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Wang X, Liu M, Xu T, Wang K, Huang L, Zhang X. New nurses' practice environment, job stress, and patient safety attitudes: a cross-sectional study based on the job demands-resources model. BMC Nurs 2024; 23:473. [PMID: 38997677 PMCID: PMC11241995 DOI: 10.1186/s12912-024-02135-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 06/28/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND Patient safety is paramount for all healthcare agencies. Health professionals' lack of patient safety competencies threaten patients' lives, and increase patients, families, hospitals, and social burdens. The new nurse-related patient safety issues have particularly attracted much attention. The aim of this study was to examine the impacts of practice environment and job stress on new nurses' patient safety attitudes by employing the job demands-resources model. METHODS The study used a cross-sectional structural equation modeling (SEM). A convenience sample of 370 new nurses was recruited from seven tertiary hospitals in Anhui province, China, from April 2022 to August 2022. Data were collected using self-report questionnaires including the Chinese version of the Nurse Job Stressors Scale, the Practice Environment Scale, and the Safety Attitudes Questionnaire. RESULTS New nurses' patient safety attitudes scores were moderate (126.99 ± 14.39). Practice environment had a significant direct effect on job stress (β = -0.337, t = 6.120), patient safety attitudes (β = 0.604, t = 13.766), practice environment had an indirect effect on patient safety attitudes through job stress (β = 0.066, t = 3.690), and the indirect effect accounted for 9.9% of the total effect. This model was able to explain 48.3% of patient safety attitudes with moderate prediction accuracy. CONCLUSIONS This study emphasizes the importance of improving new nurses' attitudes toward patient safety. Hospital administrators should develop policies and strategies to address job characteristics, and establish a favorable work environment to reduce new nurses' job stress as well as to improve patient safety.
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Affiliation(s)
- Xin Wang
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, China
| | - Ming Liu
- Peking University Health Science Center - Macao Polytechnic University Nursing Academy, Macao Polytechnic University, Macao, China
| | - Tao Xu
- School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Kangyue Wang
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, China
| | - Liebin Huang
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, China
| | - Xiancui Zhang
- Health Management Center, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China.
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2
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Zhang R, Wu X, Zhong M, Yu C, Yu J, Jiang J, Duan X. Perspectives and experiences of newly registered nurses surrounding the objective structured clinical examination in an obstetrics and gynecology hospital: A qualitative study in Shanghai, China. NURSE EDUCATION TODAY 2023; 124:105754. [PMID: 36870224 DOI: 10.1016/j.nedt.2023.105754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 01/19/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES Newly registered nurses in China are required to attend two years of standardized training programs after graduation, and an evaluation of the training program's effectiveness is critical. The objective structured clinical examination is a relatively new and objective approach to exploring the effectiveness of training programs and is increasingly being encouraged and used in clinics. However, the perspectives and experiences of newly registered nurses in obstetrics and gynecology regarding the objective structured clinical examination are unclear. Therefore, the objective of this study was to investigate newly registered nurses' perspectives and experiences of the objective structured clinical examination in an obstetrics and gynecology hospital. DESIGN This qualitative study was conducted using a phenomenological approach. DATA SOURCES Twenty-four newly registered nurses taking the objective structured clinical examination in a third-level obstetrics and gynecology hospital in Shanghai, China. REVIEW METHODS Semi-structured face-to-face interviews were conducted between July and August 2021. The Colaizzi seven-step framework was applied for data analysis. RESULTS Three main themes and six sub-themes emerged: 1) high satisfaction with the objective structured clinical examination; 2) gaining experience and growing as nurses; and 3) high pressure. CONCLUSION The objective clinical structured examination can be used to assess the competence of newly registered nurses after training in an obstetrics and gynecology hospital. The examination not only enables an objective and comprehensive evaluation of others and self-evaluation but also leads to positive psychological experiences in newly registered nurses. However, interventions are needed to relieve examination pressure and to provide effective support for participants. The objective clinical structured examination can be incorporated into the training assessment system; this study provides a basis for improving training programs and the training of newly registered nurses.
