1
|
Koppolu R, Van Graafeiland B, Hansen BR. Outcomes of pediatric-focused advanced practice provider fellowship programs: An integrative review. J Am Assoc Nurse Pract 2024:01741002-990000000-00241. [PMID: 39094025 DOI: 10.1097/jxx.0000000000001038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 05/06/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND An increased demand for pediatric-focused advanced practice providers (APPs) exists to address the health care needs of children with medical complexity. Postlicensure advanced practice fellowship programs have been developed to help improve novice provider transition to practice, reducing attrition. OBJECTIVES The objectives of this integrative review are to (1) identify outcome measurements of pediatric-focused advanced practice fellowship programs and (2) evaluate the outcome measures to guide future implications for practice. DATA SOURCES A systematic integrative literature review was conducted in accordance with the Preferred Reporting Items for Systemic Reviews and Meta-Analyses. PubMed, CINAHL, Embase, and Google Scholar were searched in August and September 2022. Articles met inclusion criteria if they included new graduate APPs, reported the intervention of a pediatric fellowship program, and shared outcome measurements. Studies were excluded if they did not directly report on fellowship program outcome measures. Thirteen studies met inclusion criteria and were summarized and appraised for quality using the Johns Hopkins Evidence-Based Practice Model. CONCLUSIONS Four themes from the literature included the favorable impact of advanced practice fellowship programs on (a) job satisfaction, (b) retention, (c) clinical and professional performance, and (d) financial outcomes. Variable strategies were used to measure outcomes across programs. IMPLICATIONS FOR PRACTICE Postlicensure pediatric-focused advanced practice fellowship programs seem to improve retention and job satisfaction, increase provider confidence, and bring a favorable return on investment for the organization. Future work should include investment in developing validated, standardized assessment tools to support future development of these programs in the pediatric population.
Collapse
Affiliation(s)
- Rajashree Koppolu
- Advanced Practice Professional Development, Stanford Medicine Children's Health, Palo Alto, California
| | | | | |
Collapse
|
2
|
Morris AL, Bosque EM. Super-Mentors to Train Multiple Neonatal Advanced Practice Providers: Pros and Cons. Adv Neonatal Care 2024; 24:354-363. [PMID: 38976901 DOI: 10.1097/anc.0000000000001181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
BACKGROUND Despite available training programs for neonatal advanced practice providers (Neo APP), including neonatal nurse practitioners and physician assistants, it is difficult to meet the demand for these providers. There are no publications regarding training models with greater than 1 Neo APP learner per mentor. PURPOSE To create and measure outcomes of a 12-month program to educate Neo APP "Super-Mentors" able to train 2 Neo APP learners simultaneously. METHODS Super-Mentors were selected and attended monthly classes to learn mentorship concepts and receive support. Learners received didactic content and support through a Fellowship program. Quantitative data regarding recruitment and retention, as well as Misener Nurse Practitioner Job Satisfaction Scale (MNPJSS) results were compared pre- and postprogram. Qualitative satisfaction measures via survey from 21 stakeholders were analyzed through a phenomenological approach. RESULTS Six Super-Mentors trained 14 Neo APPs, as compared to 7 in the previous year. One Neo APP left after training. Summative preprogram MNPJSS scores were better (5.1 ± 0.37) than postprogram (4.7 ± 0.47) ( P < .001). The most important preprogram subscale item was "vacation" versus "quality of assistive personnel" postprogram. Both pre- and postprogram scores reflected positive job satisfaction so differences may not be clinically significant. Qualitative program benefits included faster and increased onboarding, stronger relationships, and dedicated time. Challenges included role clarity among other stakeholders, learning culture, and spacial/technological logistics. IMPLICATIONS FOR PRACTICE Super-Mentors can train twice the number of Neo APP learners, with optimal preparation and support of all stakeholders, adequate space, and appropriate technology.
Collapse
Affiliation(s)
- April L Morris
- Neonatal Nurse Practitioner, Neonatal Associate Chief, Advanced Practice Services, Neonatology Regional Program, Seattle Children's Hospital, Seattle, Washington (Ms Morris); and Neonatal Nurse Practitioner, Neonatal Advanced Practice Professional Development Lead, Neonatology Regional Program, Seattle Children's Hospital, Seattle, Washington (Ms Bosque)
| | | |
Collapse
|
3
|
Hicks RW. A reflection on the value of participating in a journal club: Early findings from a transition to practice program. J Am Assoc Nurse Pract 2024; 36:413-415. [PMID: 39079093 PMCID: PMC11286152 DOI: 10.1097/jxx.0000000000001044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/29/2024] [Accepted: 06/03/2024] [Indexed: 08/02/2024]
Abstract
ABSTRACT The column describes the intersection of a transition to practice program for advance practice providers and incorporating monthly journal club activities. Reflections on the value of the journal club highlight opportunities for education, clinical care, and system-level care.
