Newly graduated nurses' clinical competencies and need for further training in acute care hospitals

How Can Nursing Faculty Create Case Studies Using AI and Educational Technology?

BACKGROUND

Applying artificial intelligence (AI) technology to the development of unfolding case studies in nursing education can reduce barriers to implementation of this educational strategy.

PROBLEM

Unfolding case studies are effective for improving nursing student outcomes related to clinical judgment skills, but these are often time consuming and difficult to develop.

APPROACH

This article describes the use of AI in developing case studies for nursing education.

OUTCOMES

Both students and faculty found case studies developed using an AI platform to be effective learning tools, and faculty especially found that using this platform greatly reduced the time required to develop cases.

CONCLUSION

The use of AI to support development of unfolding case studies is an innovation that allows flexibility for faculty as well as improving student outcomes in practice domains that may otherwise be difficult to target.

Comparing the impact of PASS-BAR handoff education for new nurses between simulation-based and case-based approaches: A quasi-experimental design

AIM

To develop a patient, assessment, situation, safety concerns, background, action, recommendation (PASS-BAR) handoff training program and compare the educational effects of the program between simulation-based (experimental group) and case-based (control group) groups using repeated measures among new nurses.

BACKGROUND

New nurses are not well prepared to provide clear handoff reports because nursing schools and healthcare institutions rarely offer structured programs or training for handoff communication practices.

DESIGN

This study used a pretest-posttest quasi-experimental design with repeated measures with two non-randomized groups.

METHODS

This study targeted new nurses with less than 12 months of experience and was conducted at a university hospital's clinical nursing education center in Seoul, South Korea, between September 2022 and April 2023. Seventeen participants were allocated to the experimental group and 17 participants to the control group. Both groups were given lectures and exercises for both scenarios. Participants were asked to complete a questionnaire on nursing handoff competency, handover performance competency and perceived self-efficacy of handoff at pre- and posttest and two weeks after training. Satisfaction with learning was measured after the intervention.

RESULTS

We developed a simulation-based learning handoff program that includes a simulated handoff performance and debriefing and a case-based learning handoff program that includes discussion, handoff performance and feedback. This study found no immediate difference in the educational effect of PASS-BAR handoff training between simulation-based learning and case-based learning; however, over time, simulation-based learning was more effective than case-based learning in improving nursing handoff competency and handover performance competency.

CONCLUSIONS

Based on the results of this study, a simulation-based handoff training program using PASS-BAR can enhance handoff competencies and help new nurses strengthen their communication skills to understand patients and convey important information.

TWEETABLE ABSTRACT

Developing a simulation-based handoff training program using PASS-BAR helps nurses strengthen their communication skills with colleagues.

Career adaptability among new oncology nurses: A longitudinal exploration

AIM

This study aims to explore the longitudinal predictive effect of self-awareness on career adaptability in new nurses at a tumor specialty hospital and the mediating mechanisms of work readiness and transition shock.

BACKGROUND

Career adaptability is crucial for the personal development of nurses and also intricately linked to the retention rates among newcomers in oncology nursing. Inadequate career adaptability contributes to higher turnover, which in turn exacerbates the shortage of qualified nursing personnel in this field. There is a pressing need for dedicated research and interventions that support new nurses, especially in specialized areas like oncology, to promote their well-being and career advancement. Comprehending these challenges is essential for devising effective strategies that will retain nursing talent and ensure the sustainability of a robust healthcare workforce.

METHODS

Longitudinal data from four follow-up surveys were collected from 248 new clinical nurses at the National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College. Mediation analyses using R 4.1.2 were conducted to examine the pathways between self-awareness, work readiness, transition shock, and career adaptability.

CONCLUSIONS

Self-awareness not only directly predicts career adaptability but also influences it through the bidirectional and chained mediating pathways of work readiness and transition shock.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

These findings equip nursing managers with flexible strategies to foster and enhance nurses' career adaptability, providing targeted support as nurses assimilate into their clinical roles. This not only strengthens workforce stability but also mitigates turnover, ultimately reinforcing the healthcare workforce.

Self-reported competence among advanced practice nursing students in Denmark, Finland and Norway: a cross-sectional multicentre study

BACKGROUND

The health care systems in the Nordic countries and worldwide are under pressure due to increased longevity and a shortage of nurses. Providing nurses with a high level of education, such as advanced practice nursing, is of great importance to ensure effective, safe and high-quality care.

