2004 OPEN FORUM Abstracts
EARLY RECOGNITION AND CRITICAL THINKINGIN CLINICAL PRACTICE
Lynda T. Goodfellow, Ed.D. RRT and Ptlene Minick, Ph.D., RN Department of Cardiopulmonary
Care Sciences and School of
Nursing,
Georgia State University, Atlanta, GA USA.
One would believe that the greater the healthcare provider knowledge
and
expertise, the more positive the patient outcomes, yet there are
little data to
support this premise. The purpose of this study was to develop a
single
instrument
that would measure different aspects of clinical expertise in
registered
nurses (RNs) and respiratory therapists (RTs). In a pilot project,
two
previously tested instruments were combined to captures skill
elements
needed by
both RNs and RTs in critical care areas. A descriptive correla-tional
comparative research design was used. The sample consisted of RTs
and RNs in
critical care areas who provide direct patient care for at least 50%
of their
day-to-day assignment. All RNs enrolled in a graduate nursing course
and all RTs
on a respiratory therapy alumni list were invited to participate.
IRB approval
was obtained. The number of cases analyzed was 161.
Reliability
coefficients for early recognition and critical thinking behaviors
are as
follows:
Construct RN RRT
Early recognition (full scale) .85 .86
Knowing the patient .83 .87
Knowing the self .60 .61
Knowing the institution .67 .65
Critical thinking (full scale) .88 .95
Prioritizing .91 .91
Trouble shooting .82 .83
Reflecting .79 .79
Communicating .73 .83
Anticipating .78 .66
Negotiating .37 .87
Decision making .72 .77
The combined instrument appears to be a stable instrument. This
initial pilot
study provides the basis for further study of exploring the
relationship between
clinical expertise of the healthcare employee to better outcomes for
the
patient.