Hosseinzadeh Touba, Tabrizi Kian Norouzi, Fallahi-Khoshknab Masoud, Khankeh Hamidreza, Shokooh Forozan
Department of Nursing, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran.
Social Determinants of Health Research Center, Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Iran J Nurs Midwifery Res. 2022 Nov 18;27(6):567-574. doi: 10.4103/ijnmr.ijnmr_164_21. eCollection 2022 Nov-Dec.
Clinical Reasoning (CR) is a main professional competency for nurses which have significant contribution to sound clinical performance in critical clinical conditions. Nonetheless, evidence shows that nurses do not have the necessary competencies and thinking skills for managing complex conditions in critical care units. This study aimed at exploring the barriers to the development of CR skills among coronary care nurses.
Using conventional content analysis, this qualitative study was conducted in 2020 in the Coronary Care Unit (CCU) of Heshmat Subspecialty Heart Center in Rasht, Iran. Participants were 15 nurses, head nurses, nursing supervisors, nursing managers, and nursing instructors. Data were collected using semi-structured interviews and were analyzed using conventional content analysis.
The four main categories of the barriers to CR skill development among nurses were limited professional development, inefficient educational program, ineffective professional interactions, and limited professional self-efficacy.
There are different personal, educational, professional, and interprofessional barriers to the development of CR skills among CCU nurses. Study findings can be used to develop effective strategies for supporting and developing nurses' CR skills.
临床推理（CR）是护士的一项主要专业能力，对在危急临床情况下的良好临床表现有重大贡献。尽管如此，有证据表明，护士缺乏在重症监护病房处理复杂情况所需的能力和思维技能。本研究旨在探讨冠心病护理护士临床推理技能发展的障碍。
本定性研究于2020年在伊朗拉什特市赫什马特心脏专科医院冠心病监护病房（CCU）采用常规内容分析法进行。参与者包括15名护士、护士长、护理主管、护理经理和护理教员。通过半结构化访谈收集数据，并使用常规内容分析法进行分析。
护士临床推理技能发展障碍的四大主要类别为专业发展受限、教育项目效率低下、专业互动无效和专业自我效能感有限。
冠心病监护病房护士临床推理技能的发展存在不同的个人、教育、专业和跨专业障碍。研究结果可用于制定支持和发展护士临床推理技能的有效策略。
