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名を対象に,臨床判断について患者を捉える視点や印象に残っている場面等について半構成的面接を実施し,質的記述的に分析した.\n結果 ICU 中堅看護師の臨床判断は,【ガイドラインと経験に基づく患者の生命維持のための準備と対応】【危機的状況における徴候や症状が示す意味を洞察】【周囲の状況把握をしながら看護援助の優先度を見極めた対応】【患者の意思が優先されない状況に対する葛藤の中での対応】であった.\n考察 ICU 中堅看護師の臨床判断の特徴は,入院から退院までの経時的変化の中で,患者個々の状況を捉えて判断している一般病棟の中堅看護師とは異なり,断片的で限られた情報下の中で,即時的に異常の早期発見と生命維持に向けた治療処置を担いながら対応していることである.その一方で,熟練看護師のような豊富な経験を有しておらず,治療やケアに確信が持てないために,迷いや葛藤を抱きながらの対応をしていた.これらは,患者の生命維持と看護師としての倫理観や看護観とを照らし合わせながら臨床判断を実践している状況が考えられた.\n\nPurpose To identify the characteristics of clinical judgment practiced by mid-career nurses with 3-5 years of ICU experience.\nMethod Five mid-career nurses with three to five years of ICU experience participated in semi-constructive interviews about their perspectives on patients and memorable situations,and their clinical judgment was analyzed qualitatively and descriptively.\nResults The clinical judgement of ICU mid-level nurses were “preparation and response to sustain patient life based on guidelines and experience,” “insight into 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ICU 中堅看護師の臨床判断の特徴 ─ ICU 経験3~5年目の中堅看護師の看護実践に着目して─
https://doi.org/10.34359/00001401
https://doi.org/10.34359/0000140147bb5525-9ab0-4c7e-9da8-f34e7c039de6
名前 / ファイル | ライセンス | アクション |
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2023_12_75-84 (1.2 MB)
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Item type | 紀要論文 / Departmental Bulletin Paper(1) | |||||
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公開日 | 2023-06-02 | |||||
タイトル | ||||||
タイトル | ICU 中堅看護師の臨床判断の特徴 ─ ICU 経験3~5年目の中堅看護師の看護実践に着目して─ | |||||
タイトル | ||||||
言語 | en | |||||
タイトル | Characteristics of Clinical Judgement of ICU Mid-Career Nurses: Focusing on the Nursing Practice of Mid-Career Nurses With 3-5 Years of ICU Experience | |||||
言語 | ||||||
言語 | jpn | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | ICU 中堅看護師|臨床判断|看護実践 | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | ICU mid-career nurses|clinical judgment|nursing practice | |||||
資源タイプ | ||||||
資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
資源タイプ | departmental bulletin paper | |||||
ID登録 | ||||||
ID登録 | 10.34359/00001401 | |||||
ID登録タイプ | JaLC | |||||
著者 |
馬場, 好恵
× 馬場, 好恵× Baba, Yoshie |
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抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | 目的 ICU 経験 3 ~ 5 年目の中堅看護師が実践している臨床判断の特徴を明らかにする. 方法 ICU 経験 3 ~ 5 年目の中堅看護師 5 名を対象に,臨床判断について患者を捉える視点や印象に残っている場面等について半構成的面接を実施し,質的記述的に分析した. 結果 ICU 中堅看護師の臨床判断は,【ガイドラインと経験に基づく患者の生命維持のための準備と対応】【危機的状況における徴候や症状が示す意味を洞察】【周囲の状況把握をしながら看護援助の優先度を見極めた対応】【患者の意思が優先されない状況に対する葛藤の中での対応】であった. 考察 ICU 中堅看護師の臨床判断の特徴は,入院から退院までの経時的変化の中で,患者個々の状況を捉えて判断している一般病棟の中堅看護師とは異なり,断片的で限られた情報下の中で,即時的に異常の早期発見と生命維持に向けた治療処置を担いながら対応していることである.その一方で,熟練看護師のような豊富な経験を有しておらず,治療やケアに確信が持てないために,迷いや葛藤を抱きながらの対応をしていた.これらは,患者の生命維持と看護師としての倫理観や看護観とを照らし合わせながら臨床判断を実践している状況が考えられた. Purpose To identify the characteristics of clinical judgment practiced by mid-career nurses with 3-5 years of ICU experience. Method Five mid-career nurses with three to five years of ICU experience participated in semi-constructive interviews about their perspectives on patients and memorable situations,and their clinical judgment was analyzed qualitatively and descriptively. Results The clinical judgement of ICU mid-level nurses were “preparation and response to sustain patient life based on guidelines and experience,” “insight into the meaning of signs and symptoms in a crisis situation,” “nursing interventions based on the judgement of priorities by assessing overall situations,” and “response to conflict in situations where patient wishes are not given priority.” Discussion In contrast with mid-level nurses in general wards,who make decisions based on an individual patient's situation from admission to discharge,ICU mid-level nurses make immediate decisions with limited information when detecting abnormalities and providing life-sustaining treatments.Nevertheless,they did not have the same wealth of experience as experienced nurses,and were unsure of the treatment and care.These were considered to be situations in which the nurses made clinical judgments while weighing the need to preserve the patient’s life against their ethical and nursing perspectives. |
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書誌情報 |
聖泉看護学研究 en : Seisen Journal of Nursing Studies 12 2023 巻 12, p. 75-84, 発行日 2023 |
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出版者 | ||||||
出版者 | 聖泉大学 看護学部 | |||||
ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 2187-1981 | |||||
書誌レコードID | ||||||
収録物識別子タイプ | NCID | |||||
収録物識別子 | AA12578604 | |||||
著者版フラグ | ||||||
出版タイプ | VoR | |||||
出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 |