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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; 36:504-511. [PMID: 39094025 DOI: 10.1097/jxx.0000000000001038] [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: 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.
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Affiliation(s)
- Rajashree Koppolu
- Advanced Practice Professional Development, Stanford Medicine Children's Health, Palo Alto, California
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Searby A, Burr D, Blums C, Harrison J, Smyth D. Exploring a pilot alcohol and other drug (AOD) nurse practitioner mentoring program: Empirical research mixed methods: A pilot nurse practitioner mentoring program. Nurs Open 2024; 11:e2250. [PMID: 39126170 PMCID: PMC11315737 DOI: 10.1002/nop2.2250] [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: 05/10/2023] [Revised: 07/09/2024] [Accepted: 07/31/2024] [Indexed: 08/12/2024] Open
Abstract
AIM To explore the effectiveness and acceptability of a pilot mentoring program for alcohol and other drug (AOD) nurse practitioners (also known globally as addiction nurse practitioners). DESIGN Mixed method evaluation. METHODS Two-phase evaluation comprising survey (demographics, pre- and post-program perceived competency and confidence) with 15 participants completing the pre survey and 10 participants completing the post survey, and qualitative interviews after the program with 10 participants. RESULTS The quantitative results indicate statistically significant increases in some domains of perceived competence and confidence in treatment. Qualitative findings indicate that participants valued peer support and mentoring from experienced nurse practitioners. Where formal residency or internship programs for nurse practitioners do not exist, informal mentoring programs may address issues inherent in nurse practitioner transition that may impact retention. We recommend further exploration of mentoring programs with larger sample sizes to determine if self-reported clinical improvements are noted. IMPLICATIONS FOR PROFESSION AND/OR PATIENT CARE Nurse practitioners are a vital part of the healthcare system; their advanced skills and knowledge place them in an ideal position to address prescriber shortages and access to care for populations underserved by healthcare. However, literature indicates that they are often underutilised, and transition to autonomous practice remains a challenge. Our exploration of a pilot mentoring program for nurse practitioners shows that their knowledge and perceived skills are high, yet peer assistance is valued in transitioning from advanced practice registered nurse to autonomous nurse practitioner. We recommend further trialling and evaluation of nurse practitioner mentoring programs to both increase supply of nurse practitioners and provide greater access to quality healthcare for underserved populations. IMPACT What problem did the study address? The ability of nurse practitioners to offer advanced practice interventions such as diagnosis and medication management potentially provides a solution to healthcare resource shortages. However, current literature indicates that advanced nurses transitioning to nurse practitioner roles suffer transition shock, leading to burnout and poor retention. What were the main findings? Although this pilot mentoring program shows significant improvements in survey responses on confidence and capability, qualitative data shows that neophyte nurse practitioners value peer support and mentoring from more experienced practitioners. Participants described maintaining ongoing connections with both mentors and fellow mentees, which aided transition to the role of autonomous nurse practitioner. Where and on whom will the research have an impact? The results of this pilot mentoring program indicate that there is benefit to these programs for neophyte nurse practitioners in many specialties. This paper indicates that mentoring programs for nurse practitioners may provide a community of practice and may have a positive impact on transition shock. REPORTING METHOD Good Reporting of a Mixed Methods Study (GRAMMS) checklist. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Adam Searby
- Monash University School of Nursing and MidwiferyClaytonVictoriaAustralia
- Drug and Alcohol Nurses of Australasia (DANA)BrisbaneQueenslandAustralia
| | - Dianna Burr
- Monash University School of Nursing and MidwiferyClaytonVictoriaAustralia
| | - Colleen Blums
- Drug and Alcohol Nurses of Australasia (DANA)BrisbaneQueenslandAustralia
| | - Jason Harrison
- Drug and Alcohol Nurses of Australasia (DANA)BrisbaneQueenslandAustralia
- Central Queensland Mental HealthAlcohol and Other Drug ServiceRockhamptonQueenslandAustralia
| | - Darren Smyth
- Drug and Alcohol Nurses of Australasia (DANA)BrisbaneQueenslandAustralia
- Queensland Injectors Health Network (QuIHN)Gold CoastQueenslandAustralia
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Kidd VD, Douglas G. Perceptions of Nurse Practitioners and Physician Assistants/Associates Toward the Concept of Developing an Advanced Practice Postgraduate Residency/Fellowship Program at a Large Academic Medical Center. Cureus 2024; 16:e67820. [PMID: 39188334 PMCID: PMC11346813 DOI: 10.7759/cureus.67820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2024] [Indexed: 08/28/2024] Open
Abstract
Introduction There have been exponential growth and increased interest in postgraduate residency/fellowship formalized training among nurse practitioners (NPs) and physician assistants/associates (PAs). Although not a requirement for state licensure and entry-level practice, postgraduate NP and PA residency/fellowship programs offer a structured pathway for new graduates and experienced PAs and NPs looking to transition into a new medical or surgical specialty/subspecialty. In this article, we examine the perceptions of employed NPs and PAs toward postgraduate training including the concept of developing a program at our institution. Methodology This was a cross-sectional single-large academic medical center (AMC) study, where an anonymous electronic survey was initially developed by the director of advanced practice providers (APPs). The survey was piloted by members of the Advanced Practice Council (APC) comprising NPs, PAs, and certified registered nurse anesthetists (CRNAs), and their collective feedback was used to finalize the survey prior to distribution. Descriptive statistics were used to describe and summarize the data. In addition, we assessed the association between respondents' characteristics and perceptions regarding NP and PA residency/fellowship programs using chi-squared tests of independence. Results The majority of the respondents (69.1%; 65/94) believed that starting an advanced practice residency/fellowship program at our AMC has many benefits such as increasing specialty-specific knowledge and training (79.8%; 75/94), improving medical decision-making (73.4%; 69/94), promoting professional development and clinical education (73.4%; 69/94), and improving procedural competency (60.6%; 57/94). Moreover, over half of the respondents (53.2%; 50/94) indicated that there is value in an APP residency/fellowship program obtaining optional accreditation. Additionally, over half of the respondents (56.4%; 53/94) indicated that they would be interested in participating as a clinical preceptor if an APP residency/fellowship program was developed at our AMC. Lastly, about one-third of the respondents felt strongly that APP residency/fellowship training programs should offer post-professional doctoral degree options such as Doctor of Nursing Practice (DNP), Doctor of Medical Science (DMSc), and Doctor of Health Science (DHSc). Conclusion Although most respondents have never completed a formalized postgraduate training program and were less familiar with the published literature regarding these programs, our findings suggest that the attitudes of employed NPs and PAs are generally positive toward the concept of postgraduate specialty-specific training.