Collapse
|
4
|
Kilpatrick K, Savard I, Audet LA, Costanzo G, Khan M, Atallah R, Jabbour M, Zhou W, Wheeler K, Ladd E, Gray DC, Henderson C, Spies LA, McGrath H, Rogers M. A global perspective of advanced practice nursing research: A review of systematic reviews. PLoS One 2024; 19:e0305008. [PMID: 38954675 PMCID: PMC11218965 DOI: 10.1371/journal.pone.0305008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 05/21/2024] [Indexed: 07/04/2024] Open
Abstract
INTRODUCTION The World Health Organization (WHO) called for the expansion of all nursing roles, including advanced practice nurses (APNs), nurse practitioners (NPs) and clinical nurse specialists (CNSs). A clearer understanding of the impact of these roles will inform global priorities for advanced practice nursing education, research, and policy. OBJECTIVE To identify gaps in advanced practice nursing research globally. MATERIALS AND METHODS A review of systematic reviews was conducted. We searched CINAHL, Embase, Global Health, Healthstar, PubMed, Medline, Cochrane Library, DARE, Joanna Briggs Institute EBP, and Web of Science from January 2011 onwards, with no restrictions on jurisdiction or language. Grey literature and hand searches of reference lists were undertaken. Review quality was assessed using the Critical Appraisal Skills Program (CASP). Study selection, data extraction and CASP assessments were done independently by two reviewers. We extracted study characteristics, country and outcome data. Data were summarized using narrative synthesis. RESULTS We screened 5840 articles and retained 117 systematic reviews, representing 38 countries. Most CASP criteria were met. However, study selection by two reviewers was done inconsistently and language and geographical restrictions were applied. We found highly consistent evidence that APN, NP and CNS care was equal or superior to the comparator (e.g., physicians) for 29 indicator categories across a wide range of clinical settings, patient populations and acuity levels. Mixed findings were noted for quality of life, consultations, costs, emergency room visits, and health care service delivery where some studies favoured the control groups. No indicator consistently favoured the control group. There is emerging research related to Artificial Intelligence (AI). CONCLUSION There is a large body of advanced practice nursing research globally, but several WHO regions are underrepresented. Identified research gaps include AI, interprofessional team functioning, workload, and patients and families as partners in healthcare. PROSPERO REGISTRATION NUMBER CRD42021278532.
Collapse
Affiliation(s)
- Kelley Kilpatrick
- Susan E. French Chair in Nursing Research and Innovative Practice, Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada
- Centre Intégré Universitaire de Santé et de Services sociaux de l’Est-de-l’Île-de-Montréal (CIUSSS-EMTL), Montréal, Québec, Canada
| | - Isabelle Savard
- Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada
| | - Li-Anne Audet
- Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada
| | - Gina Costanzo
- Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada
| | - Mariam Khan
- Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada
| | - Renée Atallah
- Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada
| | - Mira Jabbour
- Centre Intégré Universitaire de Santé et de Services sociaux de l’Est-de-l’Île-de-Montréal (CIUSSS-EMTL), Montréal, Québec, Canada
| | - Wentao Zhou
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore; National University Health System, Singapore, Singapore
- Singapore National Neuroscience Institute, Singapore, Singapore
| | - Kathy Wheeler
- College of Nursing, University of Kentucky, Lexington, Kentucky, United States of America
| | - Elissa Ladd
- MGH Institute of Health Professions, School of Nursing, Boston, Massachusetts, United States of America
| | - Deborah C. Gray
- School of Nursing, Old Dominion University, Virginia Beach, Virginia, United States of America
| | - Colette Henderson
- School of Health Sciences, University of Dundee, Dundee, Scotland, United States of America
| | - Lori A. Spies
- Louise Herrington School of Nursing, Baylor University, Dallas, Texas, United States of America
| | - Heather McGrath
- St James Public Health Services, Montego Bay, St James, Jamaica
| | - Melanie Rogers
- Department of Nursing and Midwifery, University of Huddersfield, Queensgate, Huddersfield, United Kingdom
| |
Collapse
|
5
|
McDonough KE. Outcomes of postgraduate fellowships and residencies for nurse practitioners: An integrative review. J Prof Nurs 2024; 53:95-103. [PMID: 38997205 DOI: 10.1016/j.profnurs.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 04/26/2024] [Accepted: 05/08/2024] [Indexed: 07/14/2024]
Abstract
BACKGROUND In 2011, the Institute of Medicine published a report on the future of nursing, which recommended nurse practitioner postgraduate training in the form of fellowships or residencies. Since then, the number of postgraduate programs has grown, but data is still scarce regarding their efficacy and benefits. AIM The goal of this integrative review is to synthesize available literature regarding the outcomes of nurse practitioner postgraduate fellowships and/or residencies on clinical competence and perceived readiness to practice. METHODS CINAHL, PubMed, and citation searching were used to search relevant subject headings, MeSH headings, and keywords related to fellowships and residencies for nurse practitioners, resulting in 11 articles being included based on inclusion and exclusion criteria. Synthesis was completed using the Garrard Matrix method to identify common themes among the studies. RESULTS Eight quasi-experimental and three cross-sectional studies were included in this review. Programs included multiple areas of focus, including primary care, critical care, and pediatric acute care. Common themes among the studies were an increased level of preparedness, reduced turnover, and greater job satisfaction. CONCLUSIONS The major theme found among the studies was an increased confidence and preparedness to practice. Minor themes include increased job satisfaction and decreased intent to quit.
