A systematic review of the effectiveness of strategies and interventions to improve the transition from student to newly qualified nurse

Reject the "Practice Readiness Myth": Ask if systems are ready for nursing graduates instead

The nursing profession is engaged in robust national dialogue on how to implement competency-based education. This dialogue often conflates the concept of "competency-based education" with nursing "competence" or "practice readiness." Our aim is to discuss the potential harms of conflating "competency-based education" with "competence" or "practice readiness." This commentary explores the possible risks of issue conflation. Risks include (a) suggesting that nurses who have successfully obtained licensure are not "competent" or "ready to practice," and (b) de-emphasizing the importance of safe and sustainable work environments for new graduate nurses. We discuss the need to separate conversations about "competency-based education" and "practice readiness"; the need to increase the clarity and specificity of discourse surrounding competency-based education; and the need for strategic alignment across academia and practice.

Employers' requests when advertising for nurses-A national mapping of recruitment advertising for nurses in Sweden

INTRODUCTION

There is a shortage of nurses and many are leaving the profession. Maintaining sufficient nursing staff is a major healthcare challenge for societies worldwide. Work conditions, job orientation, and career opportunities all factor into nurses' rates of attrition, exit, and turnover. Newly graduated nurses have requested structured introductory and/or mentoring programmes to ease their transition from education to work life and develop the skills and knowledge necessary in their particular work setting. Nurses also seek opportunities to continue learning and developing professionally.

AIMS

To map and describe the content of recruitment advertisements for nurses. Research questions were: 'What qualifications do healthcare employers request when recruiting nurses?' and 'What sorts of professional development do healthcare employers offer nurses?

MATERIALS AND METHODS

A comprehensive national mapping of recruitment advertisements for nurses in Sweden where all advertisements, N = 450, on 20 of the 21 regional hospital websites were collected. A qualitative and a quantitative content analysis was performed.

RESULTS

Personal characteristics dominated requested competence in recruitment advertisements. Employers offered general nursing opportunities with unspecific work content and focused more on recruiting newly registered, rather than experienced, nurses. In only a few advertisements, employers asked for a master's degree. No employer requested nurses with a PhD or research experience.

CONCLUSION

While the World Health Organization stresses the need for a sustainable recruitment and attainment of nurses to secure health care, employers' recruitment of mostly newly graduated nurses and offering little professional development and few career opportunities may be one explanation for the difficulties in securing safe nurse staffing.

Exploring registered nurses' perspectives as mentors for newly qualified nurses: a qualitative interview study

OBJECTIVE

Existing research has focused mostly on mentees' experiences of mentoring rather than mentors' experiences. Therefore, this study describes registered nurses' experiences of being a mentor for newly qualified nurses.

DESIGN

A qualitative interview study based on semistructured individual interviews. Interviews were analysed using qualitative content analysis.

PARTICIPANTS AND SETTING

A purposive sample of experienced registered nurses (n=21) from healthcare units in northern Sweden and northern Norway. Inclusion criteria were to have been a mentor to at least one newly qualified nurse, hold permanent employment of 75%-100% as a registered nurse and to be able to communicate in Swedish or Norwegian.

RESULTS

Our study's findings suggest that being a mentor plays a crucial role in establishing safety in complex work environments. The main theme consists of three themes: feeling motivated in being a mentor; continuously developing the learning environment; and navigating obstacles and cultivating support.

CONCLUSION

Being a mentor is a complicated role for registered nurses. The mentoring role is beneficial-ie, positive and rewarding-if facilitated sufficiently in the context of a structured organisation. This study brings a more profound understanding of and provides new insights into registered nurses' perspectives and needs regarding being a mentor and the study's findings make an important contribution to the field of nursing regarding the facilitation of mentoring.

Perceived professional preparedness and identity among senior nursing students: a latent profile Analysis

BACKGROUND

Senior nursing students' perceptions of their professional preparedness help them for expectations of their future nursing role with more confidence, and professional identity may contribute to cultivating nursing students' perceptions of professional preparedness. In this study we applied latent profile analysis to identify the latent profiles of perceived professional preparedness among senior nursing students and to examine their identity and predictors.

METHODS

This was a cross-sectional descriptive study. A total of 319 senior nursing students from five universities in China were enrolled. Data were collected using the Perceived Professional Preparedness of Senior Nursing Students' Questionnaire and the Professional Identity Scale for Nursing Students.

RESULTS

Three latent profiles were identified and labeled as "low perceived professional preparedness" (n = 90, 28.2%), "low clinical competency-low EBP (Evidence-Based Practice)" (n = 190, 59.5%), and "high perceived professional preparedness" (n = 39, 12.2%). Place of residence, average clinical practicum hours per day, part-time experience, good relationships with classmates, and feeling nobility toward nursing due to COVID-19 significantly predicted profile membership. The average professional identity score was also statistically different across the three profiles (F = 54.69, p < 0.001).

CONCLUSIONS

Senior nursing students' perceptions of their professional preparedness were divided into three profiles, and out results show that promoting professional identity may effectively foster their perceived professional preparedness. This study therefore highlights the importance of targeted interventions by considering their distinct perceptions of professional preparedness patterns.

How are new nurses satisfied with their jobs? From the work value perspective of Generations Y and Z nurses

BACKGROUND

Job satisfaction has garnered significant interest across multiple disciplines as it plays a vital role in shaping human resource strategies. In the field of nursing, enhancing job satisfaction can help prevent workforce shortages. Work values and job-related characteristics are significant predictors of job satisfaction. However, the influence of factors may change as younger generations join the nursing workforce. Although research on generational commonalities and differences in work values is increasing, there is insufficient information on generational differences in the interplay between work values and job satisfaction. This study investigated the factors associated with job satisfaction of new nurses in each generational group based on a work value perspective.

METHODS

A total of 280 new nurses (151 from Generation Y and 129 from Generation Z) were selected from the Graduates Occupational Mobility Survey. Multiple linear regression analyses were performed to determine the factors associated with job satisfaction in both groups.

RESULTS

Most participants graduated with a diploma (61.1%), were paid less than the average salary of each group (60.4%), and conducted shift (72.9%) and overtime work (64.3%). Work values and job satisfaction levels were not significantly different between the two groups. Multiple linear regression analyses showed that career growth and task work values were associated with job satisfaction for Generation Z, while task, reputation, and environment work values were associated with job satisfaction for Generation Y. Among the job-related characteristics, nurses' job tenure was associated with job satisfaction in both groups; salary and overtime had varying relationships with job satisfaction between the two generations.

CONCLUSIONS

Understanding generational differences is crucial for improving the effective management of new generational nurses. Our study findings support that different work value dimensions and job-related characteristics were associated with job satisfaction in each generation. Accordingly, it is essential to develop distinct initiatives, such as a well-structured program, to support the continued career growth of the new Generation Z nurses, thereby enhancing their job satisfaction. Furthermore, providing a conducive working environment that helps new-generation nurses overcome challenges and ensures personal lives should be considered.

Surgical Patients' Evaluation of Pain Management Quality and Surgical Nurses' Pain-Related Knowledge and Attitudes

PURPOSE

The present study was aimed at investigating the quality of pain management evaluated by inpatients in surgical clinics, and pain-related knowledge and attitudes of nurses working in surgical clinics, surgical units, or emergency services.

METHODS

The study was conducted as a descriptive and cross-sectional study. The study data were collected from inpatients in surgical clinics (N = 306), and from nurses working in surgical clinics, surgical units, or emergency services (N = 57) between January 2020 and September 2020. The Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) and Nurses' Knowledge and Attitudes Survey Regarding Pain (NKASRP) were the tools used for data collection.

RESULTS

The mean scores the participants obtained from the severity of worst pain, pain relief, and satisfaction with pain treatment components of the APS-POQ-R were 6.14 ± 2.59, 59.28 ± 22.26, and 8.99 ± 1.62, respectively. There were significant differences between many components of the APS-POQ-R in terms of such variables as age, sex, undergoing previous surgery, presence of pain before surgery, surgery performed, and type of anesthesia (p < .05). The mean score the participants obtained from the NKASRP was 15.35 ± 3.87.