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Affiliation(s)
- Runa Zhang
- Nursing Department, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xiaoyun Wu
- Department of Cardiovascular Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Minhui Zhong
- Nursing Department, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Chan Yu
- Department of Gynecology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai 200092, China
| | - Jia Yu
- School of Medicine, Tongji University, Shanghai 200092, China.
| | - Jinxia Jiang
- Emergency Department, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
| | - Xia Duan
- Nursing Department, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.
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Yun B, Su Q, Ye X, Wu Y, Chen L, Zuo Y, Liu J, Han L. The relationships between clinical teaching behaviour and transition shock in newly graduated nurses. Nurs Open 2023; 10:2107-2117. [PMID: 36329679 PMCID: PMC10006593 DOI: 10.1002/nop2.1458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 08/17/2022] [Accepted: 10/22/2022] [Indexed: 11/06/2022] Open
Abstract
AIM To explore the relationships between clinical teaching behaviour and transition shock in newly graduated nurses and significant differences in the northwest and northeast China. DESIGN A cross-sectional design. METHODS A total of 211 (nurses) and 925 (preceptors) were recruited in six Third-class different hospitals from July to August 2019. RESULTS The transition shock is negatively correlated with the clinical teaching behaviour in northwest and northeast China, while the transition shock in the northwest is higher than that in the northeast for the behindhand economy and natural limit. CONCLUSION The transition process of newly graduated nurses in northeast China with ethnic minorities and the behindhand economy is more difficult. For newly graduated nurses, personal health and a supportive environment need further improvement. Teaching strategies for preceptors need to be enhanced. Two-way feedback is more useful for both the newly graduated nurses and preceptors to improve quality care, and holistic care.
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Affiliation(s)
- Bei Yun
- School of Nursing, Naval Medical University (Second Military Medical University), Shanghai, China.,School of Nursing, Lanzhou University, Lanzhou, China
| | - Qian Su
- The First Clinical Medical College of Lanzhou University, Lanzhou, China.,Nursing Department, Gansu Provincial Hospital, Lanzhou, China
| | - Xuchun Ye
- School of Nursing, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Yuhan Wu
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Lian Chen
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Yamei Zuo
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Jia Liu
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Lin Han
- School of Nursing, Lanzhou University, Lanzhou, China.,The First Clinical Medical College of Lanzhou University, Lanzhou, China.,Nursing Department, Gansu Provincial Hospital, Lanzhou, China
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Tan KAZY, Seah B, Wong LF, Lee CCS, Goh HS, Liaw SY. Simulation-Based Mastery Learning to Facilitate Transition to Nursing Practice. Nurse Educ 2022; 47:336-341. [PMID: 35667017 DOI: 10.1097/nne.0000000000001224] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Simulation-based mastery learning (SBML) was developed and implemented to facilitate nursing students' transition to clinical practice. PURPOSE To evaluate nursing students' perspectives on the impact of SBML on their transition to clinical practice. METHOD A descriptive qualitative study using focus group discussions was conducted with final-year nursing students who had completed their clinical practicum and SBML. RESULTS Three themes emerged: authenticity of simulations, whereby students were able to draw some parallels between their simulations and clinical experiences; self-efficacy in clinical practice, which was gained through deliberate practice; and application of cognitive tools, which provided mental frameworks to guide clinical performances. CONCLUSION This study highlights the need to ensure the fidelity of the simulations to achieve authentic experiences, provide deliberate practice to develop self-efficacy, and use cognitive tools for mental model formation to create a high-quality SBML program to foster better transfer of simulation learning to real-life setting.