Collapse
Affiliation(s)
- Kevin E McDonough
- University of Illinois Chicago College of Nursing, 845 S Damen Ave, Chicago, IL 60612, USA.
| |
Collapse
|
6
|
Forbes MF, Carter N, MacKenzie KL, Kouroukis CT, Balonjan KS, Bryant-Lukosius DE. The Nurse Practitioner Role in Complex Malignant Hematology: A Qualitative Descriptive Study. Semin Oncol Nurs 2024; 40:151625. [PMID: 38556365 DOI: 10.1016/j.soncn.2024.151625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/16/2024] [Accepted: 03/08/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVES Internationally, there is limited evidence about the role and impact of nurse practitioners (NPs) in complex malignant hematology (CMH). In one Canadian CMH program, NPs have existed for 20 years but not been evaluated. This study aimed to understand stakeholder perceptions of CMH NP role structures, processes, and outcomes and the extent to which the role meets patient and health service needs. METHODS A qualitative descriptive study was conducted, guided by the PEPPA-Plus framework. Purposive sampling was used to recruit stakeholders who participated in focus groups and interviews. Content analysis was used to analyze the data. RESULTS Participants included patients (n = 8) and healthcare professionals (n = 27). Themes about structures related to evolution of the CMH Program, model of care, and need for strategic vision. Process themes related to provision of accessible, comprehensive, and holistic care and NP workload. Positive and negative outcomes and lack of outcome measurement were identified. CONCLUSION Structures related to patient and NP characteristics, organizational change, staffing, and how NP work is organized impacts on NP role implementation and outcomes. Organizational structures can be strengthened to improve the model of care and NP role implementation and workload. Value-added NP contributions related to providing comprehensive care with attention to safety and social determinants of health. Research is needed to evaluate NP role outcomes in CMH. IMPLICATIONS FOR NURSING PRACTICE The results can inform role design and organization policies and strategies to promote the recruitment, retention, and optimization of NP roles in CMH settings. Priorities for future research are also identified.
Collapse
Affiliation(s)
- Margaret F Forbes
- Nurse Practitioner and Nurse Practitioner Lead for Hematology, Juravinski Hospital and Cancer Center at Hamilton Health Sciences and Assistant Clinical Professor, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Nancy Carter
- Associate Professor and Assistant Dean Graduate Nursing Programs, Department Education Coordinator, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Kristi L MacKenzie
- Director, Regional Cancer Program and Hematology, Juravinski Hospital and Cancer Centre at Hamilton Health Sciences, Hamilton, Ontario. Canada
| | - C Tom Kouroukis
- Hematologist, Juravinski Hospital and Cancer Centre at Hamilton Health Sciences and Associate Professor, Department of Oncology, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Kerry S Balonjan
- Registered Nurse and Graduate Student, School of Nursing, Faculty of Health Sciences, McMaster University Hamilton, Ontario, Canada
| | - Denise E Bryant-Lukosius
- Professor and Alba DiCenso Chair in Advanced Practice Nursing, School of Nursing, Faculty of Health Sciences, McMaster University; Scientist, Escarpment Cancer Research Institute; Clinician Scientist, Juravinksi Hospital and Cancer Centre at Hamilton Health Sciences, Hamilton, Ontario, Canada.
| |
Collapse
|
7
|
Wang J, Xu Y, Zhang W, Guo Z, Zhang W, Zhang Y, Ma W. Transition status and influencing factors of newly graduated nurses: A descriptive survey design. Nurse Educ Pract 2024; 77:103992. [PMID: 38744095 DOI: 10.1016/j.nepr.2024.103992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 04/17/2024] [Accepted: 05/03/2024] [Indexed: 05/16/2024]
Abstract
AIMS To assess the transition status of newly graduated nurses in China and identify its influencing factors. BACKGROUND Newly graduated nurses are the indispensable part of nursing human resource. The successful transition of into clinical work is crucial for their future career development. However, the transition status of new nurses in China remains inadequately explored. DESIGN A descriptive survey design was employed in this study. METHODS From October 2022 to January 2023, 1261 newly graduated nurses were surveyed online with the Transition Status Scale for Newly Graduated Nurses. Description statistical analysis was adopted to evaluate the transition status of new nurses. Independent-samples t-test, Analysis of Variance and Multiple Regression Analysis was used to explore the influencing factors of the transition status. RESULTS The total mean score of Transition Status Scale for Newly Graduated Nurses was 4.00 (SD=0.61). Competence for nursing work (Mean=4.20; SD=0.57) was rated the highest among the five dimensions of the scale, while the dimension of balance between work and life (Mean=3.65; SD=0.89) was rated the lowest. Mentored by senior nurses, night shift, attribute of working hospital, educational background, interned in the same department, tertiary general hospital, reasons for choosing nursing and working time can affect the transition status of new nurses, accounting for 17.9% of the variance in transition status (R²= 0.179, P<0.001). CONCLUSION The transition status of newly graduated nurses in China is at a relatively high level, especially in the dimension of competence for nursing work. However, newly graduated nurses are in a relatively poor status of work-life balance. Nurse educators and managers need to pay more attention to the transitional training of highly educated nursing talents and the optimization of clinical transition training programs to prevent talent loss. Experienced tutors should be allocated to provide guidance for newly graduated nurses.
Collapse
Affiliation(s)
- Jia Wang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yutong Xu
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Wanting Zhang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zihan Guo
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Wei Zhang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yuying Zhang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Weiguang Ma
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| |
Collapse
|
8
|
Stiesmeyer JK, Lundin E, Galves L, Wade K, Pelowitz K. Designing an impactful APRN residency program for rural communities. Nurse Pract 2024; 49:20-30. [PMID: 38530376 DOI: 10.1097/01.npr.0000000000000162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
ABSTRACT The largest healthcare system in New Mexico, in collaboration with the University of New Mexico College of Nursing, identified an opportunity to increase and retain the number of family practice NPs and certified nurse midwives in rural communities by creating an immersive 1-year rural residency program for newly graduated advanced practice registered nurses (APRNs). This article describes the journey to design this program and build its infrastructure with the aim of addressing the needs of both APRNs during their transition to practice and patients in rural areas, while providing a return on the healthcare system's business investment. Program results are also reported. Program funding was provided by a Health Resources and Services Administration grant, the Presbyterian Healthcare Services executive team, and the Presbyterian Healthcare Foundation.
