Abstract
AimThis study aimed to assess (a) nurses' knowledge and their attitude towards the Advanced Nursing Process—nursing assessment, diagnoses, interventions, outcomes, (b) the quality of the Advanced Nursing Process and (c) relationships with patient characteristics.DesignA cross‐sectional, descriptive correlational study was performed.MethodsNinety‐two registered nurses and ninety nursing records of six hospital wards were included. In January 2016, a knowledge test, a self‐assessment tool for measuring nurses' attitude (PND) and the Quality of Diagnoses, Interventions and Outcomes Revised instrument (Q‐DIO R) were applied. The correlations between nurses' knowledge, attitude, patient characteristics, organizational factors and the Advanced Nursing Process quality were investigated.ResultsNurses demonstrated low levels of knowledge, positive attitudes and an average Advanced Nursing Process quality. Accurate nursing diagnoses were strong and highly significantly related to effective nursing interventions and better nursing‐sensitive patient outcomes. A higher proportion of registered nurses was related to better nursing outcomes.
Highlights
Patients benefit from the Advanced Nursing Process: By its use, nurs‐ ing interventions were more effective, better nursing outcomes were reached, patients felt more comfortable and patient safety increased (Müller‐Staub, Needham, Odenbreit, Lavin, & Achterberg, 2008; Pèrez Rivas et al, 2016)
It consists of valid assessment tools and on defined, valid concepts of nursing diagnoses (NDs), nursing interventions and nursing outcomes “that are rooted in scientifically based nursing classifications” (Müller‐Staub, Abt, Brenner, & Hofer, 2015, p. 13)
The accuracy of NDs relies on the PES format and is the ini‐ tial point for choosing effective nursing interventions and outcomes showing the effectiveness of interventions
Summary
Patients benefit from the Advanced Nursing Process: By its use, nurs‐ ing interventions were more effective, better nursing outcomes were reached, patients felt more comfortable and patient safety increased (Müller‐Staub, Needham, Odenbreit, Lavin, & Achterberg, 2008; Pèrez Rivas et al, 2016). Nurses' attitude towards the Advanced Nursing Process is often am‐ bivalent or negative (Romero‐Sànchez et al, 2013) and organizational factors like bed occupancy rate, skill‐ and grade‐mix and length of stay (LOS) are hindering its implementation (Conrad, Hanson, Hasenau, & Stocker‐Schneider, 2012). This is supplemented by increasing num‐ bers of elderly, multimorbid patients with complex care needs and a simultaneous trend towards hiring fewer registered nurses (RNs) and higher staff turnovers (Buchan, Shaffer, & Catton, 2018). Studies fo‐ cusing on all these relationships with the entire Advanced Nursing Process—nursing assessment, diagnoses, interventions and out‐ comes—are missing
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