Benner's Theory Research Articles

Self‐appropriation in nurse engagement: Facilitating the development of expert nurses using Benner and Lonergan

AbstractExpert nurses, as described by the work of Patricia Benner, are at the peak of clinical nursing practice and vitally important in ensuring the best possible patient care and clinical outcomes. The development of Benner's theory and its relationship with the Dreyfus model of skill acquisition provides context for understanding the progression necessary for expert development. Contemporary healthcare challenges present implications to the development of advancing levels of nursing practice. Engagement has been identified as critical to achieving expert practice. I propose the incorporation of the philosophical framework of self‐appropriation from Benard Lonergan as a strategy to develop internal engagement in nurses to facilitate expert practice. I outline the synergy between Benner's theory and the work of Lonergan, which provide overlap and opportunity to overcome barriers to developing expert nursing practice. In the challenging climate of healthcare, there is an obligation to promote engagement and facilitate expert nurse development, necessary for patient outcomes as well as clinical role models, preceptors, and leaders to guide future nurses.

PENERAPAN DAN ANALISIS PHYLOSOPHICAL THEORY PATRICIA BANNER “NOVICE TO EXPERT” PADA ASUHAN KEPERAWATAN CHF

Congestive Heart Failure (CHF) is the inability of the heart to maintain adequate cardiac output to meet metabolic and oxygen needs in the tissues despite adequate venous return, with signs and symptoms of shortness of breath and fatigue caused by abnormalities in the function of the heart structure. Patricia Benner's theory explains that practitioner knowledge produces new ideas in scientific disciplines. By using appropriate operational and theoretical terms to define the concepts in the theory. The theory developed by Patricia Benner has 5 levels "Novice, Advanced Beginner, Competen, Proficience, Expert" which describes the main levels of experience for each practitioner. Objective: to find out the application of Patricia Benner's theoretical concepts in nursing care. Method: nursing process approach using Patricia Benner's nursing theory model, data collection technique namely case study. Results: The Benner model places nurses according to their level of expertise from Novice nurses who carry out assessments and formulate diagnoses through the guidance of Advanced Begginer nurses. Begginer intervenes according to the level of dependency. Results and implementation criteria are determined by Competent nurses, the success of the intervention according to the evaluation is carried out by Proficient nurses. As a consultation for nurses and families, it is carried out by expert nurses. Conclusion: Achieving success in nursing care, especially for patients with CHF, can be determined by the level of expertise of the nurse providing care.

Utilizing GPT 4.0 with prompt learning in nursing education: A case study approach based on Benner's theory

BackgroundArtificial intelligence (AI) and large language models, such as ChatGPT, have the potential to enhance nursing education by serving as a virtual mentor who can provide real-time guidance and resources. However, integrating AI chatbots into nursing necessitates a detailed understanding of how to align these technologies with established nursing theories. AimTo develop guidelines on how to employ GPT 4.0 using the prompt learning method. MethodsIn the method of prompt learning, users give specific prompts, and the AI model reacts according to its training, specifically aligned with the progression of knowledge and skills in nursing education as outlined by Benner's theory. This study used a case study methodology. ResultsThe customization of a conversational AI chatbot is shown to support the development of nursing knowledge and skills. This paper outlines how to integrate Benner's theory with ChatGPT's capabilities, addresses bias issues, and establishes best practices for the safe and effective use of AI in nursing. ConclusionThe findings have important implications for the advancement of nursing education and the safe and responsible use of AI tools in clinical environments.

Mentorship Education for Advanced Practice Registered Nurses.