AIM

The aim of this study was to investigate self-reported competence using the Nurse Professional Competence Scale Short-Form for the first time among master's students of advanced practice nursing in the Nordic countries and to relate the findings to age, work obligations, child-rearing responsibilities, level of education and clinical nursing experience.

METHODS

A multicentre, cross-sectional design was used in this study conducted at five universities in Denmark, Finland and Norway. The Nurse Professional Competence Scale Short-Form consisting of six competence areas was used with a maximum score of 7 per item for the analysis of single items and a transformed scale from 14.3 to 100 for analysing the competence areas (higher score equals higher self-reported competence). Descriptive and comparative statistics were used to analyse the data.

RESULTS

The highest mean score was found for the competence area 'Value-based nursing care'. Students living with home-dwelling children (≤ 18 years) reported significantly higher competence in 'Nursing care', while students ≥33 years reported significantly higher competence in 'Nursing care' and 'Value-based nursing care'. No significant differences were found between students working and those not working alongside their studies, between students with and without further nursing-related education, or between students with long and short experience as nurses.

CONCLUSIONS

The findings from this study might help to further develop curricula in advanced practice nursing master's programmes to ensure high-quality nursing and sustainable health care in the future. Future high-quality master's programmes might benefit from systematic collaboration between Nordic higher education institutions as also Sweden is planning master's programme. Higher age, having children at home and working while studying should not be considered causes for concern.

The impact of transition programs on well-being, experiences of work environment and turnover intentionamong early career hospital nurses

BACKGROUND

Transition programs for newly graduated nurses in hospital settings are reported to provide learning opportunities, strengthening confidence, workplace integration and skills, retention and job satisfaction. Still, our knowledge of long-term effects is scarce and few studies have used control groups.

OBJECTIVE

To explore the long-term impact of having attended a transition program on the nurses' experiences of the first years of practice. More specifically, ideology-infused psychological contract, ethical stress, perceived organizational support, job satisfaction, opportunities for learning, and intention to stay in the nursing profession, were explored as outcome variables.

METHODS

A questionnaire survey was carried out among registered nurses from November 2019 to January 2020, with a 54% response rate. The analysis was based on 149 nurses who had attended a transition program, and 72 who had not attended. The nurses had seniority between one and three years. Independent samples t-test were used to investigate differences between the groups.

RESULTS

The two groups showed small and non-significant differences in the outcome variables. However, regarding the frequency of ethical value conflicts induced by insufficient resources, as well as experiences of ethical value conflict distress, the group of nurses who had attended a transition program showed statistically significantly higher mean values, although the effect sizes were small.

CONCLUSION

Newly graduated nurses need more than transition programs and skills training to progress in their nursing role and develop competence, increase job satisfaction, and reduce stress. Achieving these goals requires a long-term supportive learning environment that is integrated into everyday work.

Barriers and Facilitators Experienced by Undergraduate Nursing Faculty Teaching Clinical Judgment: A Qualitative Study

Background

Clinical judgment is declining in new graduate nurses, which affects patient safety and is therefore tested on the Next Generation NCLEX. There is limited research describing barriers and facilitators impacting nursing faculty's experiences teaching clinical judgment.

Aims

The purpose of this study was to explore barriers and facilitators affecting undergraduate nursing faculty's clinical judgment teaching methods.

Methods

Sixteen qualitative interviews were conducted with full-time nursing faculty at seven universities in the Northeast and Southeast regions of the United States.

Results

The findings revealed program, student, and faculty factors affecting clinical judgment teaching methods. Subthemes included time, class size, students' class preparation, critical thinking, task orientation, professional development, and faculty resistance.

Conclusion

Minimizing barriers and strengthening facilitators based on participants' practices and previous research can support more effective clinical judgment pedagogy, which has the potential to achieve Next Generation NCLEX success and potentially increase patient safety.

Higher Vocational Nursing Students' Clinical Core Competence in China: A Cross-Sectional Study

Introduction

Understanding the clinical core competence of nursing students in higher vocational colleges is crucial for adjusting the nursing core curriculum and training of nursing professionals. However, little is known about the level of clinical core competence of higher vocational nursing students in China.

Objective

To investigate nursing students' clinical core competence in the school of nursing and health at a vocational and technical college in Guangdong, China.