Collapse
|
9
|
Ma W, Xu Y, Liu Y, Liang T, Ma F. Perspectives of Chinese New Nurses Regarding Successful Transition: A Qualitative Study. J Nurs Res 2024; 32:e321. [PMID: 38506572 DOI: 10.1097/jnr.0000000000000607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Transition issues have been discussed for many decades, yet little is known about successful transition expectations in the context of Chinese culture. PURPOSE This article was designed to describe the expectations of newly graduated nurses in China regarding successful transition. METHODS A qualitative, descriptive study design was employed, and a purposive sampling method was used to recruit interviewees. All of the one-to-one conversations were held in a quiet room to ensure privacy. All of the interviews were transcribed and then analyzed using thematic analysis. RESULTS Nineteen new nurses were recruited from seven tertiary hospitals and participated in the in-depth interview process. Transition success, that is, "professional metamorphosis," was revealed through the four themes of "being competent in nursing work," "establishing a professional identity," "establishing comfortable interpersonal relationships," and "achieving balance between work and life." CONCLUSIONS/IMPLICATIONS FOR PRACTICE Chinese new nurses expect their successful transition to achieve a professional metamorphosis in many aspects. A successful transition is not only a journey of professionalization but also a process of socialization. New nurses expect to achieve both maturity in their work and wisdom in life. The results of this study provide a greater understanding of transition issues in the context of Chinese culture. Thus, support and strategies cannot be limited to interventions designed to improve working competence but should be individualized to help new nurses achieve a smooth transition.
Collapse
Affiliation(s)
- Weiguang Ma
- PhD, RN, Professor, School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, China
| | - Yutong Xu
- BSN, RN, Master Student, School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, China
| | - Yuanfei Liu
- MSN, RN, Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine, Zhejiang University, China
| | - Tao Liang
- PhD, RN, Professor, School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, China
| | - Fang Ma
- PhD, RN, Associate Professor, Nursing Department, The First Affiliated Hospital of Kunming Medical University, China
| |
Collapse
|
10
|
Ma W, Dai Z, Liang T, Zhang H, Liu Y. The transition issue among new nurses in China: A mediation model analysis. Int Nurs Rev 2024; 71:108-114. [PMID: 37392463 DOI: 10.1111/inr.12858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 06/01/2023] [Indexed: 07/03/2023]
Abstract
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.
Collapse
Affiliation(s)
- Weiguang Ma
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhenwei Dai
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tao Liang
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huan Zhang
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yitao Liu
- Department of Internal Medicine, Peking Union Medical College Hospital, Beijing, China
| |
Collapse
|
11
|
Smith H, Lynn S, Menefee F. Development of a Universal Advanced Practice Provider Fellowship: A Roadmap to Increase Program Accessibility and Financial Sustainability. J Contin Educ Nurs 2024; 55:4-6. [PMID: 38165216 DOI: 10.3928/00220124-20231208-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
Advanced practice providers (APPs) are a growing and essential component of today's health care delivery models. APP fellowship programs have been developed by health care systems to address APP recruitment, retention, and preparedness. However, APP fellowship programs are not widely accessible to most new graduate APPs or experienced APPs who wish to change their specialty. The development of these programs can be costly for health care systems to initiate and maintain. This article discusses the development of a "universal" APP fellowship program that allows for increased program accessibility and financial sustainability for health care systems. [J Contin Educ Nurs. 2024;55(1):4-6.].
Collapse
|
12
|
Lynn S, Smith H, Menefee F, Meyer K. Battling the "Imposter": Our Experience in the Development of an Advance Practice Provider Fellowship. Nurs Adm Q 2023:00006216-990000000-00017. [PMID: 38112696 DOI: 10.1097/naq.0000000000000615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
In the face of ever-evolving shifts in health care, the demand for advanced practice providers (APPs), including nurse practitioners and physician assistants, continues to grow as the nation faces provider shortages and increased patient complexity. Because of different educational backgrounds and previous professional experience, there is a gap in readiness for practice following completion of academic programs, leading to high rates of turnover and financial implications for health care institutions. The creation of APP fellowship programs is a strategy many health institutions implement to provide enhanced support for new graduate APPs. These programs offer fully licensed and credentialed nurse practitioners and physician assistants additional experience within medical specialty areas. The establishment and operational cost associated with an APP fellowship program is a significant barrier health systems face. This article discusses how Saint Luke's Health System developed an APP fellowship program to address these barriers. The model addresses specific fellow needs and has contributed to improved employee retention rates, increased clinical competency, and overall provider satisfaction within Saint Luke's Health System. The evolution of the model, successes, barriers, and opportunities for future program growth are discussed within this article.