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Affiliation(s)
- Vasco Deon Kidd
- Orthopedic Surgery, University of California Irvine School of Medicine, Irvine, USA
| | - Geraldina Douglas
- Perioperative Services, University of California Irvine School of Medicine, Irvine, USA
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Ljungbeck B, Carlson E, Forss KS. Swedish stakeholders' views of the preparatory work needed before introducing the nurse practitioner role in municipal healthcare-A focus group study. Scand J Caring Sci 2024; 38:284-293. [PMID: 37984433 DOI: 10.1111/scs.13224] [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: 02/03/2023] [Revised: 09/30/2023] [Accepted: 10/28/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND The nurse practitioner role has become important globally in handling the growing healthcare needs of older adults with chronic diseases. Nevertheless, research shows that introducing the role is a complex process, and more studies are needed to prepare for its introduction into different healthcare contexts, such as municipal healthcare. AIM The aim is to investigate what Swedish stakeholders identify as the preparatory work needed before introducing the nurse practitioner role into municipal healthcare. METHODS Data were collected through four focus group interviews conducted virtually on the TEAMS digital platform, with three to six participants in each group and 18 participants total. The transcribed interviews were analysed using a six-step thematic approach: familiarisation with the data, coding the data, generating initial themes, reviewing themes, defining and naming the themes and producing the report. FINDINGS The findings are divided into two main themes, each with two sub-themes. In the first, clarifying why the nurse practitioner role is needed, participants stressed the importance of having a clear intention for introducing the role. The second, ensure a national framework to bolster the introduction at the local level, demonstrates the need for collaboration among national actors to clarify the role's mandate and authority before its introduction. CONCLUSIONS Adding the nurse practitioner role to municipal healthcare can help increase the supply of nursing competence and the quality of patient care, but preparation for introducing the role requires extensive work. The development of the nurse practitioner role requires decision-makers and leaders to take primary responsibility for its introduction. This study can support countries in the early phase of developing the nurse practitioner role by identifying both best practices and pitfalls.
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Affiliation(s)
- Birgitta Ljungbeck
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmo, Sweden
- Municipal Healthcare in Hässleholm, Management of Care and Welfare, Malmo, Sweden
| | - Elisabeth Carlson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmo, Sweden
| | - Katarina Sjögren Forss
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmo, Sweden
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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.
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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.
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Rodríguez C, Archibald D, Grad R, Loban K, Kilpatrick K. Professional identity work of nurse practitioners and family physicians in primary care in Quebec and Ontario - a study protocol. BMC PRIMARY CARE 2024; 25:178. [PMID: 38773473 PMCID: PMC11107061 DOI: 10.1186/s12875-024-02415-3] [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: 04/08/2024] [Accepted: 04/30/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND Solo medical practices in primary healthcare delivery have been abandoned in favor of interdisciplinary teamwork in most Western countries. Dynamics in interdisciplinary teams might however be particularly difficult when two or more autonomous health professionals develop similar roles at the practice level. This is the case of family physicians (FPs) and nurse practitioners (NPs), due to the fact that the latter might accomplish not only the traditional role proper to a nurse, but also several medical activities such as requesting diagnostic exams and prescribing medical treatments. The tensions that this overlap might generate and their implications in regard of the development of professional identities, and consequently of the quality of health care delivered, have been suggested, but rarely examined empirically. The goal of this study is to examine identity work, i.e., the processes of (re)construction of professional identities, of NPs and FPs working together in primary care interdisciplinary teams. METHODS A longitudinal, interpretive, and comparative multiple (n = 2) case study is proposed. Identity work theory in organizations is adopted as theoretical perspective. Cases are urban primary care multidisciplinary teams from two different Canadian provinces: Quebec and Ontario. Participants are NPs, FPs, managers, and patients. Data gathering involves audio-diaries, individual semi-structured and focus group interviews, observations, and archival material. Narrative and metaphor techniques are adopted for analyzing data collected. Within- and cross-case analysis will be performed. DISCUSSION For practice, the results of this investigation will: (a) be instrumental for clinicians, primary care managers, and policy decision-makers responsible for the implementation of interdisciplinary teamwork in primary healthcare delivery to improve decision-making processes and primary care team performance over time; (b) inform continuing interdisciplinary professional development educational initiatives that support competency in health professionals' identity construction in interdisciplinary primary care organizations. For research, the project will contribute to enriching theory about identity construction dynamics in health professions, both in the fields of health services and primary care education research.
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Affiliation(s)
- Charo Rodríguez
- Department of Family Medicine, School of Medicine, Faculty of Medicine and Health Sciences, McGill University, 5858 Côte-des-Neiges Road, 3rd floor, suite 300, room 328, Montreal, QC, H3S 1Z1, Canada.
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.
| | - Douglas Archibald
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
| | - Roland Grad
- Department of Family Medicine, School of Medicine, Faculty of Medicine and Health Sciences, McGill University, 5858 Côte-des-Neiges Road, 3rd floor, suite 300, room 328, Montreal, QC, H3S 1Z1, Canada
| | - Katya Loban
- Research Institute of the McGill University Health Center, Montreal, QC, Canada
| | - Kelley Kilpatrick
- Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
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Clarke V, Lehane E, Cotter P, Mulcahy H. Advanced nurse and midwife practitioners' experience of interprofessional collaboration when implementing evidence-based practice into routine care: An interpretative phenomenological analysis. J Adv Nurs 2024; 80:1559-1573. [PMID: 37950366 DOI: 10.1111/jan.15917] [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: 02/15/2023] [Revised: 09/02/2023] [Accepted: 10/15/2023] [Indexed: 11/12/2023]
Abstract
AIM To understand advanced nurse and midwife practitioners' experience of interprofessional collaboration in implementing evidence-based practice into routine care. DESIGN A qualitative interpretative phenomenological analysis. METHODS A purposeful sample of 10 Registered Advanced Nurse and Midwife Practitioners from a range of practice settings in the Republic of Ireland participated in semi-structured interviews over a 10-month timeframe. Interviews were transcribed verbatim and data were analysed using a multi-stage approach in line with guidance for interpretative phenomenological analysis. RESULTS Six superordinate themes emerged: Understanding of advanced practice; 'Treated as an equal and as a "nurse"'; Nursing management support; 'A voice to implement anything new'; Confidence and Emotional intelligence. These factors impacted interprofessional relationships and the extent to which advanced practitioners could implement evidence-based practice. CONCLUSION There is scope to improve advanced practitioners' ability to collaborate with the interprofessional team in implementing evidence-based practice into routine care. IMPACT AND IMPLICATIONS The study findings demonstrate that enhancing understanding of the advanced practice role; increasing organizational support for advanced practitioners and augmenting specific practitioner skills and attributes will increase their ability to collaborate effectively and implement evidence-based practice. Supporting advanced practitioners in this important aspect of their role will positively influence health outcomes for patients. CONTRIBUTION TO THE WIDER GLOBAL CLINICAL COMMUNITY As numbers of both nurse and midwife practitioners increase globally, this study provides timely evidence from a range of practice settings to guide the design of education programmes and policies governing advanced practice. Study recommendations have broad applicability to all healthcare professionals who are engaged in implementing evidence-based practice into routine care. REPORTING METHOD Consolidated criteria for reporting qualitative research (COREQ). PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Vanessa Clarke
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
- Nursing and Midwifery Planning and Development, Health Service Executive North East, Ardee, County Louth, Ireland
| | - Elaine Lehane
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Patrick Cotter
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Helen Mulcahy
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
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Brickley S, Barrolle S, Pentland A. Implementation of a postgraduate dermatology fellowship program for nurse practitioners. J Am Assoc Nurse Pract 2024; 36:180-186. [PMID: 37906505 PMCID: PMC10898538 DOI: 10.1097/jxx.0000000000000963] [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: 04/10/2023] [Revised: 09/01/2023] [Accepted: 09/12/2023] [Indexed: 11/02/2023]
Abstract
ABSTRACT Transition to practice programs (also referred to as fellowship, residency, or postgraduate training programs) for nurse practitioners (NPs) are becoming more popular, especially in specialties such as dermatology. A nationwide shortage of dermatology clinicians, which had led to long appointment wait times and inadequate patient access to care, has led to more NPs practicing dermatology to help meet the demand for care. New graduate NPs may struggle in their transition to practice, and fellowship programs have been shown to support NPs as they transition from novice to expert. In this article, the University of Rochester Medical Center shares its experience in developing, implementing, and managing a postgraduate dermatology fellowship program for NPs.
