Refining nursing practice through workplace learning: A grounded theory
Refining nursing practice through workplace learning: A grounded theory
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DOI：
10.1111/jocn.14841
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发表时间：
2019-07-01
影响因子：
4.2
通讯作者：
Jantzen, Darlaine
中科院分区：
文献类型：
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作者：
Jantzen, Darlaine
目的和目标 研究经验丰富的注册护士在直接患者护理方面如何在不断变化的当代医疗保健环境中学习。主要目标是检查工作场所、护士和护理实践之间的教育互动，重点关注环境的影响。背景 注册护士必须在整个职业生涯中保持能力。相关的持续学习是由外部需求和护士的内部动机触发的。即将退休的经验丰富的护士经历了最近医疗保健领域的动荡变化，因此可以深入了解他们如何维持优质的患者护理。设计 本研究的方法是基于符号互动主义的扎根理论。应用 EQUATOR 定性研究指南 (COREQ)。方法 数据收集需要对不同环境下的经验丰富的护士进行半结构化访谈，并对两个急症护理病房进行参与观察。使用三级编码、不断比较、理论抽样和广泛记忆进行数据分析。结果 完善护理实践始于护理教育和早期就业。脚踏实地涉及建立关键能力，特别是自我意识、设定高标准、培养健康的忧虑以及了解患者的整体情况。职场学习的三个催化剂是导师、职场友情和高效的职场团队。完善护理实践包括正式和非正式学习；然而，重要的护理专业知识是通过困惑和探究而发展起来的，这是一个边护理边学习的迭代过程。结论 在护理教育和早期工作经验过程中促进护士工作场所学习能力的发展有助于实现出色的患者护理。医疗保健组织需要重视和支持导师在临床环境中的独特贡献，并通过培养友情和发展高效的工作场所团队来促进个人专业知识的发展。与临床实践的相关性 参与护士工作场所学习的流程和催化剂将有助于实现出色的患者护理。
Aims and objectives To examine how experienced registered nurses in direct patient care learn within the constantly changing contemporary healthcare environment. The key objectives were to examine educational interactions amongst workplace, nurse and nursing practice, with a focus on the influence of context. Background Registered nurses must maintain competence throughout their careers. The related ongoing learning is triggered by external demands and nurses' internal motivation. Experienced nurses, poised to retire, have worked through the recent tumultuous changes in health care and therefore provide insight into how they sustained excellent patient care. Design The methodology for this study was a grounded theory informed by symbolic interactionism. EQUATOR guidelines for qualitative research (COREQ) applied. Methods Data collection entailed semi-structured interviews with experienced nurses across diverse settings and participant observation on two acute care units. Analysis of data was conducted using three-level coding, constant comparison, theoretical sampling and extensive memoing. Results Refining nursing practice begins during nursing education and early employment. Getting grounded involves establishing key capabilities, specifically becoming self-aware, setting high standards, cultivating healthy apprehension and seeing the whole patient picture. Three catalysts for workplace learning are mentor-guides, workplace camaraderie and a highly functional workplace team. Refining nursing practice includes both formal and informal learning; however, significant nursing expertise is developed through puzzling and enquiring, an iterative process of learning while nursing. Conclusions Facilitating the development of capabilities for nurses' workplace learning during nursing education and early work experiences contributes to excellent patient care. Healthcare organisations need to value and support the unique contributions of mentor-guides in the clinical setting and promote individuals' development of expertise by nurturing camaraderie and developing highly functional workplace teams. Relevance to clinical practice Attending to the processes and catalysts for nurses' workplace learning will contribute to excellent patient care.