Gunawan Joko, Aungsuroch Yupin, Fisher Mary L, Marzilli Colleen, Liu Ying
Postdoctoral Researcher, Faculty of Nursing, Chulalongkorn University Bangkok, Thailand.
Associate Professor, Faculty of Nursing, Chulalongkorn University Bangkok, Thailand.
J Nurs Scholarsh. 2020 Nov;52(6):623-633. doi: 10.1111/jnu.12594. Epub 2020 Aug 30.
To determine the factors associated with the clinical competence of registered nurses.
Systematic review and meta-analysis was used. The search strategy was limited to 10 years, ranging from January 2009 to December 2019, in Science Direct, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, ProQuest, and Google Scholar. A meta-analysis was performed using R Studio with the metafor package (Boston, MA, USA; https://rstudio.com/products/rstudio/older-versions/).
A total of 22 studies were included, representing 33,961 nurses. There were 28 factors associated with clinical competence. Of those, 13 factors were significantly supported and included for meta-analysis, grouped into (a) individual-related factors, (b) job satisfaction, (c) bullying, (d) burnout, and (d) specific knowledge. The effect size of those factors ranged from -0.14 to 0.50.
Among individual-related factors, salary has the largest effect size on competence and is considered important. Clinical competence is positively affected by job satisfaction, but negatively influenced by bullying and burnout. Although specific knowledge has a large effect size, it does not significantly affect the clinical competence of registered nurses.
It is critical to understand factors related to the clinical competence of registered nurses to maintain quality care and patient outcomes in clinical settings. The findings serve as data to help nurse managers find effective ways to improve the knowledge, skill, attitudes, and performance of registered nurses.
确定与注册护士临床能力相关的因素。
采用系统评价和荟萃分析。检索策略限于2009年1月至2019年12月这10年期间，检索数据库包括科学Direct、护理及相关健康文献累积索引（CINAHL）、PubMed、ProQuest和谷歌学术。使用R Studio和metafor软件包（美国马萨诸塞州波士顿；https://rstudio.com/products/rstudio/older-versions/）进行荟萃分析。
共纳入22项研究，涉及33961名护士。有28个与临床能力相关的因素。其中，13个因素得到显著支持并纳入荟萃分析，分为（a）个人相关因素、（b）工作满意度、（c）欺凌、（d）职业倦怠和（d）特定知识。这些因素的效应大小在-0.14至0.50之间。
在个人相关因素中，薪资对能力的效应大小最大，被认为很重要。临床能力受到工作满意度的积极影响，但受到欺凌和职业倦怠的消极影响。虽然特定知识的效应大小较大，但对注册护士的临床能力没有显著影响。
了解与注册护士临床能力相关的因素对于在临床环境中维持优质护理和患者预后至关重要。这些研究结果可为护士管理者提供数据，以帮助他们找到有效方法来提高注册护士的知识、技能、态度和表现。
