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PubMed2006

What does expert nursing practice mean?

Becoming an expert practice nurse should be the goal of all nurses and those planning for such a career. But the meaning of what an expert nurse in clinical practice is, is not as easy to define or evaluate, as it is in nursing education or nursing research. The Royal College of Nursing's Expertise in Practice Project has studied nursing throughout the United Kingdom and has made a considerable contribution by re-defining expert nursing practice. This column explicates that contribution.

Clinical Competence↗
PubMed1998

The use of professional nursing practice standards in nursing labour arbitrations in British Columbia, 1987-1994.

This study examined the use of nursing practice standards in British Columbia in labour arbitrations related to patient care for the years 1987-1994. Retrospective secondary content analysis was the method used to analyse the cases. Although practice standards were referred to in some of the cases, the nature and clarity of these standards were not always evident. In addition, corporate and industrial precedents, rather than health care precedents, formed the basis for much of the arbitration deliberations. The perspectives of nurses, patients, and families were not significantly represented. Many of the arbitration hearings did not get beyond procedural matters, and so did not address substantive patient care situations. Clearly, the visibility and importance of nursing standards need to be raised among nurses and non-nurses alike. Implications and recommendations for nursing practice, administration, education and research, as well as for nursing professional associations and unions are discussed. Research questions for the future are suggested.

British Columbia↗
PubMedDate not supplied

Molding the future of advanced practice nursing.

During this time when the walls that divide inpatient, outpatient, primary, tertiary, and community care are coming down, society should expect that the nursing profession will prepare and regulate advanced nursing practice for the good of patient care and society as a whole. To do so, schools with clinical practice graduate programs must create a consistent product; professional credentialing bodies must use consistent criteria to acknowledge advanced practice knowledge and expertise; and state boards of nursing must give legal recognition for advanced practice to these same nurses. Within this environment, advanced practice nurses will be prepared to serve society, even if their skills are applied in a variety of roles.

American Nurses' Association↗
PubMed2005

Nurse practitioner and practice nurses' use of research information in clinical decision making: findings from an exploratory study.

BACKGROUND: There is a lack of evidence regarding the kinds of decisions made by primary care nurses and the information sources they use in clinical decision making. OBJECTIVE: To describe the decisions made by nurses working in general practice and the sources of information they use to underpin those decisions. METHODS: Qualitative methods (interviews, observation, documentary analysis) were used to collect data on the clinical decision making and information seeking behaviour of a purposive sample of 29 practice nurses and four nurse practitioners from general practices in the North of England. Data were collected November 2001-September 2002. RESULTS: A seven-fold typology captured the types of decisions the nurses made on a daily basis concerning assessment, diagnosis, intervention, referral, communication, service delivery and organization (SDO) and information seeking. Faced with clinical uncertainty, the majority of the nurses in the study relied on personal experience, or obtained advice and information from GP or other colleagues. These 'human sources' of information were overwhelmingly preferred to text or on-line resources. Despite encounters with evidence-based resources through continuing professional development, the nurses rarely used them to seek answers to routine clinical questions. CONCLUSION: The decisions of the nurses in the study were mainly concerned with undifferentiated diagnosis and treatment, in the context of acute conditions and chronic disease management. 'Human sources' of information were preferred to any other; however, we do not know whether information obtained from colleagues is based on research.

Adult↗