Background: Mentorship is a vital part of the nursing profession. The evidence suggests that competent mentors aid in facilitating role transitions, improving job satisfaction, enhancing patient care, and decreasing nursing turnover. Advanced practice registered nurses (APRNs) have the skills and knowledge to provide safe, high-quality, patient-centered care; however, they may be lacking in mentorship abilities. Objective: Currently, there is no formal mentorship training in the organization, which may cause variability in the mentoring of new staff. The focus of this project was to create a staff educational intervention to improve the mentoring competency of surgical APRNs. The knowledge gap, lack of mentoring education given to APRNs acting as mentors to novice practitioners, was noted, and this project identified a staff educational intervention on mentorship training that was developed and implemented. Methods: The project practice-focused question asked if a formal APRN mentorship training program geared toward the six elements of mentoring (as measured by the Mentoring Competency Assessment [MCA]) increased the mentoring competency of APRNs serving in a mentorship role. Benner's theory guided the planning and development of this project, while the MCA was used for the self-reflection survey. Following a pretest survey, participants experienced an educational intervention geared toward mentoring and mentoring competencies. Formal APRN mentorship training program with an educational intervention that addressed the six domains of mentoring competency geared toward increasing the mentoring competency of APRNs who serve in a mentorship role. Results: A total of 18 surgical APRNs (N = 18) with more than 2 years of experience participated in the staff educational intervention. There was a statistically significant difference in six of the 26 individual items and in the overall pretest mean scores and the posttest mean scores (z = -3.41, p < .01), indicating that the APRN mentorship training increased the mentoring competency of the APRNs. Conclusion: The results of this quality improvement project demonstrated how an educational intervention geared toward mentoring competencies can increase the knowledge among a group of APRNs. Educating APRNs in mentorship competencies may enhance mentorship abilities and result in positive patient and organizational outcomes. Implications for Nursing: Educating APRNs in mentorship competencies may enhance mentorship abilities and result in positive patient and organizational outcomes.

Is the Triage System Welcomed in the Tertiary Hospital of the Limpopo Province? A Qualitative Study on Patient's Perceptions.

A triage system in the emergency department is necessary to prioritize and allocate scarce health resources to the medical needs of the patients to facilitate quality health service delivery. This paper aimed to ascertain if the triage system is welcomed in the tertiary hospital of Limpopo Province by exploring patients' perceptions in the emergency department in South Africa. A qualitative research approach was used in this study with descriptive, explorative, and contextual research design to reach the research objective. Purposive sampling was used to select the patients who participated in semi-structured one-on-one interviews, which lasted between 30 and 45 min. The sample size was determined by data saturation after 14 participants were interviewed. A narrative qualitative analysis method was used to interpret and categorize the patients' perceptions into seven domains of Benner's theory. The six relevant domains illustrated mixed patients' perceptions regarding the triage system in the emergency departments. The domain-helping role of the triage system was overweighed by the dissatisfaction of the needy patients who waited for an extended period to receive emergency services. We conclude that the triage system at the selected tertiary hospital is not welcomed due to its disorganization and patient-related factors in the emergency departments. The findings of this paper are a point of reference for reinforcing the triage practice and improved quality service delivery by the emergency department healthcare professionals and the department of health policymakers. Furthermore, the authors propose that the seven domains of Benner's theory can serve as a foundation for research and improving triage practice within emergency departments.

A ladder that matters: Conceptual development of a clinical ladder program for nurse practitioners and physician assistants.

Clinical ladders are professional enhancement models that encourage and reward participants for continued professional engagement and leadership development. They have the potential to affect patient care through improved provider retention, advanced and refined clinical skills, and increased engagement. Recent literature has demonstrated development and implementation of clinical ladder models for nurse practitioners (NPs) in the acute care setting. A free standing pediatric academic hospital in Florida identified the need for such a program for nurse practitioners and given its increased utilization of physician assistants, these providers were also targeted for inclusion. This new clinical ladder included development strategies appropriate and attainable for both NP and PA scopes of practice. Consistent with Benner's theory of novice to expert (1982), each advancing rung in the ladder contains more stringent criteria and additional competencies demonstrating increased engagement, learning, and leadership. As this was a development project only, future directions for the new model include implementation and evaluation of various metrics including nurse practitioner and physician assistant retention and satisfaction. This model has laid the foundation for ladder development for additional health care professions within the institution.

Development and psychometric properties of the Therapeutic Relationship Assessment Scale-Nurse.

