特定行為研修を修了した看護師が認識する看護実践の変化

Changes in Nursing Practice Recognized by Nurses Who Have Completed the Training for the Tokutei Acts

要旨

　目的：ジェネラリスト看護師が特定行為研修を修了したことによって，医療チームの中で自らの看護実践がどのように変化したと認識しているかを明らかにする．

　方法：研究参加者10名に半構造化面接を行い，質的記述的に分析した．

　結果：データ分析の結果，【医学的な推論や判断ができるようになる】【フィジカルアセスメントを行う視点が広がる】【診断や治療に踏み込んだ発言ができるようになる】【特定行為が行えるからこその提案を医師にできるようになる】【特定行為が行えるからこそ提供できるケアが増える】等の7カテゴリーを抽出した．

　結論：研究参加者は特定行為研修を修了し，診断プロセスについての知識を習得したり，特定行為を行えるようになったことで，これまでできなかった医師への提案やケアが行えるようになったと認識していた．看護実践の変化として語られた内容が，療養上の世話の視点からのサービス提供とどのように関連づけられていたのかを明らかにすることが，今後の課題と考える．

　Objective: We aimed to identify the awareness among nurses regarding how their nursing practice in their medical team changed after completing the Training for the Tokutei Acts.

　Methods: We conducted a semi-structured interview with ten study participants and analyzed the data using a qualitative descriptive method.

　Results: Our analysis of data extracted seven categories, including the following: (1) Being able to exercise medical reasoning and judgement; (2) Performing physical assessment from a wider perspective; (3) Expressing in-depth opinions about diagnosis and treatment; (4) Providing suggestions to physicians made possible after completing the training to perform Tokutei Acts; and (5) Increasing the types of care that can be provided because of completing the training to perform Tokutei Acts.

　Conclusions: After completion of the Training for the Tokutei Acts, which gave trainees knowledge about diagnostic processes and qualified them to perform Tokutei Acts, they became aware that they could make suggestions to physicians and provide expanded care, which they had been unable to do prior to the training. Our future challenge is to clarify how such changes in nursing practice mentioned by trainees were associated with their service provision from a medical care viewpoint.