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Affiliation(s)
- Sylvana Brickley
- Department of Dermatology, Beth Israel Lahey Health, Burlington, Massachusetts
| | - Shimika Barrolle
- Department of Dermatology, University of Rochester Medical Center, Rochester, New York
| | - Alice Pentland
- Department of Dermatology, University of Rochester Medical Center, Rochester, New York
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Pleshkan V. A systematic review: Clinical education and preceptorship during nurse practitioner role transition. J Prof Nurs 2024; 50:16-34. [PMID: 38369368 DOI: 10.1016/j.profnurs.2023.10.005] [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: 10/12/2022] [Revised: 10/15/2023] [Accepted: 10/16/2023] [Indexed: 02/20/2024]
Abstract
BACKGROUND The demand for nurse practitioners (NP) is growing; however, the NP role transition is difficult. NP role transition starts with NP student entering the program and can last for as long as two years post-graduation. NP clinical education and preceptorship model is outdated and is in need of restructuring. PURPOSE The purpose of this literature review was to describe and explain the issues and resources within the NP clinical education and preceptorship that is used to support NPs' role transition both before and after graduation. METHODS The search years included 2010-2022. The following search terms were used: graduate nurse, advanced nursing, nurse practitioner, APRN, masters prepared, advanced nurse, nursing student, practicum, residency programs, residencies, school, program, clinical, clinical education, nursing education, health education, training, clinical site, student, preceptor, preceptorship, apprenticeship, mentor, mentorship, transition, role transition, role change, nurse's role, primary care, qualitative research, collaboration, and clinical competence. RESULTS In this review pre-graduation persistent issues with availability of clinical sites and preceptors as well as lack of consistency in competency based clinical education assessment practices were identified. Difficult transition to practice post-graduation showed inconsistent and limited support available to further develop the newly graduated entry level NPs' clinical skills. CONCLUSION Restructuring the old clinical education and preceptorship model used during the pre-graduation NP role transition stage is necessary to improve NP role transition process and graduate the required number of practice ready NPs.
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Affiliation(s)
- Viktoriya Pleshkan
- Loewenberg College of Nursing, 4055 North Park Loop, Community Health Building, Memphis, TN 38152, United States of America.
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Morgan P, Barnes H, Batchelder HR, Tuttle B, Covelli AF, Everett C, Jackson GL, Anglin L, Pate NO, Dieter P, Bludorn J. NP and PA transition to practice: A scoping review of fellowships and onboarding programs. JAAPA 2023; 36:1-9. [PMID: 37943670 DOI: 10.1097/01.jaa.0000991352.36720.09] [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: 11/12/2023]
Abstract
OBJECTIVES Newly graduated NPs and physician associates/assistants (PAs) benefit from transition to practice (TTP) support to move successfully into practice. TTP programs (such as onboarding programs, fellowships, and residencies) hold promise for improving workforce outcomes. The purpose of this scoping review was to describe the literature regarding NP/PA TTP programs. METHODS Using the Joanna Briggs Institute methodology, a specific approach for systematically conducting reviews, publications from January 1990 to May 2022 were included if they addressed fellowships, residencies, or onboarding programs for NPs or PAs. Final data extraction involved 216 articles. RESULTS The pace of publication increased over time, with a noticeable increase since 2015. Articles were most commonly about fellowships or residencies, NPs, and programs set in nonrural, acute care US settings and in academic health centers. CONCLUSIONS A gap exists in our understanding of onboarding programs and programs focusing on PAs, as well as TTP support in rural and primary care settings. In addition, few articles assess TTP program outcomes such as benefits and costs. This review describes the need for more published literature in these areas.
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Affiliation(s)
- Perri Morgan
- Perri Morgan is a professor in the PA program at Duke University in Durham, N.C. Hilary Barnes is an assistant professor at Widener University School of Nursing in Chester, Pa. Heather R. Batchelder is a research program leader in the Department of Family Medicine and Community Health at Duke University. Brandi Tuttle is a research and education librarian at Duke University Medical Center Library and Archives. Asefeh Faraz Covelli is an associate professor in the School of Nursing at George Washington University in Washington, D.C. Christine Everett is founding PA program director and division chief of PA studies at the Medical College of Wisconsin in Milwaukee, Wisc. George L. Jackson is a professor and director of the Program on Implementation and Improvement Science at the Peter O'Donnell Jr. School of Public Health at the University of Texas Southwestern Medical Center in Dallas, Tex., and a research health scientist and director of the Implementation and Improvement Science Lab in the Center of Innovation to Accelerate Discovery and Practice Transformation at Durham (N.C.) Veterans Affairs Health Care System. Lorraine Anglin is an assistant professor and academic coordinator of the PA program at Duke University and practices at Triangle Residential Options for Substance Abusers medical clinic in Durham, N.C. Nathalie Ortiz Pate is an assistant professor in the PA program at Campbell University in Buies Creek, N.C., and practices family medicine at Moncure (N.C.) Community Health Center. Patricia Dieter is a professor emeritus in the Department of Family Medicine and Community Health at Duke University School of Medicine. Janelle Bludorn is an assistant professor and academic coordinator of the PA program at Duke University. The authors have disclosed no potential conflicts of interest, financial or otherwise
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Morgan P, Barnes H, Batchelder HR, Tuttle B, Faraz Covelli A, Everett C, Jackson GL, Anglin L, Ortiz Pate N, Dieter P, Bludorn J. Nurse practitioner and physician assistant transition to practice: A scoping review of fellowships and onboarding programs. J Am Assoc Nurse Pract 2023; 35:776-783. [PMID: 38047888 DOI: 10.1097/jxx.0000000000000932] [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: 03/28/2023] [Accepted: 06/28/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Newly graduated nurse practitioners (NPs) and physician assistants (PAs) benefit from transition-to-practice (TTP) support to move successfully into practice. Transition-to-practice programs (i.e., onboarding programs and fellowships/residencies) hold promise for improving workforce outcomes. PURPOSE The purpose of this scoping review was to describe the literature regarding NP/PA TTP programs. METHODOLOGY Using the Joanna Briggs Institute methodology, a specific approach for systematically conducting reviews, publications from January 1990 to May 2022 were included for review if they addressed fellowships/residencies or onboarding programs for NPs or PAs. Final data extraction involved 216 articles. RESULTS The pace of publication increased over time, with a noticeable increase since 2015. Articles were most commonly about fellowships/residencies, NPs, and programs set in United States nonrural, acute care settings, and academic health centers. CONCLUSIONS/IMPLICATIONS There is a gap in our understanding of onboarding programs and programs focusing on PAs, as well as TTP support in rural and primary care settings. In addition, there are few articles that assess TTP program outcomes such as benefits and costs. This review describes the need for more published literature in these areas.
