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对高级护理流程质量的影响。

Effekte von auf die Qualität des Advanced Nursing Process.

机构信息

Institut für Pflegewissenschaft, Universität Wien.

Lectoraat Nursing Diagnostics, HANZE University, Groningen.

出版信息

Pflege. 2021 Apr;34(2):92-102. doi: 10.1024/1012-5302/a000792. Epub 2021 Feb 4.

Abstract

Effects of Guided Clinical Reasoning on the Advanced Nursing Process quality - An experimental intervention study The correctly applied Advanced Nursing Process leads demonstrably to more accurate nursing diagnoses and better nursing outcomes. It requires nurses' knowledge, clinical decision-making competency, and a positive attitude. Former Guided Clinical Reasoning (GCR) trainings significantly enhanced the Advanced Nursing Process quality. However, the congruence between nursing records, care situations, and patient interviews was not yet investigated. Which effects has GCR on nurses' knowledge, attitude, clinical performance, and on the quality of the Advanced Nursing Process? An experimental intervention study was carried out from 2016 until 2018 in a Swiss hospital. The 5-month intervention contained four seminar days and GCR-case meetings and was investigated by an evaluation model (n = 95 nurses, n = 24 patients, n = 225 nursing records). After GCR training, nurses showed greater knowledge (p < 0,0001) and a more positive attitude (p = 0,004) on the Advanced Nursing Process than the control group. The congruence of nursing diagnoses, interventions, and outcomes between observations, interviews, and nursing records was higher in the intervention group. At the last measurement point, nursing diagnoses were stated significantly more accurate, interventions were more effective, and better patient outcomes were achieved (all p < 0,0005). GCR trainings should be used to enhance the Advanced Nursing Process quality, so that based on more accurate nursing diagnoses better patient outcomes are achieved.

摘要

引导临床推理对高级护理流程质量的影响——一项实验干预研究

正确应用高级护理流程可明显提高护理诊断的准确性和护理效果。它需要护士的知识、临床决策能力和积极的态度。以前的引导临床推理(GCR)培训显著提高了高级护理流程的质量。然而,护理记录、护理情况和患者访谈之间的一致性尚未得到调查。

引导临床推理对护士的知识、态度、临床表现以及高级护理流程的质量有何影响?

一项实验性干预研究于 2016 年至 2018 年在瑞士一家医院进行。为期 5 个月的干预措施包括 4 天研讨会和 GCR 案例会议,并通过评估模型进行了调查(n=95 名护士,n=24 名患者,n=225 份护理记录)。

在 GCR 培训后,与对照组相比,护士在高级护理流程方面表现出更高的知识(p<0.0001)和更积极的态度(p=0.004)。观察组、访谈组和护理记录组的护理诊断、干预和结果之间的一致性更高。在最后一次测量点,护理诊断的陈述明显更准确,干预更有效,患者的结果更好(均 p<0.0005)。

应使用引导临床推理培训来提高高级护理流程的质量,以便根据更准确的护理诊断实现更好的患者结果。

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