Methods

The Core Competency Scale for Registered Nurses in China was used to evaluate the clinical core competence of higher vocational nursing students from February to March 2022. Data were analyzed by descriptive statistics, Mann-Whitney U test and Kruskal-Wallis test.

Results

A total of 1,120 nursing students were investigated, 1,069 were valid questionnaires, and the response rate was 95.4%. The total score of core competence score of higher vocational nursing students was 176.55 ± 43.95, only 43.3% of students obtained an overall score more than 178, and 47.7% of students scored between 116 and 178 scores. The lowest score was on critical thinking and scientific research (2.72 ± 0.77) following by clinical nursing (2.85 ± 0.80), which had differences in gender, category of students, and years of study. There were differences in the total average score of core competence in terms of gender and category of students. Leadership and interpersonal relationships differ significantly by gender, while professional development, teaching, and coaching differ significantly by category of student.

Conclusions

The findings revealed the core competence of higher vocational nursing students is at a medium level. Moreover, critical thinking and scientific research, and clinical nursing ability are significantly insufficient.

Changes in evidence-based practice self-efficacy among nursing students and the impact of clinical competencies: Longitudinal descriptive study

INTRODUCTION

Evidence-based practice (EBP) is essential to ensure patient safety and improve the quality of nursing care. Nursing students' self-efficacy in employing EBP is crucial for the formation of a culture of EBP in healthcare organizations.

OBJECTIVE

This study aimed to investigate the changes in nursing students' self-efficacy in employing EBP and the extent to which clinical performance affects these changes.

METHODS

This study was a longitudinal descriptive study. Participants were nursing students who had received education on EBP theory and had clinical practice experience. Convenience sampling was used to select nursing students in their third year of study at a nursing college located in the southern region of Korea in 2020. The researcher measured EBP self-efficacy and clinical competence using an online survey tool at three time points (second semester of third year, first semester of fourth year, and second semester of fourth year). Multilevel modeling was used to identify factors affecting changes in EBP self-efficacy.

RESULTS

The results showed that nursing students' EBP self-efficacy increased over time. Nursing leadership (p = .022), nursing skills (p = .028), communication (p < .001), and nursing process (p = .003) were significant factors that affected the changes in EBP self-efficacy. Individual differences in initial levels and change rates were still observed.

CONCLUSION

Systematic education on EBP theory and practical training should be provided to nursing students from the beginning of their studies to graduation to deepen their EBP and clinical competence.

The effect of scenario-based training on the Core competencies of nursing students: a semi-experimental study

INTRODUCTION

Competency is defined as the variety of skills and knowledge required to perform a specific task. Due to the specificity of pediatric nursing, students face some challenges in acquiring core competencies. Therefore, the use of new training methods in pediatric nursing is necessary. One of the modern learning methods is learning based on clinical scenarios. Thus, this study aimed to investigate the effect of scenario-based education on the core competencies of nursing students.

METHOD

This quasi-experimental study employed a pre-test and post-test design. All participants (n = 72) were selected via the census method and randomly divided into intervention (N = 33) and control groups (N = 40). The data were collected using a demographic information questionnaire and the Nursing Students' Clinical Competencies Questionnaire. Before the intervention, both groups completed the pre-tests. After one month, the students in both groups completed post-tests.

RESULTS

The average score of core competencies for the students in the intervention group after the training (247.05, SD = 36.48) increased compared to before the intervention (229.05, SD = 36.58) (P > 0.05). The average score of the core competencies for the students in the control group after the training was 240.76 (SD = 35.36) compared to 235.56 (SD = 27.94) before the intervention, with no significant difference (P < 0.05). The independent t-test did not show a significant difference between the control and intervention groups before and after the intervention (P > 0.05).

CONCLUSION

The results indicated the effectiveness of scenario-based training on the core competencies of students in the intervention group. Accordingly, nursing administrators and professors are recommended to incorporate new scenario-based teaching and learning methods in educational programs of universities. It is also necessary to conduct more research into the effectiveness of this method in combination with other training methods like team-based and problem-based training.

Professional Values and Self-Reported Clinical Competence of Acute Care Nurses in Saudi Arabia: A Cross-Sectional Study

BACKGROUND

Professional values are the foundation of nursing practice. Current research evidence on the influence of professional values on clinical competence among acute care nurses in the clinical area is lacking.

PURPOSE

The purpose of this study was to examine the professional values and self-reported clinical competence among acute care nurses.