WHAT IS KNOWN ON THE SUBJECT?: The literature shows a clear relationship between a good therapeutic relationship (TR) and the efficacy of nursing interventions. For the implementation of nursing psychotherapeutic interventions, the initial establishment of a good TR is essential. Several instruments assess the relationship established between the therapist and the patient in psychotherapy. However, no tool has been found to assess the quality of the TR established between the nurse and the patient. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This study allowed the development and evaluation of the psychometric properties of a scale to assess the TR between the nurse and the patient in a sample of mental health nurses. The developed scale (Therapeutic Relationship Assessment Scale-Nurse) has psychometric properties that attest its reliability (internal consistency and test-retest) and construct validity as an instrument to assess the quality of the TR established between the nurse and the patient from the nurse's perspective. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: As the TR is crucial for providing nursing care and, in particular, for implementing nursing psychotherapeutic interventions, the scale developed is a valid tool to assess the quality of the TR established between the nurse and the patient in the perspective of the mental health nurse. The use of instruments to assess the quality of the nurse-patient TR facilitates the identification of the relationship's gaps, which can serve as a basis for improving the relationship itself and the nursing care provision. ABSTRACT: Introduction The therapeutic relationship (TR) is essential to providing psychiatric and mental health nursing care. Nevertheless, no assessment tools exclusive for assessing nursing TR were found in the literature. Aim To describe and evaluate the psychometric properties (reliability and construct validity) of a scale that allows assessing the quality of TR established between the nurse and the patient. Method A survey method was adopted, using a convenience sample of 356 mental health nurses. Internal consistency was assessed by Cronbach's alpha and Omega index. Results A total of 221 mental health nurses participated in the study (response rate=62.08%). The scale's final structure has 25 items. Cronbach's alpha was 0.93, ranging from 0.78 to 0.88 for each of the factors. The cumulative variance explained in a four-factor structure was 71.12%. Discussion The Therapeutic Relationship Assessment Scale (TRAS)-Nurse presents good psychometric properties. In the light of Benner's theory, it can be an useful tool for novice nurses to better understand what aspects they should pay attention to for establishing a successful TR. Implications for Practice Mental health nurses can use the TRAS-Nurse, thus having a scale available that allows them to self-assess the quality of TR they establish with their patients.

A strengths, weaknesses, opportunities, and threats analysis- A study of Association of Community/Public Health Nursing Educators members.

Aims of this study were to identify the Association of Community/Public Health Nursing Educators members' demographics, educational preparation, and research competencies; and, to complete a strengths, weaknesses, opportunities, and threats (SWOT) analysis. A descriptive-correlational design was employed. Primary data collection was via electronic survey. Authors developed a survey focusing on demographics and aligning Benner's theory with research skills/experience. SWOT and gap analyses were performed. A 27.2% response rate (N=352) revealed a lack of diversity among 70% doctorally prepared membership, perceived competence with interprofessional collaboration (80%), and applying research to practice (80%). Doctorally prepared members reported experience using longitudinal designs (p=.05). PhD-prepared members reported experience using psychometrics and evaluations (p=.05). SWOT revealed a lack of service engagement. Gap analysis offered solutions to execute strategic goals. Association of Community/Public Health Nursing Educators may enhance future direction by advancing member diversity, professional development, collaborative scholarship, and mentoring.

Providing Palliative Care: Oncology Nurses' Perceptions of Their Self-Reported Abilities.

Oncology nurses are pivotal in the provision of primary palliative care. However, nurses working in oncology settings, where the goal is often curative, may lack knowledge about and comfort in providing palliative care. The purpose of this study is to determine how oncology nurses perceive their ability to provide palliative care services to patients and their families. Using Benner's theory of skill acquisition as a basis for self-evaluation, this cross-sectional, descriptive pilot study surveyed oncology nurses. All participants reported ranges from capable to very capable in ability to provide precepts of palliative care. Results showed a small but statistically significant association between years of experience and perceived ability to honor patient and family preferences, provide patient and family support, appreciate demands placed on families, and provide supportive services to caregivers.

Application of nursing clinical ladder program based on Benner theory in nurses′ stratified training

Objective To explore the effect of advanced hierarchical training based on Benner theory on nurses' core competence and post competency. Methods A total of 499 nurses were selected to participat in the training from January 2016 to December 2017. They were divided into before-training group and after-training group, the training method was based on the advanced hierarchical training model of energy level under the guidance of Benner′s theory.The nurse′s core competence, post competency, and nursing satisfaction were compared. Results The ratings of nurses′ critical thinking and research, clinical nursing, ethics and legal practice, professional development and education consultation (34.21±4.56), (30.12±5.25), (27.12±5.24), (25.46±4.52), (26.24±4.21), (20.21±3.56), (23.12±5.24) points in after-training group were significantly higher than in before-training group (28.36±4.12), (26.45±4.52), (26.72±4.52), (25.12±4.12), (24.50±3.25), (18.65±3.12), (20.24±4.65) points (t=7.308-21.264, P<0.05 or 0.01). The scores of nurses' professional knowledge, professional skills, professional ability, and overall quality (72.32±9.21),(93.24±12.35), (43.34±4.12), (54.20±4.23) points were significantly higher than before training (68.25±8.32), (86.42±10.21), (41.05±5.24), (52.12±5.25) points (t=6.892-9.507, P<0.05 or 0.01), and patient satisfaction 92.67%(12 164/13 126) was significantly higher than before training 88.68% (11 106/12 524) (χ2=121.409, P<0.01). Conclusion The advanced level-stratified training model based on Benner theory is helpful to promote the development of nurses′ core competence and post competency, and improve patient satisfaction. Key words: Nursing management; Advanced level; Stratified training; Core competencies; Post competency

Self-Evaluation of Nurses Clinical Competency Based on Benner Theory

Self-Evaluation of Nurses Clinical Competency Based on Benner Theory

Relationship between the use of intuition in clinical practice and the clinical competence of critical care nurses.