CONCLUSIONS

It was concluded that the patients' pain was relieved moderately, that they were very highly satisfied with pain treatment, and that the nurses' pain-related knowledge and attitude levels were below the moderate level.

CLINICAL IMPLICATIONS

Nurses should support patients whose in-bed activities were prevented due to pain, involve them in pain treatment decisions, advise them about pain treatment options, and encourage them to use nonpharmacological methods.

Essential Components of a Neuroscience Nursing Orientation: A Delphi Study

ABSTRACT

BACKGROUND: The essential components of an effective neuroscience nurse orientation program for those caring for the adult general care population have not been well defined or standardized. METHODS : Using a 2-round, modified Delphi methodology, electronic surveys were distributed to 53 experts in neuroscience nursing orientation to gain consensus on the essential components of orientation for the neuroscience nurse. Survey data included demographics of the expert, literature-based components of neuroscience nurse orientation, and an opportunity to agree/disagree or write in additional components. RESULTS : Round 1 of the consensus survey elicited a response rate of 55% (29/53), and round 2 had a 51% (27/53) response rate. On the basis of round 1 expert responses, 4 new orientation components were added, and 36 components of a neuroscience nursing orientation were revised to include only the elements with ≥75% agreement. Twenty-two elements in round 2 met the criteria of ≥75% very important and important to include as components of a neuroscience nursing orientation. CONCLUSION : An expert consensus was reached on the necessary components of a neuroscience nursing orientation. The identified neuroscience nursing orientation components concentrated on improving nursing practice and provision of care to adult neuroscience patients. This study demonstrates priority components within a standardized orientation program for neuroscience nurses based on literature and expert consensus. A comprehensive neuroscience nursing orientation is a vital step in sustaining high-quality care for patients and improving neurological outcomes.

The transition issue among new nurses in China: A mediation model analysis

AIM

To explore the impact and interrelated pathway of work environment, career adaptability, and social support on the transition process and outcomes among new nurses.

BACKGROUND

The transition issue affecting new nurses has been discussed for many decades. However, the exact interplay of various factors influencing the transition process and outcomes needs further exploration.

METHODS

A cross-sectional, descriptive survey design was employed, and a convenient sample of 1628 new nurses from 22 tertiary hospitals in China was surveyed between November 2018 and October 2019. Mediation model analysis was used to analyze the data, and the STROBE checklist was used to report the study.

FINDINGS

The transition status mediated the effects of work environment, career adaptability and social support, and had a significantly positive influence on their intention to remain and job satisfaction. Among the influencing factors, the work environment had the most significant positive impact on both the intention to remain and job satisfaction.

CONCLUSION

Work environment was found to be the most significant factor affecting both the transition status and outcomes of new nurses. The transition status played an important mediating role between the influencing factors and the transition outcomes, whereas career adaptability was found to mediate the impact of social support and work environment in the transition process.

IMPLICATIONS FOR NURSING AND NURSING POLICIES

The results underscore the critical role of the work environment and demonstrate the mediating effects of transition status and career adaptability in the transition process of new nurses. Therefore, dynamic evaluation of the transition status should serve as the foundation for developing targeted supportive interventions. Such interventions should also focus on enhancing career adaptability and fostering a supportive work environment to facilitate the transition of new nurses.

Translation and validation of the Persian version of the perception to care in acute situations (PCAS-P) scale in novice nurses

BACKGROUND

Novice nurses providing care in acute conditions should have satisfactory performance. Accurate and appropriate evaluation of the performance of novice nurses in providing care in acute situations is essential for planning interventions to improve the quality of patient care. This study was conducted to translate and evaluate the psychometric properties of the Persian version of the Perception to Care in Acute Situations (PCAS-P) scale in novice nurses.

METHODS

In this methodological study, 236 novice nurses were selected by the convenience sampling method. 17-item scale PCAS-P was translated into Persian by the forward-backward process. Then, this version was used for psychometric evaluation. For this purpose, face validity, content validity, and construct validity were assessed using confirmatory factor analysis. Internal consistency and stability reliability were calculated. The data were analyzed using SPSS and AMOS software.

RESULTS

The PCAS-P scale maintained the meaning of the original English version and was clear, explicit, and understandable for novice nurses. Confirmatory factor analysis showed that this Persian version is consistent with the proposed model and confirmed the fit of the three-factor model. The values of Cronbach's alpha coefficient, McDonald's omega, Coefficient H, and average inter-item correlation were excellent for the overall scale and its dimensions, and the three latent factors had good convergent and discriminant validity. Additionally, the average measurement size was 0.944 ICC (95% CI 0.909 to 0.969).

CONCLUSION

The PCAS-P scale is valid and reliable for measuring novice nurses' perception of acute situations.

Gaining acceptance, insight and ability to act: A process evaluation of a preventive stress intervention as part of a transition-to-practice programme for newly graduated nurses

AIM

To investigate how NGNs perceived and applied an intervention for preventing stress-related ill health embedded in a transition-to-practice programme when entering their professional life.

DESIGN

A qualitative exploratory descriptive design was selected for this study to gain insights and perspectives on the adoption and utilization of the intervention.

METHODS

In this qualitative methodology process evaluation, semi-structured and audio-recorded interviews were conducted with a sample of 49 nurses. Data were collected between December 2016 and July 2017, and were sorted in NVivo 12 Plus, followed by thematic analysis.

RESULTS

The analysis resulted in three change processes stimulated by the intervention: (a) Building acceptance of being new; (b) Gaining insight into professional development and health and (c) Practical steps for skills development, healthy habits and better-organized work. In addition to the three themes, barriers that hindered the progression of the processes were also described. Each process influenced the development of the others by stimulating a deeper understanding, motivation to change and courage to act. Several barriers were identified, including the use of cognitively demanding intervention tools, fatigue, high work demands, inconvenient work hours and a hostile social climate on the ward.

CONCLUSION

This process evaluation showed that newly graduated nurses used knowledge from the intervention and adopted new behaviours largely in accordance with how the intervention was intended to work.

IMPACT

When entering a new profession, it is crucial to receive a well-thought-out, structured and targeted introduction to the new professional role, tasks and work group. Nurses stated that the intervention increased their understanding of the role as new nurses and their insight into how to develop skills that promoted better functioning and recovery. The intervention also stimulated the development of new health behaviour and some new learning strategies.

How to improve newly qualified midwives' transition-into-practice. A Delphi study

BACKGROUND

In the Netherlands, newly qualified midwives start work as registered midwives without any formal transition support. Research shows that newly qualified midwives do not feel sufficiently confident and competent in their work during the period following graduation. This could impact the quality of care provided by newly registered midwives. The aim of this study is to seek consensus with stakeholders concerning viable components of support for newly qualified midwives working in midwifery care in the Netherlands.

METHODS

A Delphi study was conducted among maternity care stakeholders in the Netherlands. During two rounds, sixteen statements derived from a theoretical framework of organizational socialization theory and previous studies were assessed (round 1, n = 56; round 2, n = 52). Stakeholders (N = 61) were invited and completed an online questionnaire that included spaces for opinions and remarks.

RESULTS

Stakeholders agreed about an introductory support period for newly qualified midwives, involving performance feedback and regional-level backup from fellow midwives during shifts. They further agreed on the responsibilities of established professionals that they should support newcomers in practice and provide mentoring or group coaching, although they face organizational barriers for supporting newcomers.

CONCLUSIONS

Stakeholders found consensus upon several components of support at the workplace. In addition, a stable work environment seemed less important in their opinion while previous research suggests otherwise. Practice organisations need to improve the employment conditions and support for newly qualified midwives to ensure the quality of midwifery care is guaranteed.