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Affiliation(s)
- Perri Morgan
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, North Carolina
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Hilary Barnes
- School of Nursing, Widener University, Chester, Pennsylvania
| | - Heather R Batchelder
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, North Carolina
| | - Brandi Tuttle
- Medical Center Library and Archives, Duke University, Durham, North Carolina
| | - Asefeh Faraz Covelli
- School of Nursing, George Washington University, Washington, District of Columbia
| | - Christine Everett
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
- Physician Associate Program, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - George L Jackson
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, North Carolina
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
- Division of General Internal Medicine, Duke University School of Medicine, Durham, North Carolina
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Medical Center, Durham, North Carolina
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Lorraine Anglin
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, North Carolina
| | - Nathalie Ortiz Pate
- College of Pharmacy & Health Sciences, Campbell University, Buies Creek, North Carolina. JAANP and JAAPA have arranged to publish this article simultaneously in the December 2023 issues. Although the two articles have minor style differences, they are essentially the same
| | - Patricia Dieter
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, North Carolina
| | - Janelle Bludorn
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, North Carolina
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Arnold SA, Meyer NL, Tonaus S, Shaffer BL, Baniak LM. Implementation and Evaluation of a Nurse Practitioner Onboarding Program at a Large Healthcare Facility. J Nurs Adm 2023; 53:515-519. [PMID: 37747174 DOI: 10.1097/nna.0000000000001327] [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: 09/26/2023]
Abstract
A comprehensive, evidence-based onboarding program benefits healthcare workers and institutions. Many institutions do not have onboarding programs for new nurse practitioners (NPs). In this quality improvement initiative, a standardized onboarding program was developed. The impact on NP satisfaction and retention was evaluated. Lead NPs were identified as program managers. Program components included role introduction, competency validation, review of administrative essentials, ongoing progress logs, and program evaluations. The program resulted in increased NP satisfaction and retention.
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Affiliation(s)
- Sandra A Arnold
- Author Affiliations: Nurse Practitioners (Dr Arnold, Meyer, and Dr Tonaus), Associate Director for Patient Care Services (Dr Shaffer), and Associate Chief Nurse for Research (Dr Baniak), Veterans Affairs Pittsburgh Healthcare System; and Adjunct Faculty (Dr Baniak), School of Nursing, University of Pittsburgh, Pennsylvania
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13
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Baharum H, Ismail A, McKenna L, Mohamed Z, Ibrahim R, Hassan NH. Success factors in adaptation of newly graduated nurses: a scoping review. BMC Nurs 2023; 22:125. [PMID: 37069647 PMCID: PMC10111715 DOI: 10.1186/s12912-023-01300-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 04/13/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Difficulties in adapting to the workplace can affect newly graduated nurses' transition. Such nurses must adapt quickly, as it can affect their future career prospects. Therefore, this review aimed to identify the success factors that promote newly graduated nurses' effective transition and adaptation. METHODS The Joanna Briggs Institute scoping reviews methodology was used. Data were extracted from MEDLINE, Scopus, EBSCOhost, and Web of Science publications published between 2011 and 2020. A total of 23 articles were included in this review, which comprised qualitative, quantitative, and mixed methods primary research studies focusing on the contributing factors that aided newly graduated nurses' adaptation to the work environment during their transition period. Key emerging themes were identified with thematic analysis. RESULTS Three main themes were identified: (1) organisational contribution (social development, organisational culture, work characteristics, work readiness, work commitment, professional role), (2) personality traits (self-embodiment, personality masking, being proactive and confident), and (3) academic institutions (pre-entry knowledge and role of nursing faculty). Newly graduated nurses' adaptation should begin during nursing education, be supported by the workplace organisation, and driven by the nurse's personality. We determined that that the role of nursing education in aiding the provision of the required knowledge and actual clinical experiences to students profoundly affected developing nurses' self-confidence levels in delivering nursing care effectively. Additionally, a warm environment supported nurses emotionally and physically. CONCLUSIONS While organisations and educational institutions have undertaken numerous efforts to ensure that newly graduated nurses are adequately supported, the nurse's personality and values are also equally important to ease adaptation during the transition process. Academic and workplace programs designed for newly graduated nurses should apply and emphasise this knowledge to develop and strengthen their personalities and values, especially to increase confidence and promote proactive values that facilitate newly graduated nurses' rapid and effective adaptation to their new employment.
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Affiliation(s)
- Hafidza Baharum
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia
| | - Aniza Ismail
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia.
| | - Lisa McKenna
- School of Nursing and Midwifery, La Trobe University, Bundoora, Australia
| | - Zainah Mohamed
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia
| | - Roszita Ibrahim
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia
| | - Nor Haty Hassan
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia
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Mentoring novice NPs: Recommendations for navigating the transition to autonomous practice. Nurse Pract 2023; 48:41-47. [PMID: 36700795 DOI: 10.1097/01.npr.0000000000000005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
ABSTRACT The transition to professional practice is a challenging time for the novice NP. Mentorship is an effective strategy to ease this transition and increase success in the role. This article provides recommendations for best practice in mentoring the transitioning novice NP.
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Barnes H, Faraz Covelli A, Rubright JD. A confirmatory factor analysis of the novice nurse practitioner role transition scale. Res Nurs Health 2023; 46:127-135. [PMID: 36385269 DOI: 10.1002/nur.22277] [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: 08/10/2022] [Revised: 10/13/2022] [Accepted: 10/29/2022] [Indexed: 11/18/2022]
Abstract
As interest in supporting new nurse practitioners' (NPs) transition to practice increases, those interested in measuring the concept will need an instrument with evidence of reliability and validity. The Novice NP Role Transition (NNPRT) Scale is the first instrument to measure the concept. The preliminary exploratory factor analysis revealed a five-factor structure: organizational alignment, mentorship, sense of purpose, perceived competence and self-confidence, and compensation. Using a cross-sectional design and data from 210 novice NPs, the purpose of this study was to confirm the NNPRT Scale's internal factor structure via confirmatory factor analysis (CFA). The sample was primarily female (97.5%), White (75.9%), and certified in primary care (53.5%). The CFA confirmed the five-factor structure, and model fit was improved by moving and omitting items (χ2 [619] = 1277.799, p < 0.001; Root Mean Square Error of Approximation = 0.071 [0.066-0.077]). The final NNPRT Scale includes 37-items, and internal consistency reliability was calculated at 0.95. Convergent validity evidence was supported by a positive, significant correlation with receiving a formal orientation in the first NP position; a negative, significant correlation with turnover intention; and a lack of a relationship with years of prior registered nurse experience. The NNPRT Scale is an instrument with sound evidence of reliability and validity. The NNPRT Scale will be useful for researchers, administrators, and clinicians looking to explore factors that affect NNPRT, as well as by clinicians and administrators implementing programs to support novice NPs' transition to practice.
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Affiliation(s)
- Hilary Barnes
- School of Nursing, Widener University, One University Place, Chester, Pennsylvania, USA
| | - Asefeh Faraz Covelli
- School of Nursing, The George Washington University, Washington, District of Columbia, USA
| | - Jonathan D Rubright
- Office of Research, National Board of Medical Examiners, Philadelphia, Pennsylvania, USA
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16
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Seismann-Petersen S, von der Lühe V, Inkrot S, Roos M, Dichter MN, Köpke S. [Role understanding of expert nurses in primary and acute care in Germany: A descriptive cross-sectional study]. Pflege 2023; 36:11-19. [PMID: 36625280 DOI: 10.1024/1012-5302/a000912] [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: 01/11/2023]
Abstract
Role understanding of expert nurses in primary and acute care in Germany: A descriptive cross-sectional study Abstract. Background: Innovative care concepts are necessary to cope with the increase in complex care situations due to a rising number of older people with chronic diseases and a simultaneous shortage of nursing and medical staff. In the context of the implementation and development of new, innovative nursing roles, an unclear role understanding is considered a barrier. Aim: Description of expert nurses' (EN) role understanding in primary and acute care in Germany. Method: Using questionnaires, EN are asked cross-sectionally about role clarity, competencies and performance as well as perceived autonomy and interprofessional collaboration. Results are analysed descriptively. Results: A total of eight (primary care) and 14 (acute care) EN completed the questionnaires. The majority of EN often/very often perform both the clinical (77.5% and 85.7%, respectively) and the expert role (75% and 78.6%, respectively) and indicate that they can explain their role to patients (75% and 92.9%, respectively) and physicians (87.5% and 90.9%, respectively). Having a high degree of autonomy is more likely to be perceived by EN working in acute care. Conclusion: Although there are similarities in terms of role understanding, EN working in acute care can apparently benefit from already established structures, which is reflected, among other things, in their perceived autonomy.
