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
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
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