An Evaluation of the Use of Low-Fidelity and High-Fidelity Mannequins in Clinical Simulations in a Module Preparing Final Year Children's and General Nursing Students for Internship Placement

Internationally, the use of simulation-learning environments in nursing education has escalated over the last number of years. Simulations have been recognized as providing clinical opportunities for student nurses to gain experience in a safe and controlled learning environment. A module specifically preparing fourth year children's and general nursing students for internship was developed. Preparation work for these simulation sessions included a video for the students to watch which demonstrated evidence-based care using sample simulations. This research aims to evaluate two simulation scenarios, using low-fidelity and high-fidelity mannequins for children's nursing students as part of a nursing module preparing them for internship practice placement. This mixed-methods evaluation survey of students was conducted in one School of Nursing in a Higher Education Institute in Ireland in the academic year 2021-2022. A simulated learning package was created using a partnership approach with members from the Higher Education Institute and the clinical learning site and piloted with 39 students. This was evaluated using an anonymous, online questionnaire with 17 student responses. An ethical exemption was granted for this evaluation. All students reported the use of the simulations, including the pre-simulation video as beneficial to enhance their learning and to prepare them for internship. The use of low-fidelity and high-fidelity mannequins enhanced their learning process. Students recommended implementing further simulations throughout their programme to enhance their learning experiences. The findings of this evaluation can provide guidance to aid future development of interactive simulations in preparing students for practice placements. Both low fidelity and high fidelity have their places in simulation and education, depending on the scenario and associated learning outcomes. Collaboration between academia and clinical practice is crucial, to bridge the theory-practice gap and demonstrate a positive relationship between staff in both settings.

Components of professional satisfaction among novice nurses

BACKGROUND

In Israel there are only 6.53 nurses per 1000 citizens, compared to 8.8 nurses per 1000 citizens in the OECD countries. The nursing shortage is even more severe in peripheral areas, especially in southern Israel. Nurses` professional satisfaction is crucial for preserving the nursing workforce. This study aimed to assess job satisfaction among novice nurses and identify components of professional satisfaction.

METHODS

Cross-sectional study of 216 novice nurses who graduated in 2018-2022 and were approached ten months after graduation. Job satisfaction components were constructed using factor analysis.

RESULTS

Professional satisfaction was based mainly on the intrinsic characteristics of the occupation related to personal accomplishment and organizational culture. In a multivariable model, a one-point increase in mean satisfaction with the training period during studies in the nursing department was associated with a more than a three-fold elevation in the odds for high and very high professional satisfaction (OR 3.0, 95% CI 1.7-5.1). Odds for high and very high professional satisfaction were more than four-fold and two-fold higher among graduates who rated their level of control over work schedule as high and medium vs. low (OR 4.2, 95% CI 1.0-16.7 and OR 2.8, 95% CI 1.2-6.3, respectively). Work-life balance without disturbance to daily life by work was found significantly associated with higher odds for high and very high satisfaction. Nurses who plan to continue professional development, i.e., an advanced professional course or Master's degree, had significantly higher mean professional satisfaction scales than others (4.2 vs. 3.7, p = .009 and 4.2 vs. 3.9, p < .001, respectively).

CONCLUSION

The most important components of professional satisfaction among novice nurses are self-accomplishment, which was built from work-related challenges, interest and variety of tasks, personal growth and development, and the possibility of contributing to patients` care and organizational culture, which was built from relationships with co-workers. Persons who manage nurses should cultivate an atmosphere of support and guidance, provide new nurses with interesting work tasks, and increase their ability to control their work schedule. Young nurses should be encouraged to continue their professional and academic education.

An Exploration of Student Nurses' Experiences of Burnout during the COVID-19 Pandemic Using the Copenhagen Burnout Inventory (CBI)

Burnout amongst healthcare professionals has been a long-considered condition associated with the workplace environment. Student nurses studying at Sheffield Hallam University continued to engage in their training during the COVID-19 pandemic; however, the stressors of this experience were anecdotally highlighted to their academic staff. Furthermore, burnout can be linked to the ongoing difficulties with recruitment and retention of nursing staff within the NHS workforce. This work aimed to determine the burnout among nursing students experience by obtaining quantitative data to understand their experiences. The Copenhagen Burnout Inventory was used to gauge levels of burnout across the different fields of nursing students. Results identified that: (1) mental health students reported feeling tired significantly less often than child and adult field students (mean rating of 69% versus 91.7% and 84.0%, respectively); (2) students aged 30-39 feel tired significantly less often than both younger student age groups (mean rating 59.4% versus 82.8% and 90.6%); (3) there was a significant difference in how often different age groups felt "tired of working with clients" (F(4) = 2.68, p = 0.04) and that "they couldn't take it anymore" (F(4) = 2.53, p = 0.05); (4) child-field students reported generally higher levels of global burnout (mean CBI total = 57.9%) whilst mental health students reported lower levels (mean CBI total = 54.1%). Considering these results, it is imperative for both higher education institutions and potential employers to consider the impact of COVID-19 and burnout, and the levels of support offered to student nurses during their training and transition to practice as newly qualified nurses.

Nurse manager support of graduate nurse development of work readiness: An integrative review

AIM

To systematically review relevant literature to identify how Nurse Managers support graduate nurse work readiness.

BACKGROUND

Graduate nurses face many difficulties when transitioning from student to qualified nurse. Nurse managers establish workplace culture through leadership styles, yet little is known about how they can best support graduate nurses to transition to professional practice in the acute hospital environment.

DESIGN

A five-step, systematic integrative review reported in accordance with the PRISMA 2020 Checklist.

METHODS

The steps of the review method included (1) problem identification, (2) literature search, (3) data evaluation and quality appraisal, (4) data extraction and analysis and (5) presentation. Analysis used the Framework method and was guided by theory of graduate nurse work readiness and the Theoretical Domains Framework.

DATA SOURCES

MEDLINE COMPLETE, Cumulative Index to Nursing and Allied Health (CINAHL) Complete, ERIC and PSYCINFO searched in December 2020.

RESULTS

Studies eligible for inclusion (N = 40) represented research from 15 countries; most (67.5%, n = 27) used a qualitative design, 22.5% (n = 9) were quantitative and 10% (n = 4) used mixed methods. Three themes related to the social constructs and local area work environments influenced by nurse managers emerged: supporting people, supportive environment and supporting learning.

CONCLUSION

The review identified a lack of robust evidence about the effectiveness of specific nurse manager-led strategies to support development of graduate work readiness. However, the findings provide a framework to guide nurse managers in supporting graduate nurses and provide a foundation for further research about nurse manager roles in developing graduate work readiness.

IMPLICATIONS FOR THE PROFESSION OR PATIENT CARE

Previous research has described poor transition of graduate nurses as responsible for increased workplace errors, decreased job satisfaction and high rates of attrition. Exploring the role of nurse managers in graduate nurse transition is essential to ensure quality patient care and a sustainable workforce.

IMPACT

What Problem Did the Study Address? Graduate nurses face many difficulties when transitioning from student to qualified nurse. Nurse managers establish workplace culture through leadership styles, yet little is known about how they can best support graduate nurses to transition to professional practice in the acute hospital environment. What Were the Main Findings? High rates of attrition are attributed to poor support during the initial transition phase of graduate nurses. Nurse managers can impact transition by providing a supportive environment, support learning and by providing a team of supportive people. Where and on whom will the research have an impact? The research will have an impact on graduate nurses and nurse managers.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution (integrative review exploring existing literature). This integrative review was registered with PROSPERO (CRD42021213142).

A Statewide Nurse Residency Program Evaluation

Across the nation, hospitals are answering the call to action for funding and requiring new-to-practice registered nurses to complete a nurse residency program (NRP). In response, all Maryland acute care hospitals successfully funded, adopted, and implemented a 12-month standardized, commercially available (vendored) NRP. However, although the hospitals use the same curriculum, their administrative practices, content, and deliverables vary. A statewide program evaluation was conducted by the Maryland Organization of Nurse Leaders, Inc./Maryland Nurse Residency Collaborative to understand the NRP structure and process variability, including implementation challenges, and what worked and what did not. Findings from 26 semi-structured interviews with Maryland acute care hospital NRP coordinators showed that leadership support and resources, differences in patient populations, number of nurse residents, and organizational requirements best explained programmatic adaptations. Using lessons learned, best practices are shared, including methods to garner leadership support and reduce adaptations. Although program customization is expected, program replicability and scalability are essential to achieving program outcomes. [J Contin Educ Nurs. 2023;54(9):421-429.].