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Affiliation(s)
- Swantje Seismann-Petersen
- Institut für Pflegewissenschaft (IfP), Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Deutschland
| | - Verena von der Lühe
- Institut für Pflegewissenschaft (IfP), Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Deutschland
| | - Simone Inkrot
- Sektion für Forschung und Lehre in der Pflege, Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Deutschland
| | - Marcelina Roos
- Institut für Pflegewissenschaft (IfP), Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Deutschland
| | - Martin N Dichter
- Institut für Pflegewissenschaft (IfP), Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Deutschland
| | - Sascha Köpke
- Institut für Pflegewissenschaft (IfP), Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Deutschland
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Batchelder HR, Tuttle B, Barnes H, Covelli AF, Everett C, Jackson GL, Anglin L, Pate NO, Morgan P. Transition-to-practice programs for newly graduated advanced practice registered nurses and physician assistants: a scoping review protocol. JBI Evid Synth 2022; 20:3001-3008. [PMID: 35975301 DOI: 10.11124/jbies-21-00380] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The objective of this scoping review is to map the evidence on transition-to-practice programs for newly graduated advanced practice registered nurses and physician assistants, and describe how they differ. Additional objectives include summarizing what outcomes are evaluated and what gaps remain within the literature. By consolidating this information, health care administrators may more easily reference transition-to-practice methods to enhance their own programs for advanced practice registered nurses and physician assistants.z. INTRODUCTION Transition to practice involves 2 program types: onboarding and postgraduate training. However, no existing reviews describe the state of the literature regarding these program types, and how they compare with regard to location, setting, and outcomes. Because transition-to-practice programs may improve workforce outcomes, understanding how these programs differ, and what gaps exist, is needed to help these programs grow. INCLUSION CRITERIA This review will include articles describing transition to practice for advanced practice registered nurses and/or physician assistants, including onboarding and fellowship/residency programs. Articles will be included regardless of geographic location if they take place within a professional, clinical setting. METHODS The scoping review will follow the JBI approach. Databases to be searched include MEDLINE (PubMed), CINAHL, Cochrane Central Register of Controlled Trials, Embase, ProQuest Dissertations and Theses, Scopus, and Web of Science. All included manuscripts will be screened by two reviewers and relevant data will be extracted. These data will summarize what transition to practice programs are used, how they differ, and what gaps exist.
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Affiliation(s)
- Heather R Batchelder
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, USA
| | - Brandi Tuttle
- Medical Center Library and Archives, Duke University, Durham, NC, USA
| | - Hilary Barnes
- School of Nursing, Widener University, Chester, PA, USA
| | | | - Christine Everett
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, USA.,Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.,Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - George L Jackson
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, USA.,Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.,Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.,Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, USA
| | - Lorraine Anglin
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, USA
| | - Nathalie Ortiz Pate
- College of Pharmacy and Health Sciences, Campbell University, Buies Creek, NC, USA
| | - Perri Morgan
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, USA.,Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
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Seismann-Petersen S, Köpke S, Inkrot S. Process evaluation of a multi-disciplinary complex intervention to improve care for older patients with chronic conditions in rural areas (the HandinHand Study): study protocol. BMC Nurs 2022; 21:151. [PMID: 35701815 PMCID: PMC9194343 DOI: 10.1186/s12912-022-00858-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 03/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To improve health care in rural areas, especially for increasing numbers of people with chronic diseases, academically qualified nurses could take over expanded roles to meet the challenges of an ageing society and a decreasing number of General Practitioners (GPs). In the project "HandinHand" (HiH), qualified nurses (Expert nurses, ENs) will carry out home visits to older people with chronic diseases over a period of six months. ENs will prepare a care plan in cooperation with GPs to stabilise the care situation and avoid unplanned hospital admissions and GP visits. The process evaluation aims to provide an in-depth analysis of the implementation process and gather important information on barriers and facilitators to the implementation of ENs as a complementary health care structure in primary care, taking into account several context factors. METHODS Based on the Medical Research Council (MRC) Framework for complex interventions, a logic model was developed and applied as the basis for data collection. Qualitative and quantitative data will be collected during the study. A mixed methods approach should allow to gain important insights from participants (e.g. ENs, GPs, patients) involved in the study as well as relevant stakeholders. Semi-structured interviews and surveys will be conducted. Data analysis will be based on the logical model, combining qualitative and quantitative data. Qualitative data will be analysed inductively-deductively using qualitative thematic framework analysis. DISCUSSION The process evaluation will provide guidance and conclusions on further development and transferability. Of particular interest is the expanded role of ENs in primary care, which has barely been implemented in Germany and can be seen as a precursor to the development of an Advanced Practice Nursing (APN) role in primary care.
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Affiliation(s)
- Swantje Seismann-Petersen
- Institute of Nursing Science, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50935, Köln, Germany.
| | - Sascha Köpke
- Institute of Nursing Science, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50935, Köln, Germany
| | - Simone Inkrot
- Institute for Social Medicine and Epidemiology, Nursing Research Section, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
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El Hussein MT, Ha C. Systemic barriers and facilitators to the transition of registered nurse to nurse practitioner in Canada: A scoping review. J Am Assoc Nurse Pract 2022; 34:792-801. [PMID: 35485967 DOI: 10.1097/jxx.0000000000000724] [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: 12/21/2021] [Accepted: 03/18/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND The scope of practice of nurse practitioners (NPs) is expanding, and an increasing number of registered nurses (RNs) are advancing their careers to become NPs. Nurse practitioners are prepared to improve access to high-quality care and enhance care standards. The barriers and facilitators in the transition of RNs to NPs have been seldom studied in the Canadian context. OBJECTIVE To conduct a scoping review to identify systemic barriers and facilitators affecting Canadian RN experience in transitioning to independent practice as NPs. DATA SOURCES Four electronic databases were searched for primary studies, and several search engines were used to retrieve gray literature. Keywords included NP, transition, novice, Canada, barriers, obstacles, facilitators, and their variations. Eligible studies are those published from the inception of each respective database to 2021. CONCLUSIONS Four research studies and one report in the gray literature were located. Three themes were identified from the literature review, including inconsistencies in education and the need for mentors, need for legislation supportive of NP practice, and inconsistent remuneration structures for NPs. IMPLICATIONS FOR PRACTICE Addressing systemic barriers and employing systemic facilitators are likely to facilitate the transition of RNs to NPs. The lack of primary evidence to explore the factors that affect the transition process from an RN to an NP in Canada indicates that further research must be done. Findings from the future research are likely to furnish a better understanding of the transition process so that the integration of new NPs into the health care system can be achieved efficiently.
