked for credibility, transferability, dependability, and confirmability.
The authors identified four major practical knowledge themes for ER professionals. These were (a) basic emergency treatment procedure routines and symptom management; (b) disease mechanisms, pharmacodynamics, and treatment responses; (c) newly identified diseases, updated emergency treatments and techniques, and medical treatment discussions; and (d) identifying nursing values including nursing attitudes and continuing patient care. Participants in this study had experience with the first three themes and successfully combined various types of nursing knowledge in their nursing care duties. Only few participants indicated experience with the fourth theme.
CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Findings clarify that clinical or practical knowledge in ER nurses evolves first from declarative knowledge (e.g., basic emergency treatment routines and operating procedures) to procedural knowledge (e.g., instructions from supervisors, actual practice, and drills) to conditional knowledge (e.g., observation and treatment involving direct interactions with patients). Nurses should combine and apply the various knowledge types in their nursing practice to assess comprehensively each patient's condition and administer effective treatment and service.
目前，关于临床或实践护理知识的研究成果较为匮乏。护士获取、发展和维护急诊护理技能的方式是一个值得进一步研究的领域。
本研究通过考察临床环境中的学习过程，以更好地理解急诊护士的实践知识内容。
本研究采用现象学方法，对 10 名具有至少 3 年急诊工作经验的护士进行深入访谈。研究者采用 Moustakas 方法对访谈数据进行分析。研究结果经过可信度、可转移性、可靠性和可确认性检查。
本研究确定了急诊专业人员的四项主要实践知识主题。这些主题包括：（a）基本急救处理程序和症状管理；（b）疾病机制、药效学和治疗反应；（c）新发现的疾病、更新的急救处理和技术以及医疗讨论；（d）识别护理价值观，包括护理态度和持续的患者护理。本研究的参与者在前三项主题方面有经验，并在护理工作中成功地整合了各种类型的护理知识。只有少数参与者表示有过第四项主题的经验。
结论/对实践的启示：研究结果表明，急诊护士的临床或实践知识首先从陈述性知识（例如，基本急救程序和操作程序）发展到程序性知识（例如，主管的指示、实际实践和演练），再发展到条件性知识（例如，直接与患者互动的观察和治疗）。护士应在护理实践中结合和应用各种知识类型，全面评估每位患者的病情，并提供有效的治疗和服务。
