Effekte von Guided Clinical Reasoning auf die Qualität des Advanced Nursing Process

Background: The correctly applied Advanced Nursing Process leads demonstrably to more accurate nursing diagnoses and better nursing outcomes. It requires nurses' knowledge, clinical decision-making competency, and a positive attitude. Former Guided Clinical Reasoning (GCR) trainings significantly enhanced the Advanced Nursing Process quality. However, the congruence between nursing records, care situations, and patient interviews was not yet investigated. Research question: Which effects has GCR on nurses' knowledge, attitude, clinical performance, and on the quality of the Advanced Nursing Process? Methods: An experimental intervention study was carried out from 2016 until 2018 in a Swiss hospital. The 5-month intervention contained four seminar days and GCR-case meetings and was investigated by an evaluation model (n = 95 nurses, n = 24 patients, n = 225 nursing records). Results: After GCR training, nurses showed greater knowledge (p < 0,0001) and a more positive attitude (p = 0,004) on the Advanced Nursing Process than the control group. The congruence of nursing diagnoses, interventions, and outcomes between observations, interviews, and nursing records was higher in the intervention group. At the last measurement point, nursing diagnoses were stated significantly more accurate, interventions were more effective, and better patient outcomes were achieved (all p < 0,0005). Conclusions: GCR trainings should be used to enhance the Advanced Nursing Process quality, so that based on more accurate nursing diagnoses better patient outcomes are achieved.