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Affiliation(s)
- Kimberly-Ann Zi Ying Tan
- Staff Nurse (Ms Tan), Tan Tock Seng Hospital, Singapore; Research Fellow (Dr Seah), Lecturer (Ms Wong), Senior Lecturer (Dr Goh), and Associate Professor (Dr Liaw), Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; and Nurse Educator (Ms Lee), National Healthcare Group Polyclinics, Singapore
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Berglund M, Kjellsdotter A, Wills J, Johansson A. The best of both worlds - entering the nursing profession with support of a transition programme. Scand J Caring Sci 2021; 36:446-455. [PMID: 34939203 DOI: 10.1111/scs.13058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 11/10/2021] [Accepted: 12/12/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Transition into clinical practice for newly graduated nurses is a difficult time, with high stress levels defined by a demanding period of personal and professional acclimatisation. Transitions are complicated and multi-dimensional, and to understand this process, it is crucial to identify the factors that facilitate or stand in the way of a healthy transition. AIM The phenomenological study aimed to describe newly graduated nurses' expectations of transitioning into the nursing profession at the start of a clinical nursing introduction programme, including education, supervision, and critical reflection with peers. METHOD The study was based on seven group interviews with newly graduated nurses. The interviews utilised open-ended and follow-up questions and were carried out as a dialogue to enable reflection on the phenomenon of interest. This was explored and illuminated using the reflective lifeworld research approach, based on phenomenological epistemology. FINDINGS "Expectations of transition into the nursing profession via the Clinical Nursing Introduction Programme" is signified by an oscillating movement between uncertainty, security, challenge, and growth on the threshold of a new identity. The phenomenon is constituted by the courage to grow, responsibility and fear, belonging and vulnerability, and support and challenge. CONCLUSION Transitioning into the nursing profession via the Clinical Nursing Introduction Programme means having the best of both worlds. Newly graduated nurses have the opportunity to receive education and structured support at the same time as they work independently in clinical practice.
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Affiliation(s)
- Mia Berglund
- School of Health Sciences, Skövde University, Skövde, Sweden
| | - Anna Kjellsdotter
- School of Health Sciences, Skövde University, Skövde, Sweden.,Research and Development Centre, Skaraborg Hospital Skövde, Skövde, Sweden
| | - Joanne Wills
- School of Health Sciences, Skövde University, Skövde, Sweden
| | - Anita Johansson
- Research and Development Centre, Skaraborg Hospital Skövde, Skövde, Sweden
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Nonclinical Transition-to-Practice Courses: A Review of Course Content. Nurse Educ 2021; 46:54-58. [PMID: 32195765 DOI: 10.1097/nne.0000000000000816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Both clinical and nonclinical transition-to-practice courses have been offered to facilitate the transition from student to novice nurse. PROBLEM Nonclinical transition-to-practice courses are less widely discussed in the literature; thus, their content and effectiveness have not been examined. APPROACH Academic institutions with baccalaureate nursing programs were surveyed to determine if they offered a nonclinical transition-to-practice course and to identify the associated content. OUTCOME Of 19 responding institutions, 15 reported having a nonclinical transition-to-practice course. Eighty-seven percent of the courses address ethical dilemmas, and 80% include delegation, interview preparation, stress management, and work/life balance. CONCLUSION Although schools of nursing are urged to address students' transition to practice, there is considerable variation in the nonclinical topics addressed. Research is needed to provide guidance to maximize the impact of these nonclinical transition-to-practice courses on new nurses' transition experience.
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Hampton KB, Smeltzer SC, Ross JG. The transition from nursing student to practicing nurse: An integrative review of transition to practice programs. Nurse Educ Pract 2021; 52:103031. [PMID: 33773484 DOI: 10.1016/j.nepr.2021.103031] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 03/06/2021] [Accepted: 03/16/2021] [Indexed: 01/25/2023]
Abstract
The transition from student to novice is a difficult time. Although the novice nurse is excited to start working, the nurse struggles with acclimating to a new role with new responsibilities and the need to reconcile disparities between what was taught in school and what is practiced in the real world. To lessen the impact of the transition experience, health care organizations have implemented transition-to-practice programs including orientations, preceptorships, and residencies. Despite these efforts, if the novice nurse does not find these programs helpful, there is still a risk that the transition experience will not conclude with successful results. This integrative review examined qualitative studies that explored the transition-to-practice experience of novice nurses who participated in a transition-to-practice program provided by their place of employment. Thirteen articles met the criteria for this integrative review; seven themes emerged from the commonalities in the studies: socialization, professional growth, feeling supported, transition challenges, reflections, transition shock, and feelings. Though the transition period includes unique experiences for each novice nurse, the common feelings and needs identified in these studies require nurse educators and the healthcare organizations to ensure that novice nurses are prepared and given the tools to successfully transition to professional nursing practice.