The transition to advanced practice nursing: A systematic review of qualitative studies

BACKGROUND

Advanced practice nurses have made important contributions to the tasks of stabilising the operation of the health system and improving the quality of care. However, taking on the role of an advanced practice nurse is always challenging and can even result in the intention to leave the profession. Insights into advanced practice nursing role transitions are important to implement effective interventions to help nurses cope with the corresponding turbulence and changes.

AIM

To explore the experiences of advanced practice nurses during their role transition from registered nurses to their current role.

DESIGN

A systematic review of qualitative studies.

DATA SOURCES

Five databases were searched from inception to August 2022: PubMed, Web of Science, Cochrane, Embase and CINAHL.

REVIEW METHODS

This review was reported in accordance with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. Two reviewers independently conducted study selection and data extraction, and quality appraisal was performed using the Joanna Briggs Institute critical appraisal instrument for qualitative research. Data synthesis was conducted using thematic analysis.

FINDINGS

A total of 14 studies were included in this review. Three analytical themes emerged: (1) trudging along a narrow road, (2) driving and restraining forces in the transition, and (3) embracing the new identity. Four subthemes were graded as high confidence and the other four were moderate confidence. Establishing a new role was a priority and a significant challenge for advanced practice nurses. Beliefs regarding advanced practice, the attitudes of colleagues, and the support of mentors impacted the transition process. Advanced practice nurses expressed appreciation for their new role and developed new ambitions at the end of the transition.

CONCLUSIONS

Advanced practice nurses face a series of challenges during the process of role development, especially struggles with vague feelings and a lack of confidence in practice. These difficulties could be exacerbated without the support of team and organisational managers. The implementation of mentorship and the mediation of interprofessional conflicts are necessary to facilitate successful role transitions.

Social representations of "non-eating" experienced by patients on exclusive enteral nutrition

BACKGROUND & AIMS

In a scenario where food is absent or restricted, as in the case of enteral nutrition (EN), eating becomes an experience filled with different meanings in the hospitalization process. This study aimed to understand the social representations of "non-eating" experienced by patients receiving EN.

METHOD

This was an empirical, qualitative, cross-sectional study. Hospitalized patients using EN for at least seven days and who were over 18 years of age participated in the study. The sample size was defined using the data saturation criterion. Patients were selected after an active search was conducted through the beds of a university hospital in the state of Minas Gerais, Brazil. The instruments used were (a) a semi-structured interview script and (b) the researcher's field journal. Data analysis was based on the thematic analysis of Braun and Clark, and the theoretical foundation was supported by the theory of social representations.

RESULTS

Nine patients were interviewed and four thematic categories were identified: (1) Perceptions related to the body in the experience of enteral nutrition, (2) The place of hunger and cravings in the body, (3) The price of healing, and (4) Communication with the team. The results indicate an experience largely associated with physical sensations, recognized by patients as aversive, with a tendency to a better adaptation to EN with longer use of the tube. Patients did not perceive physical hunger while the presence of "wanting" or "craving for" food, that is, the desire to taste and experience food, was reported by all, equating it to the experience of hunger. The main difficulties experienced by patients involve the absence or loss of communication with the health team and the reduction of autonomy, both in terms of mobility and the power of participation and decision-making regarding the treatment.

CONCLUSIONS

The experience of patients in EN is complex and permeated by several difficulties, such as the lack of pleasure and symbolism associated with food and eating. On the other hand, even in the face of adversity, those patients undergo treatment, to seek a "cure" for their condition. It is essential to highlight the lack of communication on the part of the health team as an important difficulty listed by the patients. These results are fundamental for the health teams to review and reconstruct the management related to the care of patients to improve their well-being.

Identifying factors associated with UK veterinary nurse resignations through examination of veterinary practice data

BACKGROUND

This study aimed to identify demographic, practice and job-specific factors that are associated with veterinary nurses resigning from UK companion animal veterinary practices.

METHODS

Employment data from nurses working across a group of practices at the end of 2020 were included. Nurses were categorised into those who remained at, or resigned from, their practice in 2021. Proposed risk factors for future resignations were analysed using multivariable binary logistic regression modelling.

RESULTS

In total, 278 of 1642 (16.9%) nurses across 418 practices resigned in 2021. The most frequently recorded reasons for nurses resigning included 'career progression' (n = 102; 36.7%), 'personal reasons' (n = 36; 12.9%) and 'better pay or benefits' (n = 33; 11.9%). Factors associated with lower odds of future nurse resignations included longer tenure (p < 0.001), higher practice property and facilities rating (p = 0.049) and being a head or student nurse (p = 0.008).

LIMITATIONS

Data were collected retrospectively and were not recorded for research purposes.

CONCLUSIONS

This study highlights key factors that are predictive of veterinary nurse resignations. With known difficulties in staff retention within veterinary practices, analysis of these data is an important addition to the evidence base surrounding the complex issue of nurse retention and could help steer future retention strategies.

Realist synthesis of factors affecting retention of staff in UK adult mental health services

OBJECTIVES

The shortage of healthcare staff is a global problem. UK mental health services have, on average, a higher turnover of staff than the NHS. Factors affecting retention of this staff group need to be explored in more depth to understand what is working for whom, for what reasons and in what circumstances. This review aims to conduct a realist synthesis to explore evidence from published studies, together with stakeholder involvement to develop programme theories that hypothesise how and why retention occurs in the mental health workforce and identify additional evidence to explore and test these theories thereby highlighting any persistent gaps in understanding. This paper develops programme theories that hypothesise why retention occurs and in what context and tests these theories thereby highlighting any persistent gaps in understanding.

METHODS

Realist synthesis was used to develop programme theories for factors affecting retention of UK mental health staff. This involved: (1) stakeholder consultation and literature scoping to develop initial programme theories; (2) structured searches across six databases to identify 85 included relevant literature relating to the programme theories; and (3) analysis and synthesis to build and refine a final programme theory and logic model.

RESULTS

Phase I combined findings from 32 stakeholders and 24 publications to develop six initial programme theories. Phases II and III identified and synthesised evidence from 88 publications into three overarching programme theories stemming from organisational culture: interconnectedness of workload and quality of care, investment in staff support and development and involvement of staff and service users in policies and practice.

CONCLUSIONS

Organisational culture was found to have a key underpinning effect on retention of mental health staff. This can be modified but staff need to be well supported and feel involved to derive satisfaction from their roles. Manageable workloads and being able to deliver good quality care were also key.

A Socioecological Model of Transition to Nursing Practice

A newly licensed nurse's (NLN) transition to practice (TTP) is affected by interactions inside and outside the hospital. The aim of this Delphi study was to create a socioecological model of TTP. Included in the socioecological model are personal characteristics and interactions at the relationship, community, and societal levels that the NLNs feel affects their TTP. This socioecological model can be used to plan TTP programs that address the holistic needs of the NLNs.

Effectiveness of transition programs on new graduate nurses' clinical competence, job satisfaction and perceptions of support: A mixed-methods study

AIM

To assess the effectiveness of two graduate nurse programs on new graduate nurses' overall competence at 3, 6, 9 and 12 months. Secondary aims were to assess new nurses' job satisfaction at 12 months and explore their experiences of support.

BACKGROUND

Most clinical settings have implemented transition programs to help new nurses to adapt to their new environments and expand their competences. To this day, very few studies have assessed the effectiveness of these programs.

DESIGN

Longitudinal mixed-methods study.