METHODS

This quantitative study used a cross-sectional, correlational design. A convenience sample of 403 nurses was recruited to answer the survey utilizing the Nurses Professional Values Scale-3 and the Nurse Competence Scale. The Pearson correlation coefficient was computed to test the relationship between study variables, and a stepwise multiple regression analysis was then performed to investigate the predictors of nurses' professional values and clinical competence.

RESULTS

The professional value of "caring" received the highest mean score, followed by "professionalism", while the factor "activism" was rated the lowest. Education was a significant predictor of all three factors of professional values. For clinical competence, "managing situations" was rated as the highest dimension, while "ensuring quality" was rated as the lowest. Moderate positive correlations were revealed between the three factors of professional values and all dimensions of nurses' clinical competence. Area of practice and "activism" were the only significant predictors of the nurses' clinical competence.

CONCLUSIONS

Nurses perceived all three factors of professional values with high importance in influencing their clinical competence. These findings can contribute to the development of educational interventions to improve and sustain professional values and clinical competence among acute care nurses.

New graduate nurses' delivery of patient care: A focused ethnography

AIM

To explore factors influencing newly graduated nurses' delivery of direct care in acute care hospital settings.

DESIGN

Qualitative study using focused ethnography.

METHODS

During the period from March to June 2022, a total of ten newly graduated nurses were purposively sampled, and data were collected through 96 h of participant observation as well as ten semi-structured interviews. This research took place in a large hospital located in Denmark. Data were analysed using LeCompte and Schensul's ethnographic content analysis.

RESULTS

Three main structures were developed from the data: 'Contrasting Intentions and Actions for care delivery', 'Organizational Constraints Block Interpersonal Aspects of Nursing Care' and 'Newly Graduated Nurses' Suppressed Need for Support Constitutes Delay in Care Actions'.

CONCLUSION

Newly graduated nurses were committed to delivering high-quality care but were aware they sometimes provided compromised care. The paradox between a commitment to care and compromised care delivery was borne out of tensions between newly graduated nurses' professional beliefs and nursing values, a desire to integrate patients' needs and preferences, and organizational constraints on everyday practices where newly graduated nurses often worked alone without the support of a more experienced nurse. Critical reflection on cultural, social and political forces that influence direct care delivery might support newly graduated nurses to deliver direct patient care more intentionally.

RELEVANCE TO CLINICAL PRACTICE

Establishment of onboarding programs and other support activities for newly graduated nurses to cope with contrasting intentions and actions that must address organizational constraints is essential. These development programs should include how critical reflection competency is supported to address value inconsistencies and emotional distress to ensure high-quality patient care.

REPORTING METHOD

The reporting adhered to the COREQ guidelines. PATIENT OR PUBLIC CONTRIBUTION: 'No Patient or Public Contribution'.

Prepared to learn but unprepared for work: A cross sectional survey study exploring the preparedness, challenges, and needs of newly graduated nurses entering a hospital-based transition program

The study aims to investigate new graduate nurses the perceptions of educational preparedness, their challenges, and their expectations during their transition to hospital care and introduction to work.

BACKGROUND

Previous research has raised questions about new graduate nurses' (NGNs) preparedness for work in the clinical setting, and transition programs have been implemented to smooth the transition process. Information about NGNs' expectations of both transition programs and their introduction to work when first entering the nursing profession is scarce.

DESIGN

A cross-sectional survey design was used.

METHOD

NGNs enrolled in a regional transition program in six hospitals were recruited from three-cohorts during September 2021, January 2022 and September 2022. After responding to a survey both a qualitative and quantitative approach was used when analyzing responses.

RESULTS

Quantitative and qualitative findings derived from 248 NGNs responses showed that 65% of the NGNs perceived that nursing education in general prepared them for clinical work, that they were prepared for and committed to workplace learning but require support from a well-designed transition program as well as from colleagues and managers in their ward unit. The conclusion is that the preparation provided by nursing education as well as organizational factors in the healthcare workplace influence new graduate nurses' readiness for clinical work, the challenges they perceive, and their needs for learning and support.

Clinical Competence of Nurses and the Associated Factors in Public Hospitals of Gamo Zone, Southern Ethiopia: A Cross-Sectional Study

Introduction

Nursing competency is an essential component for improving the quality of care in the healthcare system. However, assessing competency solely on the dimensions of skills and knowledge does not provide complete picture of a nurse ability to provide quality patient care. This is because it lacks focus on the nurse's attitudes and values, which are also important determinants of clinical competence. Therefore, this study aimed to assess the comprehensive clinical competence of nurses and its associated factors in public hospitals of Gamo Zone, Southern Ethiopia.