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Affiliation(s)
- Kimberly B Hampton
- Villanova University, M. Louise Fitzpatrick College of Nursing, 800 Lancaster Ave., Driscoll Hall, Villanova, PA, 19085, United States.
| | - Suzanne C Smeltzer
- Richard and Marianne Kreider Endowed Professor in Nursing for Vulnerable Populations, Villanova University, M. Louise Fitzpatrick College of Nursing, United States
| | - Jennifer Gunberg Ross
- Villanova University, M. Louise Fitzpatrick College of Nursing, 800 Lancaster Ave., Driscoll Hall, Villanova, PA, 19085, United States
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Murray M, Sundin D, Cope V. New graduate nurses' clinical safety knowledge by the numbers. J Nurs Manag 2019; 27:1384-1390. [PMID: 31230379 DOI: 10.1111/jonm.12819] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/17/2019] [Accepted: 06/18/2019] [Indexed: 11/24/2022]
Abstract
AIM To explore new graduate registered nurses' knowledge and attitudes concerning medical error and patient safety, during their first 6 months of professional practice. BACKGROUND New graduate registered nurses demonstrate basic skills and levels of performance due to limited exposure and experience in actual situations. There is a concern held for their clinical reasoning skills required to recognize patient deterioration, posing a threat to patient safety. METHODS An online questionnaire was used to survey new graduate registered nurses at three time points during graduate nurse programmes between August 2016 and February 2018. RESULTS A decrease in self-reported knowledge and attitudes regarding medical errors was noted over the three time points. These results indicate initial confidence in theoretical knowledge and attitudes upon completion of undergraduate education, and prior to commencing professional practice. CONCLUSION Results suggest that a theory practice gap persists with respect to medical error for transitioning new nurses. IMPACT FOR NURSING MANAGEMENT New nurses lack confidence around compromised patient safety situations and a knowledge gap around actions related to medical error. Nurse managers and educators should be made aware of this gap to implement strategies to decrease risk during novice nurse transition.
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Affiliation(s)
- Melanie Murray
- Murdoch University, Murdoch, Western Australia, Australia.,Edith Cowan University, Joondalup, Western Australia, Australia
| | - Deborah Sundin
- Edith Cowan University, Joondalup, Western Australia, Australia
| | - Vicki Cope
- Murdoch University, Murdoch, Western Australia, Australia
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Murray M, Sundin D, Cope V. New graduate nurses' understanding and attitudes about patient safety upon transition to practice. J Clin Nurs 2019; 28:2543-2552. [PMID: 30803103 DOI: 10.1111/jocn.14839] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 01/26/2019] [Accepted: 02/20/2019] [Indexed: 11/30/2022]
Abstract
AIMS To explore the transition experiences of newly graduated registered nurses with particular attention to patient safety. BACKGROUND New graduate registered nurses' transition is accompanied by a degree of shock which may be in tune with the described theory-practice gap. The limited exposure to clinical settings and experiences leaves these nurses at risk of making errors and not recognising deterioration, prioritising time management and task completion over patient safety and care. DESIGN Qualitative descriptive approach using semi-structured interviews. METHODS Data were collected during 2017-18 from 11 participants consenting to face-to-face or telephone semi-structured interviews. Interviews were transcribed verbatim, and data were analysed using thematic analysis techniques assisted by Nvivo coding software. The study follows the COREQ guidelines for qualitative studies (see Supplementary File 1). RESULTS Key themes isolated from the interview transcripts were as follows: patient safety and insights; time management; making a mistake; experiential learning; and transition. Medication administration was a significant cause of stress that adds to time management anguish. Although the new graduate registered nurses' clinical acumen was improving, they still felt they were moving two steps forward, one step back with regards to their understanding of patient care and safety. CONCLUSION Transition shock leaves new graduate registered nurses' focused on time management and task completion over patient safety and holistic care. Encouragement and support needed to foster a safety culture that foster safe practices in our new nurses. RELEVANCE TO PRACTICE Having an understanding of the new graduate registered nurses' experiences and understanding of practice will assist Graduate Nurse Program coordinators, and senior nurses, to plan and provide the relevant information and education during these initial months of transition to help mitigate the risk of errors occurring during this time.
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Affiliation(s)
- Melanie Murray
- Murdoch University, Perth, WA, Australia.,Edith Cowan University, Joondalup, WA, Australia
| | | | - Vicki Cope
- Murdoch University, Perth, WA, Australia
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