Collapse
Affiliation(s)
- Shannon Lynn
- Saint Luke's Health System, Kansas City, Missouri
| | | | | | | |
Collapse
|
13
|
Wan F, Yang L, Zhou N, He Y. Construction of learning objectives and content for newly graduated nurses in tertiary teaching hospitals: A Delphi study. NURSE EDUCATION TODAY 2023; 121:105716. [PMID: 36657320 DOI: 10.1016/j.nedt.2023.105716] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 12/21/2022] [Accepted: 01/07/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Transition education is a robust strategy to improve the core competency of newly graduated nurses and the quality of clinical nursing and ensure people's safety. Limited information about the learning objectives and educational content for newly graduated nurses in China was available. OBJECTIVE Construct the learning objectives and educational content for newly graduated nurses based on defined core competencies. DESIGN We used a literature review and the e-Delphi method to conduct this study. SETTINGS Ten tertiary teaching hospitals and six nursing schools in Zhejiang Province, China, were selected. PARTICIPANTS Experts (n = 21) were invited to the e-Delphi study. METHODS Based on seven competencies from the literature review and the research group discussions, we formed an initial set of objectives and specific educational content for newly graduated nurses. Subsequently, experts provided supportive and modification advice on the competencies, objectives, and specific content in the two Delphi rounds. The consensus percentage and the weight of each first-level, second-level, and third-level item were calculated. RESULTS Consensus was achieved on seven core competencies, 44 learning objectives, and 60 components of educational content. The positive coefficient of the two Delphi rounds was 100 %, the authority coefficient was 0.83 and 0.87, the proportion of experts who made suggestions was 71.40 %, the coefficient of variation (CV) was <0.25 (P < 0.05) except for two items and the Kendall coefficient (W) was 0.15-0.48 (P < 0.01). CONCLUSION The developed objectives and content framework provide a reference for implementing systematic and standardized education for newly graduated nurses.
Collapse
Affiliation(s)
- Fangyuan Wan
- Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China.
| | - Lili Yang
- Nursing Education Department, Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China.
| | - Na Zhou
- Department of Gynecology, Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China.
| | - Ying He
- Department of Gynecology, Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China.
| |
Collapse
|
14
|
Armstrong AB, Bowman A, Goreth M, Trabosh T, Gigli KH. Career Choices and Experiences in Role Transition: A Multistate Survey of Pediatric-Focused Hospital-Based Nurse Practitioners. J Pediatr Health Care 2023; 37:319-327. [PMID: 36737304 DOI: 10.1016/j.pedhc.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/14/2022] [Accepted: 12/19/2022] [Indexed: 02/05/2023]
Abstract
INTRODUCTION We examined factors influencing pediatric hospital-based APPs' career decisions and described the transition to practice experiences. METHOD We conducted a cross-sectional, descriptive electronic survey using a novel instrument to examine APP career decisions and transition to practice experiences among APPs in four Southeastern children's hospitals. RESULTS There were 158 respondents composed of family nurse practitioners (NPs) (30%), primary care pediatric NPs (24%), and acute care pediatric NPs (18%). APPs chose their career to further their education (46%) and because of interest in pediatrics (18%). Most APPs had experience in pediatrics on APP graduation and were well prepared for the role (47%) and to care for pediatric patients (56%). Nearly two-thirds of APPs had an orientation. DISCUSSION Early exposure to pediatrics influenced APP career choices and increased career preparedness. Although most APPs had an orientation, future studies should assess the impact of orientation on patient, professional, and organizational outcomes.
Collapse
Affiliation(s)
- Alexandra Blumenthal Armstrong
- Alexandra Blumenthal Armstrong, Pediatric Nurse Practitioner, Division of Pediatric Endocrinology, Children's of Alabama; Instructor, Acute Care Pediatric Nurse Practitioner Track, UAB School of Nursing, University of Alabama at Birmingham, Birmingham, AL..
| | - Ashleigh Bowman
- Ashleigh Bowman, Assistant Professor, College of Nursing, University of South Alabama; Nurse Practitioner, Pediatric Emergency Department, USA Health Children's & Women's Hospital, Mobile, AL
| | - Michelle Goreth
- Michelle Goreth, Pediatric Nurse Practitioner, Pediatric Neurology, University of Mississippi Medical Center, Jackson, MS
| | - Tammy Trabosh
- Tammy Trabosh, Pediatric Nurse Practitioner, Neurocritical Care, Nicklaus Children's Hospital, Miami, FL
| | - Kristin Hittle Gigli
- Kristin Hittle Gigli, Assistant Professor, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX
| |
Collapse
|
15
|
Fox I, Champion JD. A qualitative thematic analysis of mentorship for new psychiatric-mental health nurse practitioners. J Am Assoc Nurse Pract 2022; 34:1289-1299. [PMID: 36469910 DOI: 10.1097/jxx.0000000000000794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 09/26/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND A volume of literature reflects that mentorship is key in producing quality nurse practitioners. Mentoring leads to increased confidence, role clarity, and other benefits improving practice. However, there is little to no research focusing specifically on the impact of mentoring in psychiatric nurse mental health nurse practitioners (PMHNPs). PURPOSE To explore process of acquiring mentorship and mentoring experiences of newly graduated PMHNPs, all of whom obtained their respective degrees partially or completely online. The study also seeks to describe perceptions of mentoring in PMHNP leaders. METHODS Nine new graduate PMHNPs and 10 PMHNP leaders were recruited from membership rosters of professional organizations in the Southwestern United States. Informants participated in semi-structured interviews with questions sourced from an interview guide. Interviews were conducted via videoconference or telephone from informants' homes. Data were coded via an in vivo approach and analyzed by thematic methods. RESULTS New graduates reported that mentoring was dependent on four themes: connectivity, educational stewardship, practice confidence, and luck. Mentor access via work, institutions, or schools was inconsistent. Leaders were concerned about limited educational and professional investment in mentorship because this process is an important component of professional development. CONCLUSION Mentorship for new graduates is based on a variety of factors, some of which are out of their control. Lack of mentoring may affect practice, which affects patient care. Dialogue between educators, professionals, and organizations may improve mentoring stewardship. IMPLICATIONS Enhanced communication between educational institutions and professional organizations to create a more fluid process from graduate to mentorship is needed.
