The rising acuity of hospitalized patients requires that critical care nurses maintain a high level of clinical expertise. Expert skill levels (critical thinking, technical skills, and interpersonal skills) of clinicians improve patient outcomes that translates into savings for the institution through shorter length of stay and decreased frequency of re-admissions. The authors outline the steps to follow in developing a theory-based career advancement plan that encourages and rewards clinical competence.
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Lookinland et al. (1996) studied this question.