Loversidge Jacqueline, Yen Po-Yin, Chipps Esther, Gallagher-Ford Lynn, Genter Lynne, Buck Jacalyn
Author Affiliations: Assistant Professor of Clinical Nursing (Dr Loversidge); Adjunct Assistant Professor (Dr Yen); Associate Professor of Clinical Nursing (Dr Chipps); Director (Dr Gallagher-Ford), Center for Transdisciplinary Evidence-based Practice and Helene Fuld Health Trust National Institute for EBP in Nursing & Healthcare; and Clinical Associate Professor (Dr Gallagher-Ford), College of Nursing, Ohio State University; Director (Dr Yen), BMI Summer Internship Program, and Assistant Professor-Clinical, Department of Biomedical Informatics, College of Medicine, Ohio State University; and Clinical Nurse Scientist (Dr Yen); Clinical Nurse Scientist (Dr Chipps); Associate Director (Ms Genter), Nursing CE Programming & Education, Health System Nursing Services; and Administrator (Dr Buck), Health System Nursing Quality, Research, Education, and EBP, Wexner Medical Center, Ohio State University, Columbus.
J Nurs Adm. 2018 Jun;48(6):329-334. doi: 10.1097/NNA.0000000000000623.
The aim of this study was to describe differences in associate degree (ADN) and baccalaureate degree-prepared (BSN) nurses' perceptions of top-of-license (TOL) practice.
To date, no empirical work has examined whether ADN and BSN nurses approach TOL practice nursing activities differently.
We conducted a qualitative pilot study with focus groups to explore the perceptions of a group of ADN- and BSN-prepared nurses concerning nursing activities and their relation to TOL practice.
Subthemes emerged differentiating how ADN and BSN nurses perceived their responsibilities related to critical thinking, communication, and patient education. For professional nursing care, 5 subthemes further emerged: (a) approaches to assessment, (b) chart review, (c) psychosocial patient care, (d) documentation, and (e) handoff.
The differences identified in approaches to TOL practice activities by educational preparation have implications for staffing patterns that can optimize the contribution of ADN- and BSN-prepared nurses. Further research is indicated.
本研究旨在描述护理学副学士学位（ADN）护士和护理学学士学位（BSN）护士对执照顶级（TOL）实践的认知差异。
迄今为止，尚无实证研究探讨ADN护士和BSN护士在进行TOL实践护理活动时的方式是否存在差异。
我们开展了一项定性试点研究，采用焦点小组访谈法，以探究一组拥有ADN和BSN学历的护士对护理活动及其与TOL实践关系的看法。
出现了一些子主题，区分了ADN护士和BSN护士对其在批判性思维、沟通和患者教育方面责任的认知。对于专业护理，又进一步出现了5个子主题：（a）评估方法，（b）病历审查，（c）患者心理社会护理，（d）文件记录，以及（e）工作交接。
教育背景不同，TOL实践活动的方式也存在差异，这对人员配置模式有影响，有助于优化ADN护士和BSN护士的贡献。有必要进行进一步研究。
