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Study On The Practice Of ICU Advanced Practice Nurses

Posted on:2015-11-23Degree:MasterType:Thesis
Country:ChinaCandidate:W J ZhaoFull Text:PDF
GTID:2284330464959731Subject:Nursing
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Objective1. To describe the current situation of ICU advanced practice nurses’practice activities, professional competencies, and perceived impacts by themselves;2. To compare the practice of advanced practice nurses with different training programs.MethodsQuantitative research and qualitative research were conducted in this study, it divided into two parts.Part one:Qualitative research, using in-depth interviews with five ICU head nurses and ten ICU advanced practice nurses to understand and summarize the current practice and perceived impacts by advanced practice nurses.Part two:Descriptive study. A convenient sampling method was used to recruit 404 ICU advanced practice nurses from Shanghai city, Guangdong province and Anhui province. Four questionnaires entitled "ICU advanced practice nurses’ background"(to obtain professional and demographic information), "ICU advanced practice nurses’practice activities ", " ICU advanced practice nurses’professional competencies", " ICU advanced practice nurses’perceived impacts" were used to investigate the ICU advanced practice nurses’practice activities, professional competencies, perceived impacts by themselves.ResultsQualitative study results1. Current practice of ICU advanced practice nursesThe areas of their practices included direct care of patients, education for different populations, consultation and coach, communication and collaboration, clinical leadership and research.2. Perceived impacts by ICU advanced practice nursesThe impact of ICU advanced practice nurses mainly considered from individual patients, health care systems, the profession, and individual advanced practice nurses.Quantitative study results1. Results related to ICU advanced practice nurses’backgroundThe mean age was 31.34 years old, the almost 69.52% of respondents were aged between 30 and 40 years. Nearly all respondents (96.65%) were women, for the highest degree earned by respondents,84.01% of advanced practice nurses had earned the bachelor’s degree. Over half of the respondents (50.19%) held the charge nurse title. Experience in a nurse role ranged from 4 to 31 years, the mean year was 13.45+5.46, most respondents (98.14%) worked as a nurse more than 5 years. Respondents had a mean of 8.13 years of experience working in ICU, ranged from 1-27 years.42.16% of advanced practice nurses reported that their primary role was a staff nurse,41.42% worked as head nurse,41.04% worked as clinical educator, only 20.15% said that the advanced practice nurse role was their primary position. Most respondents (80.97%) still worked in ICU, and most of the one who left ICU (86.00%) worked in nursing position in hospital,55.81% of them worked as head nurse in units.2. The activities performed by advanced practice nursesThe activities performed by ICU advanced practice nurses most frequently were response to diversity(3.72±0.76), followed by caring practice(3.57±0.69), clinical judgment(3.33±0.59), facilitator of learning(3.28±0.69), collaboration(3.12±0.70), advocacy and moral agency (3.06±0.67), system thinking (3.01±0.79), the activities related to clinical inquiry(2.82±0.82) rated least. And the advanced practice nurses with graduate program rated as more activities involving clinical judgment, caring practice, collaboration, system thinking, clinical inquiry and facilitator of learning than the advanced practice nurses with non-graduate program.3. The advanced practice nurses’ professional competenciesThe competences that the advanced practice nurses rated highest were associated with the competences of clinical judgment (6.87), followed by caring practices(5.96), and then system thinking(4.89), response to diversity(4.85), collaboration(4.36), clinical inquiry(3.38), facilitator of learning(3.18). The competences of advocacy and moral agency (2.52) were rated lowest.The weighted average score of the comprehensive professional competences was 2.26±0.27, the overall level of advanced practice nurses’professional competences was assumed to be at level 3. The competences that the advanced practice nurses scored highest were associated with the competences of clinical judgment(0.51±0.06), followed by caring practices(0.35±0.06), system thinking(0.35±0.05), collaboration(0.29±0.06), response to diversity(0.28±0.06), clinical inquiry(0.20±0.05), facilitator of learning(0.14±0.02). The competences of advocacy and moral agency (0.13±0.02) were scored lowest.According to the weighted average score of comprehensive professional competences, system thinking competences, clinical inquiry competences, the score of advanced practice nurses with graduate program was higher than the score of the ones with non-graduate program.4. The perceived impacts by advanced practice nursesThe top 10 perceived impacts were mainly associated with the subjective experience and only one was associated with objective data. The advanced practice nurses with graduate program were easier to agree with using objective data to evaluate their roles.Conclusions1. The activities performed by ICU advanced practice nurses most frequently were response to diversity and caring practice, and the activities related to clinical inquiry rated least.2. The overall level of ICU advanced practice nurses’professional competenceswas assumed to be at level 3.3. The top 10 perceived impacts were mainly associated with the subjective experience, seldom related with the individual patients.4. Compared with the advanced practice nurses with non-graduate program, the advanced practice nurses with graduate program rated as more activities involving clinical judgment, caring practice, collaboration, system thinking, clinical inquiry and facilitator of learning than; had higher weighted average score of comprehensive professional competences, system thinking competences, clinical inquiry competences; and were easier to agree with using objective data to evaluate their roles.
Keywords/Search Tags:Intensive care unit, advanced practice nurse, practice activities, professional competences, training program
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