American Journal of Nursing Research
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American Journal of Nursing Research. 2014, 2(3), 50-56
DOI: 10.12691/ajnr-2-3-4
Open AccessArticle

Nurse Education, Experience and the Hospital Context. Analysis of Nurse Expertise in a University Hospital of Catalonia (Spain)

Faura T1, , Trilla A2, Lluch T1, G Martinez1, L Canillas3 and Zabalegui A2

1University School of Nursing, University of Barcelona, Barcelona, Spain

2Faculty of Medicine, University of Barcelona, Barcelona, Spain

3Intensive Care Unit, Hospital Clinic de Barcelona. Barcelona, Spain

Pub. Date: December 01, 2014

Cite this paper:
Faura T, Trilla A, Lluch T, G Martinez, L Canillas and Zabalegui A. Nurse Education, Experience and the Hospital Context. Analysis of Nurse Expertise in a University Hospital of Catalonia (Spain). American Journal of Nursing Research. 2014; 2(3):50-56. doi: 10.12691/ajnr-2-3-4

Abstract

In hospitals and other health settings expert nurses are central to ensure the efficacy and efficiency of patient care. Hospital quality and safety policies contribute in promoting and ensuring expertise among their staff to improve patient health outcomes. To allow design of these policies, research is currently needed to understand how to apply two well-established definitions of expert nurse: (i) the influence of hospital contextual factors, as well as (ii) nursing practice levels. The former were previously studied in a large nurse sample of a hospital in Pennsylvania (USA). The later were characterized in P Benner’s theory. In spite of their key importance, these two criteria are not yet standardized in nurse staffing policies. Here, the nurse expertise level following these two criteria was assessed in a University Hospital of Catalonia (Spain). To that end, we acquired primary data on the individual nurse education and experience, thereby contributing to define nurse expertise. Our findings of this cross‐sectional study from 167 registered nurses showed that the hospital indeed adheres to the two definitions of expert nurse. Further, we characterized key markers such as a statistically significant association found between a nurse reporting a more advanced expertise level and a threshold of at least five years of experience and at least one year of postgraduate studies. This result is supported in current literature. In the future, further research along these lines will hopefully aid to clarify the relationship between nurse expertise and patient health outcome.

Keywords:
nurse expertise magnet hospitals patient outcomes work environment

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References:

[1]  M. D. McHugh and E. T. Lake, “Understanding clinical expertise: nurse education, experience, and the hospital context.,” Res. Nurs. Health, vol. 33, no. 4, pp. 276-87, Aug. 2010.
 
[2]  P. Benner, “From novice to expert.,” Am. J. Nurs., vol. 82, no. 3, pp. 402-7, Mar. 1982.
 
[3]  P. Benner and C. Tanner, “Clinical judgment: how expert nurses use intuition.,” Am. J. Nurs., vol. 87, no. 1, pp. 23–31, Jan. 1987.
 
[4]  P. M. Fitts PM, “Human performance Paul M. Fitts Michael I. Posner. -,” 1967. [Online]. Available: http://www.ncbi.nlm.nih.gov/nlmcatalog/clipboard. [Accessed: 21-Nov-2014].
 
[5]  A. Bonner and J. Greenwood, “The acquisition and exercise of nephrology nursing expertise: a grounded theory study.,” J. Clin. Nurs., vol. 15, no. 4, pp. 480-9, Apr. 2006.
 
[6]  M. Christensen and J. Hewitt-Taylor, “From expert to tasks, expert nursing practice redefined?,” J. Clin. Nurs., vol. 15, no. 12, pp. 1531-9, Dec. 2006.
 
[7]  W. M. Daly and R. Carnwell, “Nursing roles and levels of practice: a framework for differentiating between elementary, specialist and advancing nursing practice.,” J. Clin. Nurs., vol. 12, no. 2, pp. 158-67, Mar. 2003.
 
[8]  D. Fairley and S. J. Closs, “Evaluation of a nurse consultant’s clinical activities and the search for patient outcomes in critical care.,” J. Clin. Nurs., vol. 15, no. 9, pp. 1106-14, Sep. 2006.
 
[9]  E. Furlong and R. Smith, “Advanced nursing practice: policy, education and role development.,” J. Clin. Nurs., vol. 14, no. 9, pp. 1059-66, Oct. 2005.
 
[10]  K. Bonsall and F. M. Cheater, “What is the impact of advanced primary care nursing roles on patients, nurses and their colleagues? A literature review.,” Int. J. Nurs. Stud., vol. 45, no. 7, pp. 1090-102, Jul. 2008.
 
[11]  G. Castledine, “Prescribing is not the only issue for nurses and drugs.,” Br. J. Nurs., vol. 15, no. 15, p. 837, 2006.
 
[12]  J. A. Fairman, J. W. Rowe, S. Hassmiller, and D. E. Shalala, “Broadening the scope of nursing practice.,” N. Engl. J. Med., vol. 364, no. 3, pp. 193-6, Jan. 2011.
 
