Voldbjerg Siri Lygum, Grønkjaer Mette, Sørensen Erik Elgaard, Hall Elisabeth O C
Department of Nursing, University College of Northern Denmark, Aalborg, Denmark.
Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.
J Adv Nurs. 2016 Aug;72(8):1751-65. doi: 10.1111/jan.12914. Epub 2016 Feb 9.
To advance evidence on newly graduated nurses' use of knowledge sources.
Clinical decisions need to be evidence-based and understanding the knowledge sources that newly graduated nurses use will inform both education and practice. Qualitative studies on newly graduated nurses' use of knowledge sources are increasing though generated from scattered healthcare contexts. Therefore, a metasynthesis of qualitative research on what knowledge sources new graduates use in decision-making was conducted.
Meta-ethnography.
Nineteen reports, representing 17 studies, published from 2000-2014 were identified from iterative searches in relevant databases from May 2013-May 2014.
Included reports were appraised for quality and Noblit and Hare's meta-ethnography guided the interpretation and synthesis of data.
Newly graduated nurses' use of knowledge sources during their first 2-year postgraduation were interpreted in the main theme 'self and others as knowledge sources,' with two subthemes 'doing and following' and 'knowing and doing,' each with several elucidating categories. The metasynthesis revealed a line of argument among the report findings underscoring progression in knowledge use and perception of competence and confidence among newly graduated nurses.
The transition phase, feeling of confidence and ability to use critical thinking and reflection, has a great impact on knowledge sources incorporated in clinical decisions. The synthesis accentuates that for use of newly graduated nurses' qualifications and skills in evidence-based practice, clinical practice needs to provide a supportive environment which nurtures critical thinking and questions and articulates use of multiple knowledge sources.
推进关于新毕业护士知识来源运用的证据。
临床决策需要基于证据,了解新毕业护士所使用的知识来源将为教育和实践提供信息。尽管来自分散的医疗环境,但关于新毕业护士知识来源运用的定性研究正在增加。因此,对新毕业生在决策中使用何种知识来源的定性研究进行了元综合分析。
元民族志。
通过2013年5月至2014年5月在相关数据库中的迭代搜索,确定了19份报告,代表17项研究,发表于2000 - 2014年。
对纳入的报告进行质量评估,诺布利特和黑尔的元民族志指导数据的解释和综合。
新毕业护士在毕业后头两年知识来源的运用在“自我和他人作为知识来源”这一主题中得到阐释,有两个子主题“实践与遵循”和“认知与实践”,每个子主题都有几个阐释类别。元综合分析揭示了报告结果中的一条论证线索,强调了新毕业护士在知识运用以及能力和信心认知方面的进展。
过渡阶段、自信心以及运用批判性思维和反思的能力,对临床决策中纳入的知识来源有很大影响。该综合分析强调,为了在循证实践中利用新毕业护士的资质和技能,临床实践需要提供一个支持性环境,培养批判性思维,鼓励质疑并阐明多种知识来源的运用。