NURSING EXPERTISE MEASURES FOR OUTCOMES RESEARCH

临床护理专业知识对患者结果的影响尚未纳入结果研究。将专门知识纳入成果研究需要制定适合组织研究框架的措施和模式。这项研究是琳达·艾肯和帕特里夏·本纳研究传统的桥梁。我建议制定临床护理专业知识调查量表，并在结果研究模型中对调查措施进行检验。调查将使用从宾夕法尼亚大学医院有目的的护士样本中收集的初步调查和叙述性数据来制定。护理专业知识措施将在结果研究模型中使用护士调查和患者结果数据进行测试，该数据是由宾夕法尼亚大学健康结果和政策研究中心资助的一项研究中收集的。我的近期目标是开发有效、可靠的临床护理专业知识调查方法。我的长期目标是建立一个研究计划，描述护理影响患者结局的机制。为了实现这些目标，研究职业发展计划包括高级定性和定量研究方法的培训。采用质的研究方法对护理鉴定工具进行验证。采用定量研究方法，对专家意见量表的心理测量学特性进行评估，并建立护理组织与结果相联系的多层次、多阶段模型。这些模型将使用多重归因、分层线性建模和结构方程建模等方法来测试临床专业知识和其他个人和组织特征对结果的直接和间接影响。我的研究职业生涯奖的目标是：1)获得新的定性和定量研究技能；2)通过将临床专业知识引入结果研究来发展我的研究计划；3)在同行评议的期刊上发表研究结果；4)制定一项外部资助建议，检查实践环境对护理专业知识的影响以及护理专业知识对结果的影响；5)与调查开发、临床护理专业知识以及先进的定性和定量研究方法领域的专家建立跨学科的合作关系。

The influence of clinical nursing expertise on patient outcomes has yet to be factored into outcomes research. Incorporating expertise into outcomes research entails the development of measures and models suitable for an organizational research framework. This study bridges the research traditions of Linda Aiken and Patricia Benner. I propose to develop survey measures of clinical nursing expertise and test the survey measures in outcomes research models. The survey measures will be developed using primary survey and narrative data collected from a purposive sample of staff nurses at the Hospital of the University of Pennsylvania. Nursing expertise measures will be tested in outcomes research models using nurse survey and patient outcomes data collected in an NINR-funded study by Penn's Center for Health Outcomes and Policy Research. My immediate goal is to develop valid, reliable survey measures of clinical nursing expertise. My long term goal is to build a program of research that delineates the mechanisms whereby nursing influences patient outcomes. To fulfill these goals, the research career development plan comprises training in advanced qualitative and quantitative research methods. The qualitative research methods will be required to validate the nursing expertise instrument. The quantitative research methods will be used to evaluate the psychometric properties of the expertise instrument and to develop multi-level mult-stage models linking the organization of nursing to outcomes. These models will test the direct and indirect effects of clinical expertise and other individual and organizational characteristics on outcomes employing such methods as multiple imputation, hierarchical linear modeling, and structural equation modeling. My aims for this research career award are to: 1) gain new qualitative and quantitative research skills, 2) develop my program of research by introducing clinical expertise into outcomes research, 3) publish findings in peer- reviewed journals, 4) develop a proposal for extramural funding examining the effect of the practice environment on nursing expertise and of nursing expertise on outcomes, and 5) establish interdisciplinary collaborative relationships with experts in the fields of survey development, clinical nursing expertise, and advanced qualitative and quantitative research methods.