Understanding Clinical Expertise: Nurse Education, Experience, and the Hospital Context

被引：108
作者：
McHugh, Matthew D. [1 ]
Lake, Eileen T. [1 ,2 ]
机构：
[1] Univ Penn, Sch Nursing, Ctr Hlth Outcomes & Policy Res, Philadelphia, PA 19104 USA
[2] Univ Penn, Dept Sociol, Secondary Fac, Philadelphia, PA 19104 USA
来源：
RESEARCH IN NURSING & HEALTH | 2010年 / 33卷 / 04期
基金：
美国医疗保健研究与质量局;
关键词：
expertise; nursing; nursing education; experience; nursing practice environment; PRACTICE ENVIRONMENTS; PATIENT MORTALITY; WORK ENVIRONMENTS; CARE; OUTCOMES; QUALITY; BURNOUT; MODELS; SAFETY; IMPACT;
D O I：
10.1002/nur.20388
中图分类号：
R47 [护理学];
学科分类号：
1011 ;
摘要：
Clinical nursing expertise is central to quality patient care. Research on factors that contribute to expertise has focused largely on individual nurse characteristics to the exclusion of contextual factors. To address this, we examined effects of hospital contextual factors and individual nurse education and experience on clinical nursing expertise in a cross-sectional analysis of data from 8,611 registered nurses. In a generalized ordered logistic regression analysis, the composition of the hospital staff, particularly the proportion of nurses with at least a bachelor of science in nursing degree, was associated with significantly greater odds of a nurse reporting a more advanced expertise level. Our findings suggest that, controlling for individual characteristics, the hospital context significantly influences clinical nursing expertise. (C) 2010 Wiley Periodicals, Inc. Res Nurs Health 33:276-287, 2010
引用
收藏
页码：276 / 287
页数：12
相关论文
共 51 条
  • [1] Educational levels of hospital nurses and surgical patient mortality
    Aiken, LH
    Clarke, SP
    Cheung, RB
    Sloane, DM
    Silber, JH
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2003, 290 (12): : 1617 - 1623
  • [2] Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction
    Aiken, LH
    Clarke, SP
    Sloane, DM
    Sochalski, J
    Silber, JH
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2002, 288 (16): : 1987 - 1993
  • [3] Measuring organizational traits of hospitals: The revised nursing work index
    Aiken, LH
    Patrician, PA
    [J]. NURSING RESEARCH, 2000, 49 (03) : 146 - 153
  • [4] Effects of hospital care environment on patient mortality and nurse outcomes
    Aiken, Linda H.
    Clarke, Sean P.
    Sloane, Douglas M.
    [J]. JOURNAL OF NURSING ADMINISTRATION, 2008, 38 (05): : 223 - 229
  • [5] Implications of the California Nurse Staffing Mandate for Other States
    Aiken, Linda H.
    Sloane, Douglas M.
    Cimiotti, Jeannie P.
    Clarke, Sean P.
    Flynn, Linda
    Seago, Jean Ann
    Spetz, Joanne
    Smith, Herbert L.
    [J]. HEALTH SERVICES RESEARCH, 2010, 45 (04) : 904 - 921
  • [6] Hallmarks of the professional nursing practice environment
    Rendon D.
    Stanley J.
    [J]. JOURNAL OF PROFESSIONAL NURSING, 2002, 18 (05) : 295 - 304
  • [7] American Association of Colleges of Nursing, 2000, BACC DEGR NURS MIN P
  • [8] [Anonymous], NQFCR0804
  • [9] CLINICAL JUDGMENT - HOW EXPERT NURSES USE INTUITION
    BENNER, P
    TANNER, C
    [J]. AMERICAN JOURNAL OF NURSING, 1987, 87 (01) : 23 - 31
  • [10] Benner P., 1984, From novice to expert: Excellent and power in clinical nursing practice
123456