Materials and Methods

A cross-sectional study was conducted using a census method to collect information from nurses through self-administered questionnaires. The data were entered into EpiData version 3.1 and exported to Stata version 15 for analysis. A linear regression model was used to identify factors associated with clinical competence.

Results

In this study, the average clinical competence of nurses was 177.32, with a standard deviation of 19.19, and 31.2% of the respondents had a high level of clinical competence. Associated factors identified with clinical competence include gender, age, marital status, qualification, position, work experience, unit, interest in their profession, critical thinking disposition, clinical self-efficacy, and emotional intelligence.

Conclusions

The overall level of clinical competence among nurses in this study was moderate. As such, nurses improve their clinical competence by receiving training and development opportunities that focus on critical thinking, clinical self-efficacy, and emotional intelligence; working in a supportive work environment that encourages them to take risks and learn from their mistakes; and being monitored and coached on a regular basis.

Emergency care nurses' self-reported clinical competence before and after postgraduate education - a cross-sectional study

Changing prerequisites in healthcare leads to the increased complexity of nursing. Since there are no regulations on re-validation of competencies for emergency nurses in Sweden there is sparse knowledge on how nurses develop competencies after registration as nurses (RN).

AIM

To describe self-reported professional competence after postgraduate education among RNs in emergency care settings.

METHOD

A cross-sectional design and STROBE guidelines were used. The short version of the Nurse Professional Competence Scale was used for data collection and the data were collected before and after postgraduate education, descriptive and comparative statistic was used for analysis.

RESULTS

62 (71%) students participated in the first data collection and an independent group of 31 (48%) students participated in the second data collection. The results showed generally good competencies before entering education and significantly improved competencies after education were found in areas of working independently and reviewing literature for evidence-based nursing Conclusion: The competencies were assessed as very good after education. Evaluating nurses' competencies supports educators in developing education to ensure the need for knowledge in emergency care. To ensure required competencies among emergency care nurses there is a need to regulate additional training and re-validation of emergency nurses' competencies.

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).

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.

The effect of community of practice in improving the role of clinical instructor in patient safety implementation by prelicensure nursing students

Introduction: Patient safety problems caused by students leads to different adverse event, hence clinical instructor plays a role in guiding them in the implementation of patient safety programs. Furthermore, the community of practice is considered to improve the role of clinical instructors in patient safety problems. This study is then conducted to measure the impact of community of practice toward the role of clinical instructors in patient safety problems. Design and methods: This is a pre-experimental design for one group and a pre-post test design without a control group. In addition, the sample includes 36 prelicensure nursing students. Result: The results showed that the score of clinical instructors’ role before and after intervention with community of practice implementation was 58 (34-67) and 79.33 with SD of 10,960, respectively, with a significant increase of 24.27. Also, the statistic analysis depicted that the role had a significant effect after implementation, with a p-value of < 0,000. Conclusions: Based on the results, the community of practice had a significant impact in increasing the role of clinical instructors in the implementation of patient safety problems by prelicensure nursing students.  

Development and psychometric testing of Perceived Preoperative Nursing Care Competence Scale for Nursing Students (PPreCC-NS)

BACKGROUND

For nurses to carry out their responsibilities related to preoperative care in the best possible way, it is very important for them to receive competency-based training and for their competences to be measured with reliable and valid tools in the training process.

OBJECTIVE

To develop a measurement tool that evaluates nursing students' perceived competence for preoperative nursing care.

DESIGN

A cross-sectional, methodological study.

SETTING

Two universities in the Eastern Black Sea Region of Turkey.

PARTICIPANTS

A total of 661 second, third and fourth grade nursing students participated in the study.

METHODS

Items were created in line with the nursing competencies published by the International Council of Nurses, the competencies in the perioperative period nursing practices published by the European Operating Room Nurses Association, and a review of the literature. Then, to test the content validity, the items were submitted for expert opinion and a pilot implementation was made with 50 nursing students. Furthermore, the construct validity of the scale was tested with exploratory factor analysis (n = 253) and confirmatory factor analysis (n = 350). Test-retest stability was also investigated for the PPreCC-NS (n = 58), in the study.