Collapse
Affiliation(s)
- Isadora Fox
- School of Nursing, The University of Texas at Austin, Austin, Texas
| | - Jane D Champion
- Doctor of Nursing Practice Program, School of Nursing, The University of Texas at Austin, Austin, Texas
| |
Collapse
|
16
|
Roberts R, DaSilva D. Do fellowships for newly qualified GPs improve retention? Evaluation of London's SPIN New to Practice Fellowships. EDUCATION FOR PRIMARY CARE 2022; 33:342-346. [PMID: 36170443 DOI: 10.1080/14739879.2022.2120832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND We explored whether having a variety of work roles and extra support during the first 2 years after qualifying would retain general practitioners (GPs) in London. Newly qualified GPs were offered a Fellowship comprising permanent salaried positions, part-time (portfolio) roles outside general practice and peer support for 1-2 years. METHODS We surveyed newly qualified GPs taking part in the Fellowship near the beginning of their Fellowship (91) and again after 8-10 months (93). We interviewed 34 newly qualified GPs taking part in the Fellowship and 20 who were not. We surveyed and interviewed representatives from employing practices (171), organisations hosting portfolio roles (20), those facilitating the Fellowship (10) and other stakeholders (43). FINDINGS Over a 2.5-year period, employers recruited and retained 425 newly qualified GPs to salaried posts using the Fellowship. Eighty-eight per cent of the newly qualified GPs taking part said they intended to stay working in local practices. They said that undertaking a portfolio role helped them feel valued, had more variety and integration with the wider professional community. Those with two or more portfolio sessions per week were the most positive. CONCLUSIONS Portfolio roles and peer support may increase newly qualified GPs intention to stay working in salaried posts, however it is too early to say whether these intentions will translate into behaviour. WHAT THIS EVALUATION ADDS TO CURRENT KNOWLEDGE Portfolio roles and monthly peer support helped newly qualified GPs feel supported and valued, which may influence their intention to stay working in general practice locally.
Collapse
|
17
|
First-year experience of transitioning from registered nurse to nurse practitioner. J Am Assoc Nurse Pract 2022; 34:978-990. [PMID: 36330551 DOI: 10.1097/jxx.0000000000000750] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 05/23/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Transitioning to advanced practice, novice nurse practitioners need to take on new roles, learn new practice areas, and develop new skills. This process requires breaking old practices and work habits and facing new challenges. PURPOSE To explore the nature of nurse practitioners' work experiences during the first year of transition from registered nurse to nurse practitioner. METHODS This qualitative study was based on Husserl's phenomenological methodology. A purposive sample of 16 first-year nurse practitioners was recruited. Data were collected through in-depth interviews and analyzed by thematic content analysis. The approaches of Lincoln & Guba were applied to improve the validity of the study. RESULTS Results showed that the first-year experience of transitioning from registered nurse to nurse practitioner fell into two overarching themes: challenge and adjustment. The challenge consists of five subthemes: "facing the expectation-reality gap," "managing others' expectations," "striving to acquire professional skills," "handling situational variability," and "bearing emotional burdens" subthemes. The adjustment includes five subthemes: "finding resources," "gaining experiences," "building relationships," "relieving stress," and "overcoming obstacles." IMPLICATIONS FOR PRACTICE Novice nurse practitioners face many challenges as they adjust to a new role during their first year on the job. New nurse practitioners develop coping strategies to help themselves adjust to their work. They also gradually gain new resources and experiences to help them stay positive in stressful situations and restore work-life balance. The challenges of transitioning from a registered nurse to a nurse practitioner cannot be overlooked. Novice nurse practitioners need appropriate support measures to adapt to advanced practice roles.
Collapse
|
18
|
Meeting the need for nurse practitioner clinicals: A survey of practitioners. J Am Assoc Nurse Pract 2022; 34:991-1001. [PMID: 35727194 DOI: 10.1097/jxx.0000000000000749] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/25/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND The increase in the number of nurse practitioner (NP) students requires increased clinical practice sites and prepared preceptors. PURPOSE This study describes NPs' clinical experiences as a student and their current practices as an NP preceptor. METHODOLOGY A descriptive study design used a 38-item web-based survey conducted in June and July 2021. RESULTS A total of 334 NPs practicing in Texas responded; most had been NPs for 10 or fewer years (58.2%) and in their positions less than 5 years (50.3%). A plurality of respondents was required to find their own clinical placements (46%). The most common challenge in obtaining clinical placements was finding preceptors (33%). Nurse practitioners reported excellent clinical experiences (39.3%) as a student and believed that they were generally well prepared for the NP role (38.9%) and to care for their specialty patient population (46.1%) upon graduation. Sixty percent of respondents reported not currently precepting, 37.6% had never been asked to precept, whereas 32.8% reported that employers restricted precepting. Family NPs were the least likely to precept. CONCLUSIONS Nurse practitioners report positive clinical experiences that prepare them for NP careers. Multiple opportunities exist to enlist additional NPs as preceptors for NP students. IMPLICATIONS There is capacity within the current NP workforce to meet the clinical educational needs of NP students. Future work should examine best practices to engage NPs who are not currently preceptors. As policies change NP education, research should examine the implications of the preparation for NP roles at the time of graduation, organizational outcomes, and quality of care.