METHODS

The study was conducted at two teaching hospitals in Australia. New nurses were recruited during orientation. Data were collected at baseline (T0; n = 88), 3 (T1; n = 29), 6 (T2; n = 15), 9 (T3; n = 11) and 12 months (T4; n = 9). At each time point, the questionnaire included demographic and the Nurse Competence Scale. At T4, the questionnaire also included the Nurse Satisfaction Scale. Semi-structured interviews were conducted from T1 to T4. This study conforms to the STROBE guidelines.

RESULTS

Competence increased significantly at T1, with participants stating that they learned by "getting out" of student mode. At T2, despite no significant difference in competence, participants expressed they were more confident and in control, because they felt supported. Again, at T3, there was no significant increase in competence. Finally, at T4, competence increased significantly, with participants acknowledging that they still had a lot to learn.

CONCLUSION

This study supports that 12-month transition programs are necessary for NGNs to expand their competence. One major factor influencing NGNs during their first year was how well they felt supported and encouraged to seek help when they needed it.

RELEVANCE

There is a need to understand how new NGNs enrolled in transition programs expand their competences. Their professional development depends on a supportive environment where NGNs feel confident in asking questions or for help.

New Graduate Nurses Navigating Entry to Practice in the Covid-19 Pandemic

BACKGROUND

The Covid-19 pandemic has significantly impacted organizational life for nurses, with known physical and psychological impacts. New graduate nurses are a subset of nurses with unique needs and challenges as they transition into their registered nurse roles. However, this subset of nurses has yet to be explored in the context of the Covid-19 pandemic.

PURPOSE

To explore the experiences of new graduate nurses entering the profession in Ontario, Canada, during the Covid-19 pandemic approximately one year after entering the profession.

METHODS

Thorne's interpretive description method was utilized.

FINDINGS

All participants identified as completing second entry nursing programs, offering a unique perspective on new graduate nurse transition. Four themes emerged in the data: 'Virtual Didn't Cut It,' 'Go Where You Know,' 'Picking Up the Pieces,' and 'Learning When to Say No and Let Go.' Participants felt ill prepared to enter the profession and were cognizant of the various challenges facing the nursing profession, and how these pre-existing challenges were exacerbated by the pandemic. They acknowledged the need to protect themselves against burnout and poor mental health, and as such, made calculated early career decisions - demonstrating strong socio-political knowing. Half of the participants had already left their first nursing job; citing unmet orientation, mental health, and wellbeing needs. However, all participants were steadfast in remaining in the nursing profession.

CONCLUSIONS

Second entry new graduate nurses remain a unique subset of nurses that require more scholarly attention as their transition experiences may differ from the traditional trajectory of new graduate nurses.

Moving from Vaccine Hesitancy to Acceptance: Engaging Underrepresented Employees in a Pediatric Academic Medical Center

Underrepresented populations historically underserved by the healthcare system and/or marginalized by systematic policies regionally and nationally were particularly vulnerable during the COVID-19 pandemic. While vaccine hesitancy has been described among hospital employees, the employees' experiences from an underrepresented population cohort have not been reported. We, therefore, sought to understand employees' vaccine experiences, hesitancy, and ways to enhance ongoing COVID-19 vaccine education and communication to build a hospital-wide culture of vaccine acceptance.

Methods

We invited interprofessional staff from 5 clinical departments to participate in qualitative focus groups. Guiding questions were used to explore the experiences and perceptions of the staff. Using content analysis, we identified themes and recommendations for improvement.

Results

We conducted 5 focus group sessions with over 50 participants. Four themes emerged; "Vaccine Fears Past and Present," "Access to Information," "Worries for Families," and "Our Hospital is a Trusted Name." Participants also provided recommendations for improvement in the messaging around the vaccine rollout. Consideration of how different employees access information, listening to staff needs, and recognizing the role of race and history were critical to engaging and improving the underrepresented employees' vaccine acceptance.

Conclusions

Exploring the concerns and fears of the COVID-19 vaccine within groups of underrepresented staff members through qualitative methods was key to understanding their vaccine hesitancy and implementing strategies to move toward vaccine acceptance in the hospital.

Factors That Influence the Retention of Graduate Nurses at a Safety Net Teaching Hospital

New nurse retention in hospitals is a national problem with significant patient safety and financial implications. This project was designed to determine retention and program completion rates of nurses who participated in a residency program. Factors influencing retention of nurses were explored using the Casey-Fink Nurse Retention Survey. Results revealed nurses' value supportive work environments, recognition, and seek mentorship for professional development. Designing nurse retention strategies is critical for organizations to prevent unnecessary turnover.

New Nurses' Perceptions on Transition to Practice: A Thematic Analysis

BACKGROUND

New nurses' transition to the workforce is often described as challenging and stressful. Concerns over this transition to practice are well documented, with the hypothesis that transition experiences influence the retention of new nurses in the workforce and profession.

METHODS

In a cross-sectional survey (N = 217) to assess new nurse transition in the province of Ontario, Canada, an open-ended item was included to solicit specific examples of the transition experience. The comments underwent thematic analysis to identify the facilitators and barriers of transition to practice for new nurses.

RESULTS

Comments were provided by 196 respondents. Three facilitator themes (supportive teams; feeling accepted, confident, and prepared; new graduate guarantee) and four barrier themes (feeling unprepared; discouraging realities and unsupportive cultures; lacking confidence/feeling unsure; false hope) to new nurse transition emerged.

CONCLUSIONS

Concerns of nursing shortages are heightened in the current COVID-19 pandemic, reinforcing the priority of retaining new nurses in the workforce. The reported themes offer insight into the contribution of a supportive work environment to new nurses' transition. The recommendations focus on aspects of supportive environments and educational strategies, including final practicums, to assist nursing students' development of self-efficacy and preparation for the workplace.

Effectiveness of formal onboarding for facilitating organizational socialization: A systematic review

OBJECTIVE

To investigate the effectiveness of formal onboarding programs and practices for new professionals.

INTRODUCTION

New professionals may experience high levels of stress and uncertainty. Formal onboarding programs and practices aim to facilitate the socialization of new professionals by structuring early experiences. However, there is a lack of evidence-based recommendations of how to onboard new professionals.

METHODS

This review considered studies that compares the effect of formal onboarding practices and programs for new professionals between 18-30 years of age (sample mean) to the effect of informal onboarding practices or 'treatment as usual' in professional organizations internationally. The outcome of interest for the review was the extent to which new professionals were socialized. The search strategy aimed to locate both published studies (dating back to year 2006) and studies accepted for publication written in English using the electronic databases Web of Science and Scopus (last search November 9 2021). Titles and abstracts were screened and selected papers were assessed by two independent reviewers against the eligibility criteria. Critical appraisal and data extraction were performed by two independent reviewers using Joanna Briggs Institutes templates. The findings were summarized in a narrative synthesis and presented in tables. The certainty of the evidence was assessed using the grading of recommendations, assessment, development and evaluations approach.

RESULTS

Five studies including 1556 new professionals with a mean age of 25 years were included in the study. Most participants were new nurses. The methodological quality was assessed as low to moderate and there were high risks of bias. In three of the five included studies, a statistically significant effect of onboarding practices and programs on new professionals' adjustment could be confirmed (Cohen's d 0.13-1.35). Structured and supported on-the-job training was shown to be the onboarding strategy with the strongest support to date. The certainty of the evidence was rated as low.

CONCLUSION

The results suggests that organizations should prioritize on-the-job training as a strategy to facilitate organizational socialization. For researchers, the results suggest that attention should be given to understanding how to best implement on-the-job training to ensure strong, broad, and lasting effects. Importantly, research of higher methodological quality investigating effects of different onboarding programs and practices is needed. Systematic review registration number: OSF Registries osf.io/awdx6/.

New nurses' experience during a two year transition period to clinical practice: A phenomenological study

BACKGROUND

New nurses' clinical competency is a central concern across the world. The China Health and Planning Commission proposed an "Outline of transition programs for newly graduated nurses (try out)" to promote the new nurses' clinical competency within the first two years. Compared with the transition program in other countries, the one in China is longer. New nurses' experiences in their transition to practice were not fully explored in China. Their lived experience may inform the better transition program in China and other countries.