RESULTS

According to the results of the exploratory factor analysis, the Kaiser-Meyer-Olkin value was 0.948, and the Bartlett test χ2 was 7765.23; p < 0.001. Three items with a factor loading value below 0.50 were removed from the scale, and the obtained factor structure explained 62.25 % of the variance. The fit indices of the scale model tested in the confirmatory factor analysis were determined as χ²/df = 2.74, RMSEA = 0.07, CFI = 0.92, GFI = 0.88, AGFI = 0.85, IFI = 0.92. The structure of the draft scale was confirmed with 5 factors and 22 items. The Cronbach alpha values were found to be 0.79-0.96 for the sub-dimensions of the scale and 0.94 for the total scale. Data also showed a good test-retest stability (ICC = 0.72).

CONCLUSIONS

This scale is a reliable and valid measurement tool for nursing students to determine their level of perceived competence for preoperative nursing care. It is recommended that the psychometric structure of the scale be evaluated with further studies on larger and more diverse samples.

The relationship between perceived competence and self-esteem among novice nurses - a cross-sectional study

BACKGROUND

Novice nurses' responsibilities are greater than what their actual level of competence can cope with. This can cause increased levels of stress, which many studies have shown is a factor resulting in reduced self-esteem, which affects not only the well-being of nurses but also the quality of care provided.

AIMS

To investigate the relationship between the self-assessment of nursing competencies and self-esteem among novice nurses and the moderation role of the sociodemographic variables and intention to leave the nursing profession on this relationship.

MATERIAL AND METHODS

A correlational cross-sectional study was performed using an online questionnaire. The study was conducted between July and October 2019 among 122 novice nurses. The study tool consisted of the Rosenberg Self-Esteem Scale, the Nurse Professional Competence Scale-Short Version, and metrics. Calculations were performed using SPSS Statistics, version 25. To approach research questions hierarchical multiple regression was performed.

RESULTS

The self-esteem level of novice nurses have been identified as low. Novice nurses who declared their willingness to leave their profession had a higher level of self-esteem than nurses who did not declare this willingness. The highest-rated competencies were in the fields of nursing care and value-based nursing care, while the lowest were in the areas of development, leadership, and the organisation of nursing care. Correlations between postgraduate education and competencies in the majority subscales were revealed. The results showed a negative correlation between self-esteem and all subscales of the competence scale. Seniority and postgraduate education were important moderators in the relationship between some competence subscales and self-esteem.

CONCLUSION

Novice nurses present a low level of self-esteem. Nurses with a higher competence level showed lower self-esteem. Developing competencies at the beginning of one's nursing practice, which is crucial for patients' outcomes, should be accompanied by the strengthening of novice nurses' self-esteem.KEY MESSAGESNovice nurses with a higher level of self-esteem more often declared their willingness to leave their profession.The results showed a negative correlation between self-esteem and all subscales of the competence scale.Seniority and postgraduate education are important moderators in the relationship between some competence subscales and self-esteem.

Storylines, metaphors, and solutions in the work-readiness literature: A frame analysis

AIM

To investigate how the literature frames the reported poor work-readiness of new graduate nurses and the solutions it recommends.

DESIGN

Critical frame analysis of work-readiness literature storylines.

METHODS

Deductive and inductive analysis of work-readiness literature published 2016-2019.

RESULTS

The three systematic reviews, literature review, and analysis of transition guidelines reinforced the belief that nursing graduates should be work-ready. In addition, the articles summarized service and academic innovations intended to assist newly qualified nurses transition to practice.

CONCLUSION

The literature attributes perceived graduates' poor work-readiness to divergent faculty and employer expectations, personal deficiencies, defective learning environments, and poor workplace support. Internships, mentorship, academic-service partnerships, and curricular and pedagogical innovation are the dominant recommendations for reform. Workplace clinical education and training are not mechanisms for correcting graduates' work performance but essential activities for sustaining the nursing workforce.

IMPACT

The study should encourage more use of frame analysis in nursing education research. Fact-checking storylines must be a priority for future studies. Research that clarifies the fault lines between advocates of work-readiness and dissident academic leaders has the potential to promote dialogue. Work-ready, theory-gap, and other deficit metaphors must be put aside for the debate because universities must not relinquish their responsibility for educating students for the 21st century.

Nurses' strategies to enable continuous positive airway pressure therapy in a general medical ward context: A qualitative study

BACKGROUND

Continuous positive airway pressure is a non-invasive therapy beneficial for patients with acute respiratory failure. The need for this therapy outside intensive care units is growing, but nurses face many challenges to enable this therapy in general medical wards.