Collapse
|
19
|
Stiesmeyer JK. Structuring the Investment Opportunity for a Transition to Practice Program. J Contin Educ Nurs 2022; 53:293-296. [PMID: 35858146 DOI: 10.3928/00220124-20220603-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Gaining organizational commitment to build or expand a transition to practice program is greatly enhanced by following a business strategy that calls out an encompassing program return on investment (ROI). This article proposes the ROI categories that are powerful investment influencers for executives responsible for funding programs. The business strategy offers insight on how to connect workforce pipeline, retention, program accreditation/reimbursement, traveler replacement, improved quality measures, and career advancement data into a persuasive investment case. Additionally, for advanced practice residency/fellowships, additional categories of linking quality outcomes, billing and revenue generation, productivity, and procedural services are highlighted. [J Contin Educ Nurs. 2022;53(7):293-296.].
Collapse
|
20
|
Powell NR, Thompson AG. Matching Access to Need: New Perspective on Nurse Practitioner Residency Programs. J Nurse Pract 2022. [DOI: 10.1016/j.nurpra.2022.02.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
21
|
Rural Midwestern Primary Care Nurse Practitioners’ Transition to Practice. J Nurse Pract 2021. [DOI: 10.1016/j.nurpra.2021.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
22
|
Do We Nurture Our Young? Qualitative Conceptual Analysis of Worst and Best Mentorship Experiences Among Neonatal Advanced Practice Providers. Adv Neonatal Care 2021; 21:E129-E137. [PMID: 33675304 DOI: 10.1097/anc.0000000000000843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is increasing demand for neonatal advanced practice providers (APPs) and a shortage of neonatal nurse practitioners (NNPs). In many neonatal intensive care units, neonatal physician assistants are trained and hired, as well as new graduate NNPs. Neonatal APPs are utilized as mentors in a regional neonatology program in the Pacific Northwest. As part of a long-term goal to develop an educational program for neonatal APP mentors, an initial survey was administered. PURPOSE The purpose of this survey was to raise personal insight and identify themes about 51 neonatal APP mentors' recollections of one's own worst and best mentorship experiences. METHODS The design used in this content analysis of survey responses included a phenomenological, qualitative approach. The participants received an online survey consisting of 2 questions asking them to describe their worst and best mentorship experiences. The blinded results were analyzed via content analysis by 2 coinvestigators. RESULTS Consistent themes about worst experiences include "Eat our young," "I am better than you," "Thrown under bus," and "Unwanted." Consistent themes about best experiences include "Validation," "Empowerment," "Positivity," and "Inclusion." IMPLICATIONS FOR PRACTICE Recommendations for successful neonatal APP mentorship based upon the recurrent themes include use of consistent, engaged, trained, and supported mentors, provision of on-time constructive feedback, avoidance of public criticism, private and public praise, focus on the learner, preparation for tasks, and semiautonomy, with adequate support. IMPLICATIONS FOR RESEARCH Absenteeism, recruitment, retention, and satisfaction data may be measured to determine whether structured mentorship programs are beneficial.
Collapse
|
23
|
McGrath B, Konold V, Forbes M, Murphy E, Cerasale M, Schram A. The 90-day orientation: An onboarding strategy for hospitalist PAs and NPs. JAAPA 2021; 34:52-55. [PMID: 34448780 DOI: 10.1097/01.jaa.0000758228.45700.9c] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Bridget McGrath
- Bridget McGrath is a hospitalist PA and director of hospitalist NP/PA service lines in the Section of Hospital Medicine at the University of Chicago in Chicago, Ill. Victoria Konold is an assistant professor of pediatrics and director of quality improvement in the Division of Infectious Diseases at University of Washington/Seattle Children's Hospital. At the University of Chicago, Meggan Forbes is director of the hospitalist night service, Elizabeth Murphy is an assistant professor of medicine and director of clinical service development in the Section of Hospital Medicine, Matthew Cerasale is an assistant professor of medicine and director of quality improvement in the Section of Hospital Medicine, and Andrew Schram is an assistant professor of medicine and director of throughput and efficiency in the Section of Hospital Medicine. The authors have disclosed no potential conflicts of interest, financial or otherwise
| | | | | | | | | | | |
Collapse
|
24
|
Abstract
ABSTRACT This cross-sectional study focuses on assessing factors related to role socialization of new NPs. Participants identified caring as the most important professional value, followed by activism and professionalism. Role socialization factors including a sense of belonging and forming professional identities were higher for experienced NPs.