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Affiliation(s)
- Mohamed Toufic El Hussein
- School of Nursing and Midwifery, Faculty of Health, Community & Education, Mount Royal University, Calgary, Canada
- Faculty of Nursing, University of Calgary, Calgary, Canada
- Acute Care Nurse Practitioner Medical Cardiology, Coronary Care Unit, Rockyview General Hospital, Calgary, Canada
| | - Calla Ha
- School of Nursing and Midwifery, Faculty of Health, Community & Education, Mount Royal University, Calgary, Canada
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20
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Beebe SL, McKague DK, Wallington SF. COVID-19 on New Primary Care Nurse Practitioners: A Qualitative Exploration. J Nurse Pract 2022; 18:601-605.e1. [PMID: 35342376 PMCID: PMC8940575 DOI: 10.1016/j.nurpra.2022.02.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
New nurse practitioners (NPs) struggle with the transition to practice and feelings of uncertainty concerning roles and responsibilities. COVID-19 has added a new layer of stress. This pilot study used a qualitative case study design featuring semistructured interviews of 10 newly graduated primary care NPs. Data analysis revealed 2 main themes: (1) emotional burden, and (2) coping and support. Emerging themes highlight the resiliency of NPs, who cope and seek support when faced with emotional burdens. This study informs educators and employers on the needs of new NPs during a global pandemic in order to better support the future workforce.
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21
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Cognitive preceptorship: An emerging nurse practitioner role transition to practice model. J Prof Nurs 2022; 39:194-205. [DOI: 10.1016/j.profnurs.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 01/30/2022] [Accepted: 02/02/2022] [Indexed: 10/19/2022]
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22
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Hart AM, Seagriff N, Flinter M. Sustained Impact of a Postgraduate Residency Training Program on Nurse Practitioners' Careers. J Prim Care Community Health 2022; 13:21501319221136938. [PMID: 36373693 PMCID: PMC9663609 DOI: 10.1177/21501319221136938] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/13/2022] [Accepted: 10/18/2022] [Indexed: 08/26/2023] Open
Abstract
INTRODUCTION In 2007, the first formal postgraduate nurse practitioner (NP) residency program was launched at Community Health Center, Inc., a large Federally Qualified Health Center in Connecticut, and focused on primary care and community health. There are numerous post-graduate nurse practitioner training programs across the nation, and many more are under development. Although the literature describes the impact of postgraduate residency training programs on new NPs' early practice transition, to date, no studies have examined the long-term impact of postgraduate NP training programs on alumni's career choices, practice, and satisfaction. This study sought to understand the impact over time of Community Health Center Inc.'s postgraduate NP residency program on the subsequent career paths of alumni who completed the program between 2008 and 2019. Additionally, it explored alumni's current reflections on the impact of their postgraduate residency training on their transition to the post-residency year and beyond, as well as their professional development and career choices. Moreover, it sought to identify any previously undocumented elements of impact for further exploration in subsequent studies. METHODS This was a retrospective cohort study that used an electronic survey and interviews. All 90 of the alumni who had completed Community Health Center Inc.'s residency between 2008 and 2019 were invited to participate. RESULTS The survey's response rate was 72%. Most (74%) of the participating alumni indicated they were still practicing as primary care providers. Of these, 57% were practicing at FQHCs. Nine subthemes were identified from the interviews, with an overarching theme that the program was foundational to a successful career in community-based primary care and that the impact of the program continues to evolve. CONCLUSION Community Health Center Inc.'s postgraduate NP residency program had a long-standing impact on alumni's commitment to continuing in primary care practice, as well as their engagement in leadership activities to ensure quality care.
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Educators’ Perceptions of the Development of Clinical Judgment of Direct-Entry Students and Experienced RNs Enrolled in NP Programs. JOURNAL OF NURSING REGULATION 2022. [DOI: 10.1016/s2155-8256(22)00011-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Pituskin E, Albert M, Norris C. FACILITATING SUCCESSFUL ROLE TRANSITIONS FROM REGISTERED NURSE TO NURSE PRACTITIONER. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2022-e001-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Pituskin E, Albert M, Norris C. FACILITANDO TRANSIÇÕES DE PAPEL BEM SUCEDIDAS DE ENFERMEIRO PARA ENFERMEIRO DE PRÁTICAS AVANÇADAS. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2022-e001-pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Pituskin E, Albert M, Norris C. PROMOCIÓN DE TRANSICIONES DE ROL EXITOSAS DE ENFERMERO A ENFERMERO DE PRÁCTICA AVANZADA. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2022-e001-es] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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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]
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Crismon D, Mansfield KJ, Hiatt SO, Christensen SS, Cloyes KG. COVID-19 pandemic impact on experiences and perceptions of nurse graduates. J Prof Nurs 2021; 37:857-865. [PMID: 34742515 PMCID: PMC9767315 DOI: 10.1016/j.profnurs.2021.06.008] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Transitioning from education to practice is stressful for new nurses and those entering new roles and can lead to workforce attrition and burnout. This dynamic is likely complicated when graduates are transitioning to practice during a pandemic. PURPOSE The purpose of this study was to describe recent nurse graduates' perceptions of the impact of the COVID-19 pandemic on their transition from education to practice. METHODS We conducted an online survey of BSN, RN-BSN, and DNP students who graduated between December 2019 and April 2020 (n = 82), including demographics, employment information, and free-response questions about the impact of the pandemic on their transition experiences, post-graduation plans, and perceptions of nursing. We used a qualitative descriptive approach to content analysis to synthesize and summarize the data. RESULTS Participants expressed three overarching concerns: 1) altered plans such as difficulty finding employment; 2) logistical, system-related stressors including licensing delays and chaotic onboarding; and 3) feeling pride in profession despite perceiving ambivalence in public discourse. CONCLUSION COVID-19 exacerbated challenges often experienced by new graduates. Common stressors, intensified during the pandemic, could exert long-term effects on the workforce. Educators and healthcare organizations must work to ensure nursing graduates receive the necessary support for a successful transition.
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Affiliation(s)
- Denise Crismon
- College of Nursing, University of Utah, Salt Lake City, UT, United States of America.
| | - Kelly J Mansfield
- College of Nursing, University of Utah, Salt Lake City, UT, United States of America
| | - Shirin O Hiatt
- College of Nursing, University of Utah, Salt Lake City, UT, United States of America; School of Nursing, Oregon Health and Science University, Portland, OR, United States of America
| | - Scott S Christensen
- College of Nursing, University of Utah, Salt Lake City, UT, United States of America; University of Utah Health, Salt Lake City, UT, United States of America
| | - Kristin G Cloyes
- College of Nursing, University of Utah, Salt Lake City, UT, United States of America
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Hayton Y, Botma Y, Heyns T. Development of a conceptual framework for a Person-centred Nurse Residency Programme. NURSE EDUCATION TODAY 2021; 104:104992. [PMID: 34111712 DOI: 10.1016/j.nedt.2021.104992] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 04/07/2021] [Accepted: 05/24/2021] [Indexed: 06/12/2023]
Abstract
Newly Qualified Professional Nurses (NQPNs) require support while transitioning from student to professional nurse. Nurse residency programmes guided by competent facilitators provide such support. We developed a conceptual framework for a Person-centred Nurse Residency Programme. This qualitative interpretive descriptive study was conducted in three phases. In phase 1, we assessed the support needs of purposively selected NQPNs as well as senior professional nurses. Data were collected using multiple methods and analysed during a consensus workshop held in Phase 2. In Phase 3, we developed a conceptual framework which was validated by six nurse education experts. The final framework comprised of four domains: learning outcomes, learning processes, learning environment, prerequisites of the facilitator, and was underpinned by the educational theories of constructivism and person-centeredness. Advocates of nurse residency programmes should recognise that these domains are interrelated and aim to achieve person-centred support for NQPNs.