AIMS AND OBJECTIVES

The aim of the study was to explore nurses' strategies for enabling continuous positive airway pressure therapy in a general medical ward context.

METHOD

An explorative qualitative design was used including semi-structured interviews with 15 Swedish nurses. Data were analysed using a conventional content analysis.

RESULTS

The nurses' strategies included a non-hierarchical approach when utilising an intra- and interprofessional collaboration. Inexperience was compensated for by collaboration. Nurses' strategies involved advanced patient-centred care using interventions to manage and ease the patient's treatment and discomfort. The creation of an alliance with the patient was crucial to prevent treatment failure. The strategies were interrelated and considered as parts of a whole.

CONCLUSION

Nurses described the strategy of a dynamic team that could be enlarged or decreased in tandem with other professionals, depending on the situation and the nurses' needs. Nurses need to have an attentive response to the patients' physical, psychosocial and relational needs and to maintain trust for a positive therapy outcome.

Umbrella review: Newly graduated nurses' experiences of providing direct care in hospital settings

AIM

To summarize existing research syntheses reporting newly graduated registered nurses' experiences of providing direct care in hospital settings.

DESIGN

Umbrella review.

DATA SOURCES

An extensive search of all relevant databases was conducted for research syntheses. Initial key terms included "new* nurse", "nursing care" and "hospital setting" in combination with index terms to find relevant literature.

METHODS

Critical appraisal, data extraction and summary were performed independently by two reviewers according to the Joanna Briggs Institute guidelines for undertaking umbrella reviews.

RESULTS

Nine research syntheses published between 2010 and 2019 and representing 173 studies were included following critical appraisal. The evidence was summarized in narrative form with supporting tables. Twenty-six sub-branches and seven main-branches were organized in a coding tree showing the structure of three overlapping themes: "Feeling a lack of competency", "Sense of emotional distress" and "In need of support".

CONCLUSIONS

Evidence demonstrates that newly graduated registered nurses' experiences of a lack of competency, emotional distress and need for support emerged as essential requirements for the provision of competent and safe direct care for the patient.

IMPACT

Newly graduated registered nurses face multiple challenges in the transition from student nurse to practicing nurse. Unmet expectations of being a newly graduated nurse might lead to low levels of job satisfaction, high attrition rates or missed nursing care. Nurse educators, leaders and policy makers should be mindful that newly graduated registered nurses' perceptions of professional and personal identity and degree of support influences newly graduated registered nurses' direct care provision.

New graduate registered nurses: Risk mitigation strategies to ensure safety and successful transition to practice

The COVID-19 pandemic has impacted traditional pathways for new graduate registered nurses (NGRN's) transition to practice. In response to stay at home emergency orders in 2020, NGRN's experienced changes in pre-licensure curriculum, clinical practicums, NCLEX testing, and licensure, all which influence preparedness for professional practice. The adverse impact on education and clinical training extends to all nursing students who attended higher education institutions of learning during 2020 to present and is a significant consideration with new graduates over the long-term, whom will be caring for patients in healthcare settings. Well before this pandemic, literature identified that NGRN's were predisposed to knowledge-practice gaps and lacked situational awareness. Recent nursing research emerging from the pandemic reveals a potentiating negative impact of the abbreviated pre-licensure experiences on patient safety in the clinical setting. In the current healthcare environment, it is preemptive for healthcare institutions and schools of nursing to work cohesively to ensure patient safety through an increased emphasis on evidence-based approaches to reduce patient harm and mitigate harm when it does occur. Further, in response to the increased demand for nurses by healthcare organizations, considerations for safety, risk management, and ethical care must be considered during the transition to practice for NGRN's.

A mentoring programme to meet newly graduated nurses' needs and give senior nurses a new career opportunity: A multiple-case study

AIM

To evaluate the implementation of a multifaceted mentoring programme in a large university hospital and describe its value from the perspectives of newly graduated nurses, experienced nurses and the hospital organisation.

BACKGROUND

Healthcare organisations need long-term competence-planning strategies to retain nurses, prevent their premature departure from the profession and use their competencies. This paper reports a mentoring programme focused on supporting newly graduated nurse' transition to practice and senior nurses' professional development as supervisors.

DESIGN

A multiple-case study.

