Exploration and prioritization of strategies to improve clinical reasoning skills among coronary care nurses: A qualitative study

Abstract

Introduction Clinical reasoning (CR) is the most important competency for safe and quality care delivery in coronary care unit (CCU). Nonetheless, evidence shows that nurses in CCU do not have the necessary CR skills to manage challenging situations and provide quality care in these units. Identifying the possible strategies for CR skill improvement is a key step in improving nurses' CR skills. Aim The aim of the study was to explore and prioritize strategies for CR skill improvement among nurses in CCU. Design A qualitative design was used. Methods This qualitative study was conducted in 2020 in the CCU of a subspecialty heart hospital. Participants were nurses, head nurses, nursing supervisors, nursing manager, clinical nursing instructors, and cardiologists. Initially, necessary data to identify strategies for CR skill improvement were collected through semistructured interviews with 16 participants and were analyzed through conventional content analysis. Then, the determined strategies were prioritized through quantitative scoring by 24 participants in three focus group discussions. The Suitability, Feasibility, and Flexibility matrix was used for scoring. Results The main three strategies of CR skill improvement were improvement of the efficiency of nursing education, effective management in nursing, and development of professional nursing. The mean scores of these categories in the possible range of 3–9 were 8.20, 8.04, and 7.83, respectively. Conclusion This study provides a firm scientific basis for strategies to improve CR skills among nurses in CCU. Strategies determined in the present study can be used to develop interventions to improve nurses' CR skills and promote strength‐based nursing.

Interprofessional Differences in Multidimensional Self-Efficacy Associated With Professional Performance in Nephrology During Case-Based Learning

“…Several studies pinpointed significant dimensions that nurses rated as most influential for cultivating their professional knowledge and skills; Hosseinzadeh et al. 45 reported that medical professional interaction and communication was an instrumental ability for achieving nursing competency and frequently coexisted with insufficient PSE. Better communication skills confer greater PSE among nurses, likely resulting from increased confidence in providing care and constructing positive interpersonal relationships with patients.…”

Psychometric properties of the persian version of the nursing clinical reasoning scale

“…CR skills development is facilitated by efficient nursing education, effective nursing management, and professional development of nursing (Hosseinzadeh et al., 2022 ). Evidence shows that CR skills development has significant relationship with the quality of nursing education, professional expertise of nursing instructors, and quality educational environments (Alfayoumi, 2019 ; Forsberg et al., 2014 ; Herron et al., 2016 ; Hunter & Arthur, 2016 ; Oostra et al., 2019 ; Yauri & Nash, 2019 ).…”

Suboptimal Knowledge and Care of Patients with Acute Coronary Syndrome Among Nurses Working in Selected Hospitals in Addis Ababa, Ethiopia 2021

“…11,13 However, several studies have shown that the knowledge and practice of nurses regarding ACS were inadequate. 14,15 It was demonstrated that nurses' knowledge and ability to correctly identify the diagnostic finding of patients with ACS was limited. 16,17 Another study conducted in Iran country revealed that nurses have poor knowledge and low critical thinking skills for managing serious conditions in emergency and critical care units.…”

“…16,17 Another study conducted in Iran country revealed that nurses have poor knowledge and low critical thinking skills for managing serious conditions in emergency and critical care units. 15 Some of the factors affecting nurses' knowledge and necessary practice in caring for patients with ACS include Socio-demographic characteristics such as age, work experience, working department, and educational level, 12,18 health system-related factors such as material resources, human resources, and in-service training, 19 poor knowledge in utilizing clinical guidelines 2 and health system-related barriers including lack of necessary diagnostic and treatment equipment. 20 Inadequate knowledge and poor practice of acute care nurses have a negative impact on patient outcomes.…”