[13]  L. Ferrús i Estopà, Recomanacions per la dotació d’infermeres a les unitats d'hospitalització: factors que influencien la pràctica infermera. Barcelona: Consell de Col·legis de Diplomats en Infermeria de Catalunya, 2006.
 
[14]  J. Romero-Nieva Lozano, “[Current state of the nursing specialty in surgical medical care].,” Enfermería clínica, vol. 20, no. 1, pp. 1-2, Jan. 2010.
 
[15]  A. Zabalegui and E. Cabrera, “New nursing education structure in Spain.,” Nurse Educ. Today, vol. 29, no. 5, pp. 500-4, Jul. 2009.
 
[16]  L. Currie and L. Watterson, “Investigating the role and impact of expert nurses.,” Br. J. Nurs., vol. 18, no. 13, pp. 816, 818-24, 2009.
 
[17]  D. S. Havens, T. G. Labov, T. Faura, and L. H. Aiken, “Entorno clínico de la enfermera hospitalaria,” Enfermería Clínica, vol. 12, no. 1, pp. 13-21, Jan. 2002.
 
[18]  L. H. Aiken and P. A. Patrician, “Measuring organizational traits of hospitals: the Revised Nursing Work Index.,” Nurs. Res., vol. 49, no. 3, pp. 146-53, 2000.
 
[19]  B. J. Foley, C. C. Kee, P. Minick, S. S. Harvey, and B. M. Jennings, “Characteristics of nurses and hospital work environments that foster satisfaction and clinical expertise.,” J. Nurs. Adm., vol. 32, no. 5, pp. 273-82, May 2002.
 
[20]  E. T. Lake, “Development of the practice environment scale of the Nursing Work Index.,” Res. Nurs. Health, vol. 25, no. 3, pp. 176-88, Jun. 2002.
 
[21]  J. de Pedro Gómez, J. M. Morales Asencio, A. Sesé Abad, M. Bennasar Veny, M. J. Ruiz Roman, and F. J. Muñoz Ronda, “Validación de la versión española del cuestionario sobre la práctica basada en la evidencia en enfermeras,” Revista española de salud pública, vol. 83, no. 4. Ministerio de Sanidad y Consumo, pp. 577-586, 2009.
 
[22]  B. J. Kalisch and K. H. Lee, “Missed nursing care: Magnet versus non-Magnet hospitals.,” Nurs. Outlook, vol. 60, no. 5, pp. e32-9, 2012.
 
[23]  J. de Pedro Gómez, J. M. Morales Asencio, A. Sesé Abad, M. Bennasar Veny, G. Artigues Vives, and C. Perelló Campaner, “Entorno de práctica de los profesionales de enfermería y competencia para la incorporación de la evidencia a las decisiones: situación en las Islas Baleares,” Gaceta sanitaria: Organo oficial de la Sociedad Española de Salud Pública y Administración Sanitaria, vol. 25, no. 3. Sociedad Española de Salud Pública y Administración Sanitaria, SESPAS, pp. 191-197, 2011.
 
[24]  L. H. Aiken, D. M. Sloane, L. Bruyneel, K. Van den Heede, and W. Sermeus, “Nurses’ reports of working conditions and hospital quality of care in 12 countries in Europe.,” Int. J. Nurs. Stud., vol. 50, no. 2, pp. 143-53, Feb. 2013.
 
[25]  “The Baccalaureate Degree in Nursing as Minimal Preparation for Professional Practice,” American Association of Colleges of Nursing, 2000. [Online]. Available: http://www.aacn.nche.edu/publications/position/bacc-degree-prep. [Accessed: 24-Nov-2014].
 
[26]  W. Sermeus, L. H. Aiken, K. Van den Heede, A. M. Rafferty, P. Griffiths, M. T. Moreno-Casbas, R. Busse, R. Lindqvist, A. P. Scott, L. Bruyneel, T. Brzostek, J. Kinnunen, M. Schubert, L. Schoonhoven, and D. Zikos, “Nurse forecasting in Europe (RN4CAST): Rationale, design and methodology.,” BMC Nurs., vol. 10, p. 6, Jan. 2011.
 
[27]  L. Bruyneel, K. Van den Heede, L. Diya, L. Aiken, and W. Sermeus, “Predictive validity of the International Hospital Outcomes Study questionnaire: an RN4CAST pilot study.,” J. Nurs. Scholarsh., vol. 41, no. 2, pp. 202-10, Jan. 2009.
 
[28]  L. H. Aiken, S. P. Clarke, R. B. Cheung, D. M. Sloane, and J. H. Silber, “Educational levels of hospital nurses and surgical patient mortality.,” JAMA, vol. 290, no. 12, pp. 1617-23, Sep. 2003.
 
[29]  M. A. Blegen, T. E. Vaughn, and C. J. Goode, “Nurse experience and education: effect on quality of care.,” J. Nurs. Adm., vol. 31, no. 1, pp. 33-9, Jan. 2001.