METHODS

We performed 35 interviews with nurses, supervisors and nurse managers in the five units that implemented the programme, mapped the programme at the hospital level and extracted the nurses' working hours. The interviews were analysed thematically using the theoretical lens of the head-heart-hand model to interpret the results.

RESULTS

Of 46 units in the hospital, 14 had implemented one or several of the components in the mentoring programme. The programme corresponded to the newly graduated nurses' needs, gave senior nurses a new career opportunity and contributed to an attractive workplace. The main theme, Giving new nurses confidence, experienced nurses a positive challenge and the organisation an opportunity to learn, reflects the value of the programme's supervisory model to new and experienced nurses and to the organisation as a whole.

CONCLUSION

The mentoring programme appeared to be a promising way to smooth the transition for newly graduated nurses. The experienced supervising nurses were key to the success of this complex programme, supporting the new nurses at the bedside and being available to respond to their questions and reflections. Embedding the supervisors in the units' daily practice was necessary to the success of the different parts of the programme. Despite the strategic and well-designed implementation of this mentoring programme aimed to solve the everyday challenge of nurse shortages in the hospital, it was a challenge to implement it fully in all the units studied.

Transition shock, preceptor support and nursing competency among newly graduated registered nurses: A cross-sectional study

BACKGROUND

Transition shock is highly prevalent among newly graduated registered nurses in their early career. Preceptors are widely used to support them in acquiring clinical nursing competencies and to promote their successful transition to practice. However, the mechanism by which transition shock and preceptor support are linked to nursing competency among newly graduated registered nurses remains unknown.

OBJECTIVES

The aim of the study was to examine the relationship between transition shock, preceptor support, and nursing competency in a sample of newly graduated registered nurses.

DESIGN

A descriptive, cross-sectional design.

SETTINGS

Six tertiary hospitals in the southeast of mainland China.

PARTICIPANTS

Newly graduated registered nurses undertaking their professional role in the first year.

METHODS

Convenience sampling was used to recruit 215 newly graduated registered nurses [184 female, 31 male] from six hospitals. Data on transition shock, preceptor support, and nursing competency were collected using questionnaires from November to December 2019.

RESULTS

The nursing competency of critical thinking/research aptitude (mean = 2.68, SD = 0.63) was scored the lowest among participants. Transition shock (r = -0.21, p < .01) and perceptions of preceptor support (r = 0.56, p < .01) were statistically significantly correlated with nursing competency. Preceptor context, whether the assigned preceptor varied day by day, and the emotional challenges of transition shock were the main predictors of nursing competency (F = 36.86, p = .00), accounting for 34% of the variance in nursing competency.

CONCLUSIONS

Educational programs aimed at increasing critical thinking and research aptitude in the educational stage and the continuing educational stage can benefit newly graduated registered nurses. A well-organized transition program in hospitals including awareness and recognition of transition shock in newly graduated registered nurses is essential to enhance their competency in providing quality nursing. More support and assistance would be useful in promoting the preceptor's role in improving nursing competency of newly graduated registered nurses.

Insufficiently supported in handling responsibility and demands: Findings from a qualitative study of newly graduated nurses

Aims and objectives

To explore newly graduated registered nurses' experiences and how they manage complex patient situations.

Background

Newly graduated registered nurses' working in acute care hospital settings are challenged by managing complex patient situations in rapidly changing clinical contexts involving increased patient acuity, comorbidities and staffing shortages.

Design

Qualitative study design.

Methods

Data were collected using focus groups interviews of a total of 16 newly graduated registered nurses with clinical work experience of 6 months of direct patient care in an acute care hospital setting. Analyses were conducted using qualitative content analysis. COREQ reporting guidelines were used.

Results

The analysis resulted in the overarching theme “Not being sufficiently prepared and supported to meet responsibilities and demands.” The theme included three categories: “Responsibility is not in proportion to competence,” “Lack of medical competence and experience complicates patient safety” and “Strives for control to manage and organise nursing care.”

Conclusion

The results show that newly graduated registered nurses' are not sufficiently supported for the level of responsibility and the demands placed on them when providing nursing in complex patient situations in acute care hospital settings. If they are given sole responsibility for multiple complex patient situations, patient safety may be compromised.

Relevance to practice

Special attention need to be paid to NGRNs support to medical competence in the areas of assessing, planning, prioritizing, leading, and distributing nursing care in daily clinical settings for at least their first year of professional work.