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Affiliation(s)
- Yolandè Hayton
- University of Pretoria, Department of Nursing Science, Pretoria, South Africa.
| | - Yvonne Botma
- School of Nursing, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
| | - Tanya Heyns
- University of Pretoria, Department of Nursing Science, Pretoria, South Africa.
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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.
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McNelis AM, Dreifuerst KT, Beebe S, Spurlock D. Types, Frequency, and Depth of Direct Patient Care Experiences of Family Nurse Practitioner Students in the United States. JOURNAL OF NURSING REGULATION 2021. [DOI: 10.1016/s2155-8256(21)00021-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Job Satisfaction and Retention of an Advanced Practice Registered Nurse Fellowship Program. J Nurses Prof Dev 2021; 37:E15-E19. [PMID: 33606444 DOI: 10.1097/nnd.0000000000000720] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to determine how an advanced practice registered nurse (APRN) fellowship program affects job satisfaction and retention after the first year of practice. The Misener Nurse Practitioner Job Satisfaction Scale was administered to nine novice APRNs at a large Midwestern children's hospital after program completion. Job satisfaction scores and retention rates were measured. Results indicate that transition-to-practice programs are helpful in bridging the gap between graduation and professional practice as an APRN.
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Barnes H, Faraz Covelli A, Rubright JD. Development of the novice nurse practitioner role transition scale: An exploratory factor analysis. J Am Assoc Nurse Pract 2021; 34:79-88. [PMID: 33625161 PMCID: PMC8715992 DOI: 10.1097/jxx.0000000000000566] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/25/2020] [Accepted: 12/07/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Novice nurse practitioner role transition (NNPRT) can be described as stressful and turbulent, leading to decreased job satisfaction and increased intent to leave. No published instrument exists to measure NNPRT. Thus, researchers, educators, and administrators are limited in their ability to measure the concept and therefore understand the factors that lead to a successful, or unsuccessful, role transition experience. An instrument with evidence of validity and reliability is needed to conduct large-scale and systematic examinations of NNPRT. PURPOSE The purpose of this study was to develop and examine the initial factor structure of a novel instrument that measures NNPRT. METHODS Initial item development was guided by concept analysis, literature review, and qualitative data. Face and content validity were established from expert review. Using pilot data from 89 novice nurse practitioners (NPs), an exploratory factor analysis (EFA) was conducted to examine the instrument's internal factor structure. RESULTS The NNPRT Scale includes 40 items that measure an individual's perception of their role transition experience. The EFA revealed a five-factor structure: organizational alignment, mentorship, sense of purpose, perceived competence and self-confidence, and compensation. IMPLICATIONS FOR PRACTICE In an evolving health care system, provider well-being is at the center of workforce, educational, and organizational conversations. Understanding how to optimize the workforce and prepare NPs for health care delivery is increasingly important. The NNPRT Scale will allow for large-scale examinations of the factors that influence NP role transition, as well as assess interventions to prepare and support novice NPs' transitions.
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Affiliation(s)
- Hilary Barnes
- School of Nursing, University of Delaware, Newark, Delaware
| | - Asefeh Faraz Covelli
- School of Nursing, The George Washington University, Washington, District of Columbia
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Identifying the support needs of newly qualified professional nurses: A multiple stakeholder needs assessment. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2021. [DOI: 10.1016/j.ijans.2021.100309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Delaney KR. Nurse fellowships: An advance for population-based mental health care. Arch Psychiatr Nurs 2020; 34:330-336. [PMID: 33032754 DOI: 10.1016/j.apnu.2019.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 11/16/2019] [Accepted: 12/12/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Kathleen R Delaney
- Rush College of Nursing, 600 S Paulina St, Chicago, IL 60612, United States of America.
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Torrens C, Campbell P, Hoskins G, Strachan H, Wells M, Cunningham M, Bottone H, Polson R, Maxwell M. Barriers and facilitators to the implementation of the advanced nurse practitioner role in primary care settings: A scoping review. Int J Nurs Stud 2020; 104:103443. [DOI: 10.1016/j.ijnurstu.2019.103443] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 09/20/2019] [Accepted: 09/24/2019] [Indexed: 11/27/2022]
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Nurse practitioners' experiences with role transition: Supporting the learning curve through preceptorship. Nurse Educ Pract 2019; 42:102655. [PMID: 31810043 DOI: 10.1016/j.nepr.2019.102655] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 10/27/2019] [Accepted: 11/06/2019] [Indexed: 11/23/2022]
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Abstract
Leaving the comfort zone of being an experienced RN for a new career as an inexperienced advanced practice registered nurse (APRN) is one of the greatest difficulties of the APRN transition to practice. Although this challenge is frequently discussed in the literature, progress in creating transition programs has been slow. To date, very few formal APRN residency or fellowship transition programs exist. Practicing APRNs can advocate for a formal transition program in their organizations.
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Martsolf GR, Sochalski J. The Need for Advanced Clinical Education for Nurse Practitioners Continues Despite Expansion of Doctor of Nursing Practice Programs. Policy Polit Nurs Pract 2019; 20:183-185. [PMID: 31640458 DOI: 10.1177/1527154419882310] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We read with great interest Mundinger and Carter's exposition of how, in their view, Doctor of Nursing Practice (DNP) education has lost its way and what consequences might result. Mundinger and Carter note that DNP programs are overwhelming focused on nonclinical practice. We share the concern of Mundinger and Carter about the future of nurse practitioner (NP) education within the context of expanding DNP programs. In this commentary, we raise concerns about NP transition to practice and the limited, but concerning, evidence that new NPs struggle in their transition to practice. We note that this concern is magnified as NPs continue to move into specialty roles. Health systems have responded to this concern by developing residency and fellowship programs. Fifteen years after the AACN position statement on the clinical doctorate was issued, the goal of DNP education remains an unfinished project. An important question remains: Can, will, and how should DNP programs deliver?
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Affiliation(s)
- Grant R Martsolf
- Department of Acute and Tertiary Care, School of Nursing, University of Pittsburgh, PA, USA
- RAND Corporation, RAND Health Care, Santa Monica, CA, USA
| | - Julie Sochalski
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
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Chamberlain D, Hegney D, Harvey C, Knight B, Garrahy A, Tsai LPS. The factors influencing the effective early career and rapid transition to a nursing specialty in differing contexts of practice: a modified Delphi consensus study. BMJ Open 2019; 9:e028541. [PMID: 31462470 PMCID: PMC6720241 DOI: 10.1136/bmjopen-2018-028541] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES This study aimed to test and further develop the 'Early Career and Rapid Transition to a Nursing Specialty' (TRANSPEC) model to a nursing specialty developed from a systematic review. Semi-structured interviews of specialist clinically based nurses and a consensus Delphi study with an expert panel were used to expand and achieve consensus, agreement, reliability and stability of the model. DESIGN A modified Delphi, two rounds (64 and 52 Likert items) of reiterative online questionnaires and one round as a nominal group technique, was informed by qualitative thematic analysis of semi-structured interviews. SETTING AND PARTICIPANTS Interviews with 14 specialists clinical practicing registered nurses and a panel of 25 national experts participated in the Delphi study. RESULTS The interview participants experienced 14 rapid transitions and three were early career transition. The overarching themes from the preliminary model were confirmed and further expanded. These were the self (personal and professional); the transition processes (final and informal); a sense of belonging; and the overarching context of practice over a time continuum. In the Delphi, the highest rating item was 'Specialty work colleagues respect, include, support, and accept specialist nurse on completion of transition processes'. Pre-entry was highlighted as an important time point prior to transition. All items reaching consensus were included in the final model. Cronbach α increased from 0.725 to 0.875 for the final model. CONCLUSIONS The TRANSPEC model is a valid and reliable evidence-based tool for use in the career pathway and development of nursing specialists. Using the Benner model 'Novice to Expert' after the novice incomer phase is achieved, further lifelong learning development will transform the novice specialist over time continuum.