Clinical competency has been the main focus of nurse educational systems. To further it, the concept of intuition was introduced into nursing in the 1970s. Benner's theory proposed that greater use of intuition was linked to higher clinical competence; however, there is still a paucity of data to verify this theory. Therefore, the current study was conducted to assess the relationship between the use of intuition in clinical practice and the clinical competence of critical care nurses. In this correlational study, 88 critical care nurses were recruited as convenience. The tools included a 'use of intuition in clinical practice' scale devised by the researcher, and a 'clinical competence' instrument. The gathered data were analyzed by SPSS version 20.0 software, using descriptive and inferential statistics. Of the 88 participants, 73.9% were women and 93.2% were at undergraduate level. The mean and standard deviation of participants' age and work experience was 32.29 ± 6.75 and 7.40 ± 5.68 years, respectively. The Pearson correlation test revealed no significant connection between the use of intuition in clinical practice and the clinical competence of critical care nurses (r = 0.091, P = 0.398), and produced similar results from the various demographic groups (P > 0.05). In this study, no significant correlation between the use of intuition and clinical competence in critical care nurses was found. This could be attributed to intuition as a nursing skill being almost excluded from the educational curriculum of nursing schools, and some background factors.

Education: The Impact of Mock Code Simulations in Pediatrics

Background: Mock code simulation is an area of practice that is growing throughout health care. Numerous references support the validity of this method of education. However, what is lacking in these references is the effect mock codes have on nurses. Objective of Study: This project was conducted in a freestanding children's hospital in a PICU (pediatric intensive care unit). The facilitator aspired to learn the effect of interventions that measure teamwork, confidence, and comfort level among nurses. Methodology: Inthisprojectthenursesweregivenapretestandposttest to evaluate their attitudes and comfort level for different aspects of a code. Answers on the pretest were compared to posttest answers following the mock code simulation. Questions included comfort level with drawing up code medications, performing compressions, administering medications, documentation, debriefing, MD-RN communication, RN to RN communication, one MD leading a code, overall comfort in a code and mock codes help with real-life codes. Framework/Model: Patricia Benner's theory on novice to expert lays the foundation for moving nurses effectively through mock code scenarios by providing firsthand experience with high-risk situations. The objective in a mock code is to move a nurse further along this model towards an expert nurse.

Evidence-based Practice: Prep for Success: How to Best Prepare Skin Before Capillary Blood Glucose Checks

