Phelan Amanda, McCormack Brendan
School of Nursing, Midwifery & Health Systems, University College Dublin, Ireland.
Division of Nursing, School of Health Sciences Queen Margaret University Musselburgh East Lothian, UK.
J Adv Nurs. 2016 Oct;72(10):2524-35. doi: 10.1111/jan.13001. Epub 2016 May 12.
To explore the expertise of Registered Nurses in residential care for older people.
As older people in residential care have many complex dependencies, nursing expertise is an essential component of care excellence. However, the work of these nurses can be invisible and, therefore, unrecognized. Thus, additional attention is required to illuminate such nursing expertise.
A mixed method design was used in this study.
The research took place in 2012 in the Republic of Ireland. Twenty-three case study nurses were recruited from nursing homes. Each case study nurse involved five data collection methods: shadowing, interview with a colleague, interview with a resident, a demographic profile and a director of nursing survey. The study was also informed by a modified focus group. Qualitative data were analysed using directed content analysis using a conceptual framework generated from the literature on nursing expertise. Quantitative data were analysed using SPSS and presented in descriptive statistics.
The findings from the case studies and the modified focus group are presented in seven themes, which represent nursing expertise in residential care of older people: transitions, context of the nursing home, saliency, holistic practice knowledge, knowing the resident, moral agency and skilled know how.
Nursing expertise in residential care of older people is a complex phenomenon which encompasses many aspects of care delivery in a person-centred framework. By rendering this expertise visible, the need for appropriate and adequate skill mix for a growing residential care population is presented.
探讨老年护理院注册护士的专业技能。
由于老年护理院的老年人存在许多复杂的护理需求，护理专业技能是优质护理的重要组成部分。然而，这些护士的工作可能不为人所见，因此未得到认可。因此，需要更多关注来凸显此类护理专业技能。
本研究采用混合方法设计。
该研究于2012年在爱尔兰共和国开展。从养老院招募了23名案例研究护士。每位案例研究护士涉及五种数据收集方法：跟班观察、与同事访谈、与居民访谈、人口统计学概况以及护理主任调查。该研究还参考了一个经过改进的焦点小组的意见。定性数据采用定向内容分析法进行分析，使用从护理专业技能文献中生成的概念框架。定量数据使用SPSS进行分析，并以描述性统计呈现。
案例研究和改进后的焦点小组的结果呈现为七个主题，这些主题代表了老年护理院护理专业技能：过渡、养老院环境、显著性、整体实践知识、了解居民、道德能动性和熟练技能。
老年护理院护理专业技能是一个复杂的现象，在以人为主的框架中涵盖了护理服务的许多方面。通过使这种专业技能可见，凸显了为不断增加的老年护理院人群配备适当且充足技能组合的必要性。
