Ara Institute of Canterbury Ltd., Christchurch, New Zealand.
Canterbury District Health Board, Christchurch, New Zealand.
J Clin Nurs. 2021 Apr;30(7-8):929-941. doi: 10.1111/jocn.15621. Epub 2021 Feb 15.
Historically, it has been reported that new graduates make limited use of their clinical assessment skills, yet these form the basis for making nursing decisions and selecting all nursing interventions.
To explore new graduates' preparedness for, and confidence with, clinical assessment and their reliance on electronic monitoring. To identify barriers that hinder, and strategies that enable, clinical assessment.
A mixed-method study comprising a cross-sectional, quantitative survey and qualitative data, gathered using the World Café method.
Data were collected from volunteers (n = 137) of all new graduates (n = 160) working in adult settings for a New Zealand district health board over a 1-year period. A paper-based survey explored use of clinical assessment, using a five-point Likert scale. Qualitative data comprised written records of group discussions and individual responses to four questions with thematic analysis of results. A STROBE checklist was used.
Most (n = 128) new graduates agreed/strongly agreed that clinical assessment was part of their role. Most (n = 119) agreed/strongly agreed that assessing patients by technology alone was inadequate. Thirty-six did not agree/strongly agree that they were well-prepared to perform clinical assessment. Forty-one did not agree/strongly agree that they were confident to perform clinical assessment, particularly those aged ≥30 years. Factors limiting use of clinical assessment were lack of time, knowledge, skill, confidence, reliance on doctors and an unsupportive work environment. Factors that would enhance clinical assessment involved increased supervision by experienced staff, provision of short courses and more in-service education on clinical assessment.
New graduates acknowledged that clinical assessment was part of their role and involved more than electronic monitoring. However, many lacked confidence and preparedness for clinical assessment in their work area, particularly those aged ≥30 years, potentially limiting clinical assessment use. Supportive changes, including short courses to revise clinical assessment skills and supervision of workplace-specific clinical assessments, could help new graduates more confidently and efficiently assimilate clinical assessment into their practice.
This research identified reasons that caused a cohort of new graduates to make limited use of their clinical assessment skills. It also reports the practical solutions they considered would help them increase their use of clinical assessment and thus support their decision-making in nursing practice.
从历史上看，有报道称新毕业生在临床评估技能的使用上有限，但这些技能是做出护理决策和选择所有护理干预措施的基础。
探索新毕业生在临床评估方面的准备情况和信心程度，以及他们对电子监测的依赖程度。确定阻碍临床评估的障碍以及促进临床评估的策略。
一项混合方法研究，包括横断面、定量调查和使用世界咖啡馆方法收集的定性数据。
在 1 年内，从在新西兰地区卫生局成人环境中工作的所有新毕业生（n=160）的志愿者（n=137）中收集数据。一份基于纸张的调查使用 5 点李克特量表探索临床评估的使用情况。定性数据包括小组讨论的书面记录和对四个问题的个人回答，结果进行主题分析。使用 STROBE 清单。
大多数（n=128）新毕业生同意/强烈同意临床评估是他们角色的一部分。大多数（n=119）同意/强烈同意仅通过技术评估患者是不够的。36 人不同意/强烈不同意他们有充分准备进行临床评估。41 人不同意/强烈不同意他们有信心进行临床评估，特别是年龄≥30 岁的人。限制临床评估使用的因素是缺乏时间、知识、技能、信心、对医生的依赖和支持性差的工作环境。增强临床评估的因素包括增加有经验的工作人员的监督、提供短期课程和更多的临床评估在职教育。
新毕业生承认临床评估是他们角色的一部分，并且不仅仅涉及电子监测。然而，许多人在工作场所缺乏对临床评估的信心和准备，特别是年龄≥30 岁的人，这可能限制了临床评估的使用。支持性的改变，包括修改临床评估技能的短期课程和监督工作场所特定的临床评估，可能有助于新毕业生更自信和有效地将临床评估融入他们的实践。
本研究确定了导致一群新毕业生在使用他们的临床评估技能方面有限的原因。它还报告了他们认为有助于增加他们对临床评估的使用的实际解决方案，从而支持他们在护理实践中的决策。