Background: Mock code simulation is an area of practice that is growing throughout health care. Numerous references support the validity of this method of education. However, what is lacking in these references is the effect mock codes have on nurses. Objective of Study: This project was conducted in a freestanding children's hospital in a PICU (pediatric intensive care unit). The facilitator aspired to learn the effect of interventions that measure teamwork, confidence, and comfort level among nurses. Methodology: In this project the nurses were given a pretest and posttest to evaluate their attitudes and comfort level for different aspects of a code. Answers on the pretest were compared to posttest answers following the mock code simulation. Questions included comfort level with drawing up code medications, performing compressions, administering medications, documentation, debriefing, MD-RN communication, RN to RN communication, one MD leading a code, overall comfort in a code and mock codes help with real-life codes. Framework/Model: Patricia Benner's theory on novice to expert lays the foundation for moving nurses effectively through mock code scenarios by providing firsthand experience with high-risk situations. The objective in a mock code is to move a nurse further along this model towards an expert nurse. Results: The findings of this study hold promise that pediatric mock code simulation increases the overall comfort level of registered nurses. There was statistical significance (pb0.05) in two areas that were surveyed. • Nurse confidence in drawing up medications during a code • Nurse perceptions that mock code experiences help with reallife codes Conclusion: Pediatric mock code simulation is an effective tool to utilize in the pediatric setting. Teamwork, collaboration and communication are positively affected by code proficiencies. Simulation is an area to practice safe nursing skills and increases nurses comfort and confidence in reallife situations. View a PDF of this poster presentation at http://www.pedsnurses.org/d/ do/855. http://dx.doi.org/10.1016/j.pedn.2015.06.018 Evidence-based Practice: Prep for Success: How to Best Prepare Skin Before Capillary Blood Glucose Checks Ruth Jacobson BSN, RN, Sanje Woodsorrel BSN, RN Children's Hospital Los Angeles Abstract Practice Problem:Many inpatient pediatric patients require capillary blood glucose measurements to appropriately monitor glucose levels and allow for prompt response if needed. Variations in site preparation and collection of the sample may interfere with the accuracy of these findings and potentially result in under or overdosing of insulin or glucose, as well as increased pain and risk of infection for the patient. Purpose: What is the best practice for site preparation during point of care glucometer use?Practice Problem:Many inpatient pediatric patients require capillary blood glucose measurements to appropriately monitor glucose levels and allow for prompt response if needed. Variations in site preparation and collection of the sample may interfere with the accuracy of these findings and potentially result in under or overdosing of insulin or glucose, as well as increased pain and risk of infection for the patient. Purpose: What is the best practice for site preparation during point of care glucometer use? Summary of Literature: Variation was noted in policy between hospitals in the Los Angeles area, and evidence-based research on best practices to promote accurate measurements was examined using the Johns Hopkins Nursing Evidence-Based Practice Model: Diabetes educators were consulted. Hospital policy on glucometer use, as well as glucometer user manuals was reviewed. Additionally, variation in results between first and second drops of blood was compared. Finally, an informal study was conducted to determine any variation in results based on site preparation. Outcomes: Current research recommends washing the hands with soap and water and thoroughly drying for the most accurate glucometer readings. Use of alcohol wipes prior to lancing has 812 Selected Abstracts from the 2015 SPN Conference

Survival Skills in Emergency Nursing Orientation

Orienting new nurses to the emergency department is expensive, time-consuming, and stressful. It is stressful for both the new nurse and the preceptor or educator tasked with guiding the new nurse through this transformation. Many orientation programs incorporate Patricia Benner's theory “from novice to expert.” According to this theory, the newly orienting nurse would be classified as an advanced beginner.1 One of the key challenges advanced beginners face is a lack of nursing instinct that can only come from experience.

Interactional nursing – a practice‐theory in the dynamic field between the natural, human and social sciences

Nursing is often described from the point of view of either the natural or the human sciences. In contrast to this, the value foundation in Interactional nursing practice is understood from the point of view of the natural sciences as well as that of the human and social sciences. This article presents many-faceted practice-theory of nursing, which is situated in the dynamic field between these three sciences. The focus of the theory is on interaction and practice resulting in a caring practice. Here practice is based on Taylor's and MacIntyre's interpretation of this concept. Action in nursing is based on Habermas' three varied modes of action seen in the light of an understanding of the world as a system world and a life world. Nursing as an interactional practice-theory is presented with examples of interpretative nursing science, seen in the ethical action-oriented, socio-cultural framework of Taylor and Habermas. It is concluded that phenomenologic and socio-cultural research into caring practice as well as an in-depth, comprehensive interpretation of nursing practice are both highly suited to forming the fundamental theoretical framework in nursing, here seen as an interpretative nursing science. Finally, a comparison is drawn between Interactional nursing practice and Benner's theory of nursing practice.

Towards an alternative to Benner's theory of expert intuition in nursing: A discussion paper

Several authors have highlighted the role of intuition in expertise. In particular, a large amount of data has been collected about intuition in expert nursing, and intuition plays an important role in the influential theory of nursing expertise developed by Benner [1984. From Novice to Expert: Excellence and Power in Clinical Nursing Practice. Addison–Wesley, Menlo Park, CA]. We discuss this theory, and highlight both data that support it and data that challenge it. Based on this assessment, we propose a new theory of nursing expertise and intuition, which emphasizes how perception and conscious problem solving are intimately related. In the discussion, we propose that this theory opens new avenues of enquiry for research into nursing expertise.

Benner's Novice to Expert Nursing Theory Applied to the Implementation of Laptops in the Home Care Setting

Recent technological advances make it possible for nurses working in home health to record patient information on a variety of devices, such as laptop computers. There are now many implementation guides and corporate briefs available that concern bottom-line issues such as productivity and back-office cost reduction. Even though nurses generally are recognized for being innovative and willing to accept new challenges in order to improve patient care, no one asks how these changes are affecting nurses' self-perceptions about their expertise. Benner's theory, Novice to Expert, is utilized here to explore and establish expectations for both staff and administration.