看護師のクリニカル・ラダーに対する認識 : 第一報

Abstract

目的 クリニカル・ラダーは、看護師のキャリア開発支援の一方法として開発・導入されている。また看護師個々の臨床実践能力や学習ニードに適した継続教育を行うための有用なツールであるといえる。しかし、ラダーの有効性の実証は未だ十分とは言えない。よって本研究は看護師のラダーに対する認識を明らかにすることを目的に、質的記述的な分析を行った。方法 クリニカル・ラダーを採用している公立総合病院に勤務し、ラダーに登録している看護師を対象に、「クリニカル・ラダーの良いところについて」無記名で自由記述を依頼した。倫理的配慮として、研究対象者には書面において研究の趣旨などを含む6項目について説明を行った上で、対象者の自由な判断に基づいて、研究に同意するか辞退するかを決定できることを保証した。尚、質問紙調査の回答が返信されたことを研究への同意とした。結果 回答者の平均年齢は27.3(SD±4.9)歳で、クリニカル・ラダーのレベルの構成は、レベルI36名、レベルII75名、レベルIII63名、レベルIV95名であった。記述内容から126コード、16サブカテゴリー、5カテゴリーが抽出された。結論 看護師は、クリニカル・ラダーを【客観的評価基準】であると認識していた。その評価結果によって【自己の課題・目標・役割の明確化】ができたり、継続教育では【個々に応じたステップ】ができると捉えていた。さらに、クリニカル・ラダーは【モチベーションの向上】につながることから、看護師一人ひとりの臨床実践能力が向上するため、組織全体で【質の高い看護の提供】が可能になると認識していると考えられた。

Aims Clinical ladder has been introduced and developed as one of the support system for nursing career development in clinical settings. It can be said that the clinical ladder is one of the useful tools for the continuous education system that is suitable for nurses' abilities in practice and satisfied their educational needs. However, the effectiveness of the clinical ladder has not been proved fully yet. Therefore, the purpose of this qualitative study is to clarify nurses' recognition of the clinical ladder. Methods Nurses worked in public general hospitals, which had introduced clinical ladder, were recruited in this study. They were asked to describe freely about the good aspects of clinical ladder. Ethical consideration The participants had an explanation with information sheets about important point of this study including the purpose of this study and the nature of their involvement. It was also explained that their participation in the study was entirely voluntary and they had the right to withdraw from the study at any time. It was judged that participants agreed with the study when the researcher received their reply in writing. Result The average age of the participants was 27.3(SD±4.9), and it was found that 36 nurse participants were in level I, 75 were in level II, 63 were in level III, and 95 nurses were in level IV, according to the clinical ladder. 5 core categories, 16 sub-categories and 126 codes were revealed as a result of qualitative analysis from participant' description. Conclusion Nurse participants recognized the clinical ladder as the objective valuation criteria, and they set their goals and clarified their roles based on the criteria. This study also revealed the participants thought that they could improve their practice in clinical settings according to their abilities, and that the continuous education system encouraged and raised their motivation. Form there results, it was presumed that the progress of nurses' abilities in clinical settings would lead to the good quality of nursing care for patients in the organization.