临床护士早期判断患者病情恶化能力的构成要素分析

doi:10.3761/j.issn.0254-1769.2025.23.012

摘要/Abstract

摘要：

目的探讨临床护士早期判断患者病情恶化能力的构成要素，为后续构建科学的能力评价体系、制订干预措施提供参考。方法基于临床判断模型，采用描述性质性研究方法，通过目的抽样法于2025年2—3月选取天津市2所三级甲等医院的22名临床护士进行半结构式访谈，运用内容分析法归纳、分析和提炼主题。结果共提炼出4个主题、11个亚主题。①问题注意能力，包括信息收集能力、敏锐的洞察能力、风险识别能力、直觉感知能力；②病情分析能力，包括知识运用能力、鉴别诊断能力；③应急反应能力，包括信息传递能力、组织协调能力、应急抗压能力；④反思提升能力，包括经验总结能力、持续学习能力。结论临床护士需要具备多方面的能力才能早期判断患者病情恶化。护理管理者应重视上述能力的培养，提升护士早期判断患者病情恶化的准确性，同时应以能力要素为导向优化护理资源配置，提高护理质量。

关键词: 病情恶化, 判断能力, 护士, 质性研究, 护理管理研究

Abstract:

Objective To explore the components of clinical nurses’ ability to early judge the deterioration of patients’ conditions，providing a reference for the subsequent construction of a scientific ability evaluation system and the formulation of intervention measures. Methods Based on the Clinical Judgment Model，a descriptive qualitative research method was adopted. Using purposive sampling，22 clinical nurses from 2 tertiary grade A hospitals in Tianjin were selected for semi-structured interviews between February and March 2025. Content analysis was used to summarize，analyze，and extract themes. Results A total of 4 themes and 11 sub-themes were identified.①Problem awareness ability，including information collection ability，keen insight ability，risk identification ability，and intuitive perception ability.②Disease analysis ability，including knowledge application ability and differential diagnosis ability.③Emergency response ability，including information transmission ability，organizational coordination ability，and emergency stress resistance ability.④Reflection and improvement ability，including experience summarization ability and continuous learning ability. Conclusion Clinical nurses need to possess multiple abilities to assess the deterioration of a patient’s condition at an early stage. Nursing managers should prioritize the development of these skills to enhance nurses’ ability to accurately assess the deterioration of a patient’s condition at an early stage. Additionally，they should optimize the allocation of nursing resources based on these skill requirements to improve the quality of nursing care.

Key words: Clinical Deterioration, Judgment Ability, Nurse, Qualitative Research, Nursing Administration Research

刘俊玲, 赵英楠, 郑鑫彤, 魏肖倩, 李冰, 吴泓悦, 王紫丹, 李燕. 临床护士早期判断患者病情恶化能力的构成要素分析[J]. 中华护理杂志, 2025, 60(23): 2901-2907.

LIU Junling, ZHAO Yingnan, ZHENG Xintong, WEI Xiaoqian, LI Bing, WU Hongyue, WANG Zidan, LI Yan. Analysis of the components of clinical nurses’ ability to judge early deterioration of patient condition[J]. Chinese Journal of Nursing, 2025, 60(23): 2901-2907.

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