OBJECTIVE

To explore the experience of new nurses during the two-year transition period to clinical practice.

DESIGN

A descriptive phenomenological study.

METHODS

Face-to-face, semi-structured in-depth interviews were conducted in two teaching hospitals in China to interview 14 nurses within three months after the completion of transition. Data were analyzed using Colaizzi's seven-step data analysis method，which includes familiarization, identifying significant statements, formulating meanings, clustering themes, developing an exhaustive description, producing the fundamental structure, and seeking verification (1978). Tape-recording and observational notes were taken and typed word by word. Two researchers verified the verbatim transcripts.

RESULTS

Five categories and 15 theme clusters were identified: 1.

CHALLENGE

early-stage stress and anxiety; perceived change of mentality and self-reflection; 2.

RESPONSE

self-encouragement; self-compulsion, tolerance, adaptation; peer support and affirmation; 3. Growth: overall clinical competency improvement; perceived harvesting; nursing skills improvement; knowledge enhancement; 4.

REFLECTION

self-inadequacy; rotation benefits; the merits of different departments; lack sense of belonging; and 5. Expectation: desire to be treated equally; hope to have more opportunities.

CONCLUSIONS

The findings of our study suggested that support was most needed while the new nurses were facing challenges in the early stage to promote their sense of belonging. In addition, more systematic learning opportunities are needed to maximize learning for NGNs with different nursing degrees.

The Relationship of Nursing Teamwork and Job Satisfaction in Hospitals

Introduction

Teamwork is identified as a key contributor to patient safety and good teamwork is recognized as one of the presumptions of healthy work environment in nursing. The importance of job satisfaction in nursing has repeatedly been confirmed, but only recently has the association of job satisfaction and nursing teamwork been identified.

Objective

To identify the level of nursing teamwork in hospitals in Iceland and its relationship with job satisfaction.

Methods

This was a quantitative descriptive cross-sectional study. Data were collected with the Nursing Teamwork Survey administered to nursing staff in medical, surgical, and intensive care units in hospitals in Iceland. This study is based on data from 567 participants.

Results

A logistic regression analysis indicated that work experience on current unit and perceived staffing adequacy contributes to job satisfaction and when controlling for unit type, role, experience on current unit and staffing adequacy, those reporting better teamwork are significantly more likely to be satisfied with their current position. With an additional unit for overall nursing teamwork, participants are almost five times likelier to be satisfied with their current position.

Conclusion

Study findings show that there is a significant relationship between nursing teamwork and job satisfaction. The findings of this study confirm the importance of adequate staffing and good teamwork for nurses' job satisfaction. Staffing however, will remain the most challenging part of the equation as lack of nursing staff is foreseen globally in the coming decades turning the spotlight to teamwork. All stakeholders, including clinical nurse leaders, administrators, and instructors, need to emphasize on strengthening nursing teamwork. Good teamwork with increased job satisfaction may prevent turnover and shortage of nurses, an issue expected to grow during and following the COVID-19 pandemic. Facilitating good teamwork should be one of the priorities of every nurse leader.

Workplace's Development of Activities and Action Plans to Prevent Violence From Clients in High-Risk Sectors

INTRODUCTION

Interventions trying to prevent violence from clients towards employees tend to show limited effect on the risk or the frequencies of violent episodes, possibly due to a too-narrow focus on only one or a few preventive strategies. This study aimed to show what employees and line managers identify as key intervention areas for preventing violence and threats.

METHODS

The study is based on data collected during a participatory intervention study aiming to improve violence prevention in Danish psychiatric units and prison and detention centers. In the intervention study, employees and line managers from 13 work units developed 293 suggestions and 92 action plans to prevent workplace violence. Through qualitative thematic analysis of the suggestions and action plans, we identified the main categories that work units viewed as important and realistic to work with to improve violence prevention.

RESULTS

We identified 12 topics of violence prevention that work units considered relevant. Action plan topics used by more than half of the work units included: specific approaches to violence prevention (e.g., de-escalating techniques), communication between employees to transfer knowledge between shifts, and introduction to new employees and temporary workers. Topics used by three to five work units were: interdisciplinary corporation, communication and relational work, uniform approaches, organization of work, and staffing. Topics used rarely were: definition of violence and threats, policy and guidelines, support from colleagues and management, and engagement in violence prevention. For nine of the 12 topics, action plans were developed in both high-risk sectors.

CONCLUSIONS

The violence prevention action plans developed by work units from two high-risk sectors indicate that workplaces estimate the prevention of client-induced workplace violence to require activities on many levels and cannot be solved by a single focused approach. This variety of preventive activities needs to be considered when designing violence prevention interventions.

Clinical experiences of final-year nursing students during the COVID-19 pandemic: A systematic review and meta-synthesis

OBJECTIVES

This systematic review aimed to qualitatively synthesise existing literature to examine the clinical nursing experiences of final-year nursing students during the COVID-19 pandemic and provide recommendations for the effective management of clinical placement of nursing students.

DESIGN

A qualitative systematic review was conducted and reported following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.

DATA SOURCES

Five electronic databases were searched and qualitative studies were included for analysis if they focussed on the clinical nursing experiences of final-year nursing students during the COVID-19 pandemic.

REVIEW METHODS

Data synthesis was conducted by extracting all findings, developing categories, and producing synthesised findings.

RESULTS

Four synthesised findings were concluded: 1) facing the unknown and willingness to help, 2) challenging the clinical environment, 3) transition improving professional identity, and 4) finding ways out of the pandemic.

CONCLUSIONS

The transition of nursing students to clinical nursing practice during the pandemic is a personally and professionally challenging process, while nursing students try to adapt to the changing clinical environment and enhance their professional identity. Nursing managers and health policymakers should acknowledge the challenges encountered by nursing students during the pandemic and support the professional growth of future nursing teams by providing high-quality supervision.

First Year Outcomes: Program Evaluation of a Statewide Nurse Residency Program

In New Jersey, a statewide nurse residency program was implemented using an apprenticeship model. The pandemic created disruption to registered nurse residency programs. This included rapid restructuring of program delivery to online methods and a need to adapt curricula to reflect changing practice and guidelines. As a result of the pandemic, new graduates had educational gaps and nurse leaders experienced staffing shortages. First year program outcomes demonstrated a 90% retention of new graduates and financial benefits for organizations participating in the statewide nurse residency program.

Effects of Problem-Based Learning Strategies on Undergraduate Nursing Students' Self-Evaluation of Their Core Competencies: A Longitudinal Cohort Study

To respond to patients' increasing demands and strengthen nursing professionals' capabilities, nursing students are expected to develop problem-solving skills before they enter the workforce. Problem-based learning (PBL) is expected to provide effective simulation scenarios and realistic clinical conditions to help students achieve those learning goals. This article aims to explore the effects of PBL strategies on nursing students' self-evaluation of core competencies. This longitudinal cohort survey study evaluated 322 nursing students attending Chung Shan Medical University, Taiwan, in 2013 and 2014, where PBL teaching strategies are used in all four undergraduate years from freshman to senior. Based on their undergraduate academic levels, students were categorized into three groups- one-year PBL exposure, two-year PBL exposure, and three-year exposure. A core competency questionnaire was administered twice to ask participants to self-assess five professional competencies: learning attitude, problem identification, information analysis, execution, and life-long learning. The results showed that students with the longest exposure to PBL (Group 3) had higher self-evaluated scores for all core competencies than the other groups, except for the execution competency. The mean total competency score increased by 0.12 points between the pre-and-test. In addition, the mean score increased significantly more in Group 3 than in Groups 1 and 2. These trends were consistent for the information analysis, execution, and life-long learning competencies. In conclusion, the changes in the self-evaluated scores between groups indicate PBL strategies effectively improve nursing students' core competencies. The longest exposure group reported higher self-evaluated core competency scores than the other groups, especially for the information analysis, execution, and life-long learning competencies.