Collapse
|
25
|
Kenny A, Dickson-Swift V, McKenna L, Charette M, Rush KL, Stacey G, Darvill A, Leigh J, Burton R, Phillips C. Interventions to support graduate nurse transition to practice and associated outcomes: A systematic review. NURSE EDUCATION TODAY 2021; 100:104860. [PMID: 33751999 DOI: 10.1016/j.nedt.2021.104860] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 12/29/2020] [Accepted: 01/18/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The aim of this mixed methods systematic review was to: i) document the interventions that support and facilitate graduate nurse transition from university to practice in a diversity of healthcare settings and ii) to identify outcomes from graduate nurse transition interventions for the graduate, patient or client, and health service. DESIGN This mixed methods systematic review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. All quantitative, qualitative, and mixed methods studies were included if they met the inclusion criteria. DATA SOURCES Primary research studies located in Medline, EmBase, CINAHL, Prospero, Cochrane Library, PsycInfo, and Web of Science (Social Science Citation Index). All quantitative, qualitative, and mixed methods studies were included if they met the inclusion criteria. REVIEW METHODS Using a comprehensive search strategy, retrieved articles were screened by two reviewers at the title, abstract, and full-text stage. Reviewer disagreements were discussed until consensus was achieved. The well-validated Mixed-Methods Appraisal Tool was used to assess quality of the quantitative, qualitative, and mixed methods studies. RESULTS A total of 130 studies were included as the review dataset. There was a myriad of terms used to describe transition interventions, and programme length and settings varied. The content of transition interventions was not well defined, and there was a lack of studies outside acute hospital settings. Data collection methods varied widely. The majority of authors reported outcomes for the graduate or the graduate and service, with only one reporting outcomes for the patient or client. There was a significant variation in quality across the studies. CONCLUSIONS This review addresses a significant gap in the literature by documenting transition interventions in a diversity of health settings and outcomes from these interventions. Interest in transition to practice continues to rise, but there is an urgent need to conduct well designed, robust, and larger-scale studies at the national and transnational levels.
Collapse
Affiliation(s)
- Amanda Kenny
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, P.O. Box 199, Bendigo, VIC 3552, Australia.
| | - Virginia Dickson-Swift
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, P.O. Box 199, Bendigo, VIC 3552, Australia.
| | - Lisa McKenna
- School Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia.
| | - Martin Charette
- School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia.
| | - Kathy L Rush
- School of Nursing, University of British Columbia - Okanagan, ART 150-1147 Research Road, Kelowna, BC V1V 1V7, Canada.
| | - Gemma Stacey
- Florence Nightingale Foundation, Deans Mews, 11-13 Cavendish Square, London, England W1G 0AN, UK.
| | - Angela Darvill
- Children's Nursing, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield HD1 3DH, UK.
| | - Jacqueline Leigh
- School Health & Society, Room MS 1-43 Mary Seacloe Building, University of Salford, M6 6PU, UK.
| | - Rob Burton
- School of Nursing and Midwifery, Griffith University, Singapore.
| | - Craig Phillips
- Clinical and Health Sciences Unit, University of South Australia, City East Campus (C5-35), GPO Box 2471, Adelaide, SA 5001, Australia.
| |
Collapse
|
26
|
Reebals C, Wood T, Markaki A. Transition to Practice for New Nurse Graduates: Barriers and Mitigating Strategies. West J Nurs Res 2021; 44:416-429. [PMID: 33724088 DOI: 10.1177/0193945921997925] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Inadequate transition to practice increases stress for new health care providers and threatens employment longevity. This integrative review aimed to synthesize the evidence on transition process for newly graduated registered nurses and advanced practice nurses in hospital settings and to identify enablers/barriers and mitigating strategies. Two databases were systematically searched for articles that described the process, strategies, participant perceptions, and implications of role transition with a final yield of 23 articles. Synthesis of the evidence revealed three major themes: (a) achieving competence for safe practice, (b) addressing stress during transition, and (c) reducing turnover. Emotional support for new graduates was instrumental to achieving clinical competence. Role transition adaptation was linked to anxiety, while emotional health was positively associated with retention. Developing best practices that address skill proficiency, attending to the emotional needs of new nurse graduates, and providing structured transition programs to improve clinical competence are the strategies of choice.
Collapse
Affiliation(s)
- Crisi Reebals
- School of Nursing, University of Alabama Birmingham Hospital, Birmingham, AL, USA
| | - Tara Wood
- Instructor, Neonatal Nurse Practitioner Specialty Track Coordinator, School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Adelais Markaki
- Dept. of Family, Community and Health Systems, School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| |
Collapse
|
27
|
Persaud-Sharma V, Hooshmand MA. Need for Nurse Practitioner Fellowships in Ophthalmology in the USA. J Ophthalmic Vis Res 2021; 16:113-121. [PMID: 33520134 PMCID: PMC7841275 DOI: 10.18502/jovr.v16i1.8257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 12/13/2020] [Indexed: 11/24/2022] Open
Abstract
Medical attention to vision impairment and associated eye care complications are a vital component of daily living and overall well-being. In the United States today, the physician to patient deficit places great strain on the availability of medical attention tenable to patients nationwide; in terms of specialty medicine, this deficit is even more widespread. The field of ophthalmology faced the same physician to patient deficit in 2020, a grim reality that has left many states void of ophthalmic care, rending millions of aging individuals without domestic eye care. The implementation of trained, ophthalmic nurse practitioners (NPs) can fill the needs of this deficit; however, efficient, accredited, and board-approved American ophthalmic fellowships and residencies that secure proper ophthalmic NP transitions from academia to clinical practice are non-existent. Though scant, evidence-based literature presents sound findings that support the efficacy and benefit for superior patient outcomes with care provided by ophthalmic-trained NPs, offering a viable, long-term solution to the need for ophthalmic medical providers across all states without mitigating patient care, emphasizing the great need for the implementation of ophthalmic NP residencies and fellowships to ensure the continuity of impeccable ophthalmic care for all populations.
Collapse
Affiliation(s)
| | - Mary A Hooshmand
- School of Nursing and Health Studies, University of Miami, Miami, FL, USA
| |
Collapse
|