重症监护高级专科护士临床角色发展的行动研究

Development of the role of critical care advanced practice nurse:an action research

目的发展我国重症监护高级专科护士临床角色。方法运用行动研究法指导研究,4名研究者与12名实践者组建行动小组,遵循提出问题、计划、行动和评价4个阶段展开研究,行动小组成员通过小组座谈收集资料,并采用内容分析法分析资料,在提出问题阶段明确高级专科护士角色发展中的问题及解决方案,为计划阶段做准备。结果国内发展重症监护高级专科护士以临床护理专家更合适,工作模式以高级专科护士统筹督导的责任小组模式为最佳,新角色可能遭遇与科室管理者角色冲突、能力发挥受限、能力与头衔不相符、同事不理解等困难,希望得到宣传、充足的人力以及继续教育的机会等资源,新角色的岗位内容涉及关注危重患者、督导护士和发动改革3方面。结论行动研究方法可应用于重症监护高级专科护士角色发展中的研究,有利于护理研究在临床实践中的开展。

Objective To develop the role of critical care advanced practice nurse （APN） in China. Methods Guided by method of ac- tion research, 4 researchers and 12 ICU practitioners formed an action group, who unfolded their work according the timeline of proposing questions, planning, taking actions and evaluation. They held panel discussions on, gathered related materials which were then analyzed by using content analysis method. Results The action group summed up the following contents： we should develop clinical nurse specialist （CNS） in critical care as APN in China which would be more appropriate; the working model of an APN having the authority to supervise or direct other providers in her team is preferable. The development of APN roles could possibly face the following problems： an APN role in a division could run in conflict with the administrator＇s role; the APN role could possibly be underutilized or limited; their competency could be inconsistent with the professional titles they hold; they could be misunderstood by coworkers, etc. To develop APN roles, we urged full propaganda of the role, enough staffing, opportunity to participate continuing education programs, etc. The practice scope of a critical care APN should at least include such 3 aspects as giving attention to severely ill patients, supervising junior nurses and initiating innovations. Conclusion Action research could be u- tilized to develop the role of critical care APN, which helps unfold nursing research in clinical settings.