Differences between clinical specialist and advanced practitioner clinical practice, leadership, and research roles, responsibilities, and perceived outcomes (the SCAPE study)
Differences between clinical specialist and advanced practitioner clinical practice, leadership, and research roles, responsibilities, and perceived outcomes (the SCAPE study)
复制标题
DOI：
10.1111/j.1365-2648.2012.06124.x
复制
发表时间：
2013-06-01
影响因子：
3.8
通讯作者：
Comiskey, Catherine M.
中科院分区：
文献类型：
--
作者：
Begley, Cecily;Elliott, Naomi;Comiskey, Catherine M.
目的 报告一项旨在比较爱尔兰临床护士专家、临床助产士专家和高级执业护士的角色、责任和感知结果的研究。背景 2000 年，爱尔兰引入了一种临床职业路径，包括从护士或助产士到临床专家再到高级执业医师级别的晋升。此类角色在国际上很常见，但很少进行评估，也很少对角色之间进行比较。设计 采用混合方法案例研究设计。方法 经研究伦理委员会批准，数据于 2009-2010 年收集，采用非参与观察（92 小时）23 名临床专家和高级执业医师，采访 21 名临床医生和 13 名护理或助产士主任。 154 名服务使用者完成了一项调查。结果 临床专家和高级执业医师之间存在明显差异，高级执业医师角色提供了改进的服务交付、更强的临床和专业领导力、更多的研究以及清晰的治理和认证结构。临床助产士专家在某些方面的评级与高级执业护士相似，但在护理和护理人员的连续性方面评级更高。结论 高级从业者确实提供了更高水平的护理，特别是在战略层面。因此，应鼓励现有的临床专家发展他们的技能和教育，以达到高级实践水平，并应设立更多的专业和高级实践职位。
Aim To report a study designed comparing the roles, responsibilities, and perceived outcomes of Clinical Nurse Specialists, Clinical Midwife Specialists, and Advanced Nurse Practitioners in Ireland. Background A clinical career pathway that encompasses progression from staff nurse or midwife through clinical specialist to advanced practitioner level was introduced in Ireland in 2000. Such roles are common internationally, but little evaluation has been conducted and few comparisons have been made between roles. Design A mixed-method case-study design was used. Methods Following Research Ethics Committee Approval, data were collected in 20092010, using non-participant observation (92hours) of 23 Clinical Specialists and Advanced Practitioners, interviews with 21 clinicians and 13 Directors of Nursing or Midwifery. A survey was completed by 154 service-users. Results A clear difference was seen between Clinical Specialist and Advanced Practitioners, with advanced practice roles providing improved service delivery, greater clinical and professional leadership, increased research, and a clear governance and accreditation structure. Clinical Midwife Specialists were rated at a similar level to Advanced Nurse Practitioners for certain aspects and rated more highly for continuity of care and carer'. Conclusion Advanced Practitioners do give a higher level of care, particularly at a strategic level. Existing Clinical Specialists should therefore be encouraged to develop their skills and education to achieve advanced practice level and more specialist and advanced practice posts should be instituted.