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

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