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Affiliation(s)
- Diane Chamberlain
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Desley Hegney
- Research Division, Central Queensland University, Brisbane, Queensland, Australia
- School of Nursing, University of Adelaide, Adelaide, South Australia, Australia
| | - Clare Harvey
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Mackay, Queensland, Australia
| | - Bruce Knight
- School of Education and the Arts, Central Queensland University, Townsville, Queensland, Australia
| | - Anne Garrahy
- Department of Health, Queensland Government, Brisbane, Queensland, Australia
| | - Lily Pei-San Tsai
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Brisbane, Queensland, Australia
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Speight C, Firnhaber G, Scott ES, Wei H. Strategies to promote the professional transition of new graduate nurse practitioners: A systematic review. Nurs Forum 2019; 54:557-564. [PMID: 31339178 DOI: 10.1111/nuf.12370] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
New graduate nurse practitioner (NP) postgraduate support programs and interventions have proliferated, sparking controversy. The Institute of Medicine/National Academy of Medicine recommends residency programs for new graduate NPs; however, the NP community debates whether new graduate NPs need additional training and whether such training compromises patient access to care. This systematic review aimed to synthesize evidence regarding the effectiveness of interventions and strategies to promote the professional transition of new graduate NPs. Interventions identified in the current literature included fellowship programs and a webinar. Strategies included mentorship, experiential learning, interprofessional training, and professional socialization. The studies reviewed primarily evaluated NPs' perceptions of the interventions' effects on their professional transitions. The findings from this systematic review highlight challenges in evidencing postgraduate support programs. The small number of available studies underscores a critical problem for the NP community: additional evidence is needed to inform whether and how to support new graduate NPs as they transition to practice.
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Affiliation(s)
- Chandra Speight
- College of Nursing, East Carolina University, Greenville, North Carolina
| | - Gina Firnhaber
- College of Nursing, East Carolina University, Greenville, North Carolina
| | - Elaine S Scott
- College of Nursing, East Carolina University, Greenville, North Carolina
| | - Holly Wei
- College of Nursing, East Carolina University, Greenville, North Carolina
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Labrague LJ, McEnroe-Pettite D, Leocadio MC. Transition experiences of newly graduated Filipino nurses in a resource-scarce rural health care setting: A qualitative study. Nurs Forum 2019; 54:298-306. [PMID: 30775787 DOI: 10.1111/nuf.12330] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 01/02/2019] [Accepted: 01/27/2019] [Indexed: 06/09/2023]
Abstract
PROBLEM Without a doubt, the transition to a professional nursing role is a challenging and stressful experience for many new nurses, regardless of where they are employed; yet, no study has been conducted to comprehend in detail the transition experiences of newly graduated nurses employed in a resource-scarce rural health care setting. PURPOSE This study describes the transition experiences of newly graduated Filipino nurses during their initial clinical placement process. METHODS A qualitative phenomenological approach using structured interviews with 15 newly graduated Filipino nurses were used along with the Coliazzi's methodological framework for data analysis. FINDINGS Four distinct themes emerged from the content analysis, as follows: experiencing transition shock, feeling pressured, learning excitement, and needing support. CONCLUSIONS Similar to the findings of other international studies, newly graduated Filipino nurses described their transition experiences as a stressful and challenging journey. Both academic and nursing administration team members can play key roles in facilitating a smooth transition and the integration of new nurses into the nursing workforce through the employment of evidence-based educational and structured organizational strategies.
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Dumphy D, DeSandre C, Thompson J. Family nurse practitioner students' perceptions of readiness and transition into advanced practice. Nurs Forum 2019; 54:352-357. [PMID: 30852846 DOI: 10.1111/nuf.12336] [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: 12/07/2018] [Revised: 02/11/2019] [Accepted: 02/21/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Utilizing skills identified in previous research on successful role transition, this study evaluated the relationship between a strategically designed practicum course and the readiness for role transition to family nurse practitioner (FNP) in graduate nursing students. METHODS A mixed methods approach evaluated pre- and post-participation survey data for the FNP role preparedness in graduate nursing students in a strategically designed practicum course. The survey addressed 22 skills associated with readiness for role transition and had three open-ended questions to collect narrative student perceptions. RESULTS Mann-Whitney U tests revealed readiness for the FNP role increased from pre to post-participation in the course for 19 out of 22 skills with significant increases (P < 0.05) for one skill and marginally significant increases (P < 0.10) for three skills. Qualitative findings yielded an overall sense of readiness in students for novice FNP roles. CONCLUSION A well-designed practicum course that reviews prior knowledge gained through the program and reinforces critical thinking, assessment, and decision-making skills facilitates role transition from registered nurse to novice FNP.
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Affiliation(s)
- Deborah Dumphy
- School of Nursing, Clayton State University, Morrow, Georgia
| | - Carolynn DeSandre
- Nursing Department, College of Health Sciences and Professions, University of North Georgia, Dahlonega, Georgia
| | - Julie Thompson
- School of Nursing, Duke University, Durham, North Carolina
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Henshall C, Doherty A, Green H, Westcott L, Aveyard H. The role of the assistant practitioner in the clinical setting: a focus group study. BMC Health Serv Res 2018; 18:695. [PMID: 30200943 PMCID: PMC6131889 DOI: 10.1186/s12913-018-3506-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 08/29/2018] [Indexed: 11/24/2022] Open
Abstract
Background Assistant practitioners have knowledge and skills beyond the level of traditional support workers, and work in many clinical settings. However, some assistant practitioners lack a clearly defined role and may be under-used due to issues around accountability and uncertainty about their purpose. This paper explores the assistant practitioner role from the perspectives of assistant practitioners and registered nurses. Methods This study aimed to explore the role of the assistant practitioner from the perspectives of assistant practitioners and registered nurses in two NHS hospital trusts in Oxfordshire, United Kingdom. Six qualitative focus groups were undertaken between February–March 2017. Ethical approval was obtained (FREC 2016/05) and written consent was provided by participants. Data was analysed thematically analysed using the Framework method. Results Nineteen participants (assistant practitioners, n = 12; registered nurses, n = 7) were recruited using convenience sampling. Emerging themes related to ‘fluctuating roles and responsibilities of assistant practitioners’, ‘role differences between registered nurses and assistant practitioners’, ‘working relationships’, ‘supervision’ and ‘redefining nursing pathways’. The Results and Discussion sections highlight a lack of role clarity and blurring of boundaries between the roles of assistant practitioners and registered nurses, with many tasks undertaken by both. This lack of ownership of ‘nurse-specific’ roles by registered nurses was evident and clear differences were only encountered with regard to accountability. The development of the Nursing Associate role provides managers with the opportunity to redefine staff banding hierarchies to ensure that clinical staff are aware of their role capabilities and limitations and are practicing safely, whilst promoting career development and progression pathways. Conclusion Addressing issues around role clarity can benefit professional development, satisfaction, role identity and ownership for registered nurses and assistant practitioners, by recognising the individual and collective value they bring to the clinical team. The findings can help inform the development of the Nursing Associate role.
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Affiliation(s)
- Catherine Henshall
- OxINMAHR, Faculty of Health & Life Sciences, Oxford Brookes University, Oxford, OX3 0BP, UK.
| | - Andrea Doherty
- Learning and