The effects of competency-based training model in the training of new nurses: A meta-analysis and systematic review

BACKGROUND

It is necessary to evaluate the effects of competency-based training (CBT) model in the clinical training of new nurses, to provide insights to the management of nurses.

METHODS

We searched PubMed, EMBASE, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database, Wanfang and Weipu Databases for the randomized controlled trials (RCTs) on the application effect of CBT in new nurse training up to December 15, 2021. Two investigators independently screened the literature, extracted the data and evaluated the quality of the literatures. RevMan 5.3 software was used for meta-analysis.

RESULTS

A total of 7 RCTs involving 639 new nurses were included. Meta-analyses indicated that CBT improved the ability of clinical nursing care [SMD = 1.52, 95%CI (0.13~2.90), P = 0.03], critical thinking and innovation[SMD = 0.69, 95%CI (0.43~0.95), P<0.001], interpersonal communication[SMD = 0.74, 95%CI (0.51~0.97), P<0.001], professional construction and development[SMD = 1.92, 95%CI (1.41~2.42), P<0.001], level of comprehensive knowledge[SMD = 1.20, 95%CI (0.63~1.76), P<0.001] and level of good personal traits[SMD = 1.89, 95%CI (1.27~2.50), P<0.001].The results of Egger regression tests indicated that there were no statistical biases amongst the synthesized outcomes (all P>0.05).

CONCLUSIONS

CBT is beneficial for improving the competency of newly recruited nurses. More RCTs from different population and regions are needed to further elucidate the role of CBT in nurse management.

Considerations on the use of carrier screening testing in human reproduction: comparison between recommendations from the Italian Society of Human Genetics and other international societies

PURPOSE

Carrier screening (CS) is a term used to describe a genetic test performed on individuals without family history of genetic disorders, to investigate the carrier status for pathogenic variants associated with multiple recessive conditions. The advent of next-generation sequencing enabled simultaneous CS for an increasing number of conditions; however, a consensus on which diseases to include in gene panels and how to best develop the provision of CS is far to be reached. Therefore, the provision of CS is jeopardized and inconsistent and requires solving several important issues.

METHODS

In 2020, the Italian Society of Human Genetics (SIGU) established a working group composed of clinical and laboratory geneticists from public and private fields to elaborate a document to define indications and best practice of CS provision for couples planning a pregnancy.

RESULTS

Hereby, we present the outcome of the Italian working group's activity and compare it with previously published international recommendations (American College of Medical Genetics and Genomics (ACMG), American College of Obstetricians and Gynecologists (ACOG), and Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG)). We determine a core message on genetic counseling and nine main subject categories to explore, spanning from goals and execution to technical scientific, ethical, and socio-economic topics. Moreover, a level of agreement on the most critical points is discussed using a 5-point agreement scale, demonstrating a high level of consensus among the four societies.

CONCLUSIONS

This document is intended to provide genetic and healthcare professionals involved in human reproduction with guidance regarding the clinical implementation of CS.

Critical thinking abilities among newly graduated nurses: A cross-sectional survey study in China

AIM

The aim of this study is to describe critical thinking dispositions among newly graduated nurses with different educational background in China and to explore related factors.

DESIGN

A cross-sectional questionnaire survey.

METHODS

The data were collected using the Chinese Version of Critical Thinking Dispositions Inventory (CTDI-CV). Overall, 588 newly graduated nurses finally completed the survey. Spearman and Pearson's correlation coefficients were used to examine the correlation between the CDTI-CV and nurses' general characteristics.

RESULTS

In terms of open-mindedness, analysis and inquisitiveness subscales, significant differences were found among nurses based on three educational level. When dichotomizing total CTDI scores into high and low, nearly 80% of the respondents fell into low score group. Pressure from workplace was high for 68.4% of them. Significant correlation was found among the new graduated nurses' critical thinking ability and their age, education level, reading habit and attitude towards nursing profession.

"Jumping into the COVID-19 arena": The professional transition into clinical practice of new graduate nurses in Italy at time of COVID-19

AIMS AND OBJECTIVES

To evaluate the impact of the professional transition of new graduate nurses during the COVID-19 pandemic.

BACKGROUND

The transition from the role of student to the professional role can be challenging for new graduate nurses for the acquisition of higher autonomy and responsibility. The COVID-19 pandemic impacted the quality of the professional transition.

DESIGN

This was a cross-sectional observational study following the Strengthening and Reporting of Observational Studies in Epidemiology checklist.

METHODS

One hundred and two nurses who graduated in three consecutive sessions (November 2019-pre-pandemic, March 2020-pandemic outbreak, and November 2020-2nd wave) in a north Italian university located in the most affected Italian region by the COVID-19 pandemic, completed an online survey assessing well-being, risk of burnout, resilience, perceived stigma, strengths and limitations and quality of the professional transition. The study was performed between March and May 2021.

RESULTS

81.4% of participants described the professional transition as worse than expected, and new graduate nurses who worked in COVID-19 settings reported a more difficult transition to professional life. No differences emerged in burnout, mental well-being and perceived stigma between new graduate nurses who worked in COVID-19 settings and those who did not. Similarly, no differences emerged amongst the three graduated cohort sessions. The most commonly mentioned challenges faced during the transition were organisational aspects, suddenly acquired autonomy and lack of suitable coaching.

CONCLUSION

New graduate nurses reported a challenging academic-professional transition, in particular, those who worked in COVID-19 settings. The mid- and long-term impact of experiencing an academic-professional transition in COVID-19 settings should be assessed and monitored.

RELEVANCE TO CLINICAL PRACTICE

The professional transition of new graduate students should be adequately planned and monitored, new graduates should be assisted to develop realistic expectations about the transition, and an adequate coaching period should be guaranteed all the more during health emergencies.

Transition to Practice Programs in Nursing: A Rapid Review

Background Transition to practice can be exceedingly stressful for newly qualified nurses as they grapple with the "reality shock" of everyday practice as an RN. Transition to practice programs were implemented as a support strategy to ease the transition from student to RN and are designed to increase graduates' confidence and competence, improve their professional adjustment, and increase their retention. Method This rapid review was framed by the Cochrane Methods Rapid Review, supported by the PRISMA statement checklist, aiming to identify and describe the benefits of transition to practice programs for newly graduated RNs and their impact on workforce retention. Results The literature revealed that mixed evidence exists regarding the value and benefits of graduate nurse transition programs to both the graduate and the health service. Conclusion There are multiple inconsistencies across clinical settings, organizations, and preceptor-ship/mentoring training, among others, particularly in relation to duration of the program and the amount of formalized contact/study days. [J Contin Educ Nurs. 2022;53(10):442-450.].

Work Readiness of Newly Licensed RNs

OBJECTIVE

The aim of this study was to examine the work readiness of newly licensed RNs (NLRNs) based on demographics, education, and work experiences.

BACKGROUND

Work readiness is the extent to which new graduates possess qualities and competencies associated with workplace success. Work readiness of NLRNs complements their clinical knowledge and skills and has been shown to predict job satisfaction and work engagement.

METHODS

Two hundred ninety-seven NLRNs participating in the nurse residency program of a health system in the southeast region of the United States were surveyed using the Work Readiness Scale-Graduate Nurse.

RESULTS

Scores on all readiness dimensions were high. Analysis revealed unexpected differences in readiness dimensions based on race, nursing degree, and completion of a nurse externship program.

CONCLUSIONS

Work readiness adds to our understanding of factors that can affect the transition of NLRNs into the work setting. Further research is needed to understand how work readiness develops over time, factors that predict work readiness, and its relationship to NLRN retention and other outcomes.

Exploring the experiences of frontline nurses caring for COVID-19 patients

AIM

This study seeks to gain a comprehensive understanding of the experiences of frontline nurses who provided direct care for COVID-19 patients.

