Alfstad Emilie, Lockertsen Veronica, Johannessen Anne-Kari, Werner Anne
Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet- Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, Oslo, Norway.
HØKH- Health Services Research Unit, Akershus University Hospital (Ahus), P.O. Box 1000, Lørenskog, N- 1478, Norway.
BMC Health Serv Res. 2025 Apr 15;25(1):547. doi: 10.1186/s12913-025-12692-y.
Primary healthcare in many Western countries faces increased patient care needs due to shorter hospital stays and an ageing population suffering from complex conditions. A shortage of qualified professionals jeopardises the quality of care in primary healthcare settings. Literature indicates that the quality of care and the occurrence of adverse events are linked to the observational competencies of healthcare professionals. In Norway, patient safety competence programmes, such as ClinObsMunicipality, have been developed to improve healthcare professionals' observational competencies in recognising and responding to clinical deterioration, thereby ensuring safety in primary healthcare. In this study, we aimed to explore and describe how healthcare professionals experienced and perceived learning and training in this competence-building programme. Specifically, we focused on their reflections on its applicability in clinical practice.
Aqualitative study was conducted. In preparing the manuscript, we applied the checklist guidelines for the Consolidated Criteria for Reporting Qualitative Research.
The study is based on 17 individual interviews with healthcare professionals from different primary healthcare settings. Data were analysed using Malteruds' systematic text condensation, a thematic cross-case analysis.
We identified three categories illustrating how healthcare professionals experienced learning and training in the competence-building programme and its applicability for clinical practice: (1) Shared base of competence through practice-based group-learning with colleagues; (2) Enhanced clinical communication: The impact and applicability of standardised language; (3) From Colleagues to team: Increased autonomy and collaboration.
This study highlights that healthcare professionals experienced learning and training in the competence programme as applicable to their clinical practice. Group-learning activities fostered a supportive environment where participants could engage with cases and scoring tools relevant to their clinical settings. This approach enhanced their observational competencies, deepened their understanding of team roles and strengthened interprofessional communication and collaboration, which may positively impact patient care and safety in primary healthcare settings. While the programme empowered healthcare professionals through increased autonomy, it also uncovered hesitance in critical situations among some participants, suggesting complex awareness and the urgency of timely interventions.
在许多西方国家，由于住院时间缩短以及患有复杂病症的老年人口增加，初级医疗保健面临着日益增长的患者护理需求。合格专业人员的短缺危及初级医疗保健机构的护理质量。文献表明，护理质量和不良事件的发生与医疗保健专业人员的观察能力有关。在挪威，已经制定了患者安全能力计划，如“临床观察市政计划”，以提高医疗保健专业人员识别和应对临床病情恶化的观察能力，从而确保初级医疗保健的安全。在本研究中，我们旨在探索和描述医疗保健专业人员在这个能力建设计划中的学习和培训体验及感受。具体而言，我们关注他们对该计划在临床实践中的适用性的反思。
进行了一项定性研究。在撰写手稿时，我们应用了《定性研究报告统一标准》的清单指南。
该研究基于对来自不同初级医疗保健机构的医疗保健专业人员进行的17次个人访谈。使用马尔特鲁德的系统文本浓缩法进行数据分析，这是一种主题跨案例分析。
我们确定了三个类别，说明了医疗保健专业人员在能力建设计划中的学习和培训体验及其在临床实践中的适用性：（1）通过与同事进行基于实践的小组学习形成共同的能力基础；（2）加强临床沟通：标准化语言的影响和适用性；（3）从同事到团队：增强自主性与协作。
本研究强调，医疗保健专业人员认为能力计划中的学习和培训适用于他们的临床实践。小组学习活动营造了一个支持性环境，参与者可以参与与他们临床环境相关的案例和评分工具。这种方法提高了他们的观察能力，加深了他们对团队角色的理解，加强了跨专业沟通与协作，这可能对初级医疗保健机构的患者护理和安全产生积极影响。虽然该计划通过增强自主性赋予了医疗保健专业人员权力，但也发现一些参与者在关键情况下存在犹豫，这表明存在复杂的意识以及及时干预的紧迫性。