BACKGROUND

Due to the COVID-19 pandemic, the demands on healthcare systems have been higher than before. Although previous studies have explored the experiences of frontline nurses, these experiences could vary depending on each country's social, cultural, and historical contexts.

INTRODUCTION

In the midst of the global pandemic, sharing the experiences of COVID-19 frontline nurses could have implications for both nursing and nursing policies that could be applied to future pandemics.

METHODS

This descriptive qualitative study comprised 14 South Korean nurses with a minimum of one month of experience working within a COVID-19 department. Individual interviews were conducted on a virtual platform, and a thematic analysis was employed. The consolidated criteria for reporting qualitative studies were used to ensure a detailed reporting of the study.

RESULTS

Four themes and 12 subthemes were developed. The themes included: (1) feeling forced into a world of uncertainty; (2) providing unique care for COVID-19 patients; (3) perceiving barriers to providing quality care; and (4) seeking meaning in caring for COVID-19 patients.

DISCUSSION

Nurses recognized their unique roles in caring for COVID-19 patients and sought new meanings within their profession. However, the poor work environment exacerbated the physical and emotional burden among the nurses and compromised the provision of quality care.

CONCLUSION

This study highlighted the nursing policy issues that need to be improved to ensure better quality care and a stronger healthcare system.

IMPLICATIONS FOR NURSING POLICY

Governmental action is essential to ensure that nurses can maintain the quality of care they have provided during COVID-19 and any future pandemics.

Challenges experienced by newly qualified nurse-midwives transitioning to practice in selected midwifery settings in northern Malawi

BACKGROUND

Literature shows that newly qualified nurse-midwives face challenges integrating into the workforce during their transition period from education to practice. However, little is known about the needs and challenges of Malawian nurse-midwives during their transition from education to practice. The aim of the study was to explore the transition experiences of newly qualified nurse-midwives working in selected midwifery units in Northern Malawi.

METHODOLOGY

A qualitative descriptive approach was used. Data were collected through in-depth interviews using semi-structured interview guides from a purposive sample of 19 participants (13 newly qualified nurse-midwives and 6 key informants). The researchers developed two interview guides; one for the newly qualified nurse-midwives and another one for the key informants. The interview guides had questions related to newly qualified nurse-midwives experiences of transitioning to practice and the support they received. Participants were from three selected hospitals in the Northern part of Malawi that have maternity units. Data were analysed manually using thematic analysis.

FINDINGS

Five themes related to challenges faced by newly qualified nurse-midwives during their transition to practice in midwifery units emerged from the thematic analysis of the data. These included (1) Theory-practice gap, (2) Lack of confidence and skills, (3) Inadequate resources, (4) Transition support system, and (5) Workplace conflict.

CONCLUSION

Newly qualified nurse-midwives in Malawi encounter many challenges while transitioning from education to practice. The study findings underscore the need to develop a national framework support system that could not only help newly qualified midwives adjust positively to their new role but also create more opportunities for learning and developing and strengthening a collaborative partnership between colleges and hospitals.

A Qualitative Study Exploring the Support Needs of Newly Qualified Nurses and their Experiences of an Online Peer Support Intervention

BACKGROUND

In the transitional period following registration, newly qualified nurses may feel socially isolated and easily overwhelmed by increases in accountability, workplace pressures and the psychological demands of the role. Such experiences place them at risk of burnout and leaving the profession.

AIMS

To explore newly qualified nurses' support needs and their experiences of an online peer support intervention.

METHOD

Eighteen newly qualified nurses participated in online peer support groups. After 3 months participants took part in interviews exploring their support needs and experiences of the groups. Eight one-to one interviews were conducted between October 2019 and January 2020. Qualitative thematic analysis was used.

FINDINGS

Two themes identified were; "The Support needs of newly qualified nurses" with two subthemes, "The role of the newly qualified nurse" and "Unmet support needs"; "The online experience" with three subthemes, "Barriers to participation", "Anticipated benefits" and "Unmet expectations".

CONCLUSION

Our findings suggested that there is insufficient support for newly qualified nurses. The newly qualified nurses wanted to use online support to help manage their stress. However, the organisation of online peer support needs careful consideration to ensure participation can be beneficial.

IMPACT STATEMENT

Online support requires careful design and clear support from employing organisations to promote improved transition experiences. Further research should focus on evaluating adjusted online support interventions.

Exploring facilitators and barriers for successful transition among new Saudi graduate nurses: A qualitative study

AIM

This study aims at exploring Saudi newly graduated nurses' perspectives on the facilitators and barriers for successful transition from being a student to being a nurse.

DESIGN

A phenomenological qualitative methodology was employed.

METHODS

Focus group discussions were carried out among 35 Saudi nurses at one major university hospital in Saudi Arabia.

RESULTS

Under the theme of barriers to transition three main subthemes emerged, namely "Fear of making medical errors," "Intense Workload and Expectations," "Bullying and lack of support," while under the facilitators of transition the subthemes which emerged were "Supportive preceptor," "Training workshops," "Need for transition programs." This research found that formal and informal techniques for strengthening institutional variables and improving individual factors are critical for new graduate nurses' effective transition into professional responsibilities.

An Innovative Workforce Initiative to Support New Graduate Nurses: Clinical Nurse Transition Coaches

Nursing leaders at Yale New Haven Health System identified a need among new-graduate nurses for further support beyond their accredited new-graduate residency program. The Clinical Nurse Transition Coach (CNTC) program focused on moving from individual tasks to caring for the entire patient, fostered by focused mentoring and education. The CNTC nurses were experienced and worked with a team of 10 new-graduate nurses.

Ability to Care in Acute Situations-The Influence of Simulation-Based Education on New Graduate Nurses

INTRODUCTION

Simulation-based education is frequently used in transition programs for new graduate nurses. Simulation-based education is implemented as a measure to practice nursing skills, gain experience, and prepare nurses for caring in challenging situations, such as acute situations. However, concerns about the data supporting the use of simulation are obtained from small studies that do not use validated measurement scales.

OBJECTIVE

This study aimed to explore the influence of simulation-based education on new graduate nurses' perceived ability to provide care in acute situations.

METHODS

A total of 102 new graduate nurses participated in simulation-based education as a mandatory part of an introductory program. They completed a premeasurement and a postmeasurement using the Perception to Care in Acute Situations scale. The Wilcoxon signed-rank test and the paired samples t test were used to test the statistical significance of outcomes for the simulation-based education, with the alpha set at 0.05. Cohen's d formula was used to calculate the effect size.

RESULTS

The Wilcoxon signed-rank test on the total scale score showed that simulation-based education resulted in a statistically significant change in the nurses' perceptions of their ability to care in acute situations (N = 99; Z = 7877; P < .001). The paired samples t test showed that the mean posteducation score was significantly higher (P < .001) in the total score. Cohen's d formula (-1.24) indicated a large effect size on the total score.

CONCLUSION

Simulation-based education can provide an effective means of improving new graduate nurses' perceived ability to provide care in acute situations.

Does Self-Directed Learning with Simulation Improve Critical Thinking and Motivation of Nursing Students? A Pre-Post Intervention Study with the MAES© Methodology

Motivation and critical thinking are fundamental for the development of adequate learning. The purpose of the present study was to assess the motivation for learning and critical thinking among nursing students before and after self-directed simulation-based training using the MAES© methodology. A cross-sectional and descriptive quantitative study was conducted with a sample of third-year nursing students. The instruments utilized were the Spanish-adapted version of the Motivated Strategies for Learning Questionnaire (MSLQ-44), and the Critical Thinking for Nursing Professionals Questionnaire (CuPCPE). The students improved their levels both of motivation components, (such as self-efficacy, strategy use, self-regulation) and critical thinking components (such as personal characteristics, intellectual and cognitive abilities, interpersonal abilities and self-management, and technical abilities). These improvements could be a result of the intrinsic characteristics of the MAES© methodology (as a team-based, self-directed, collaborative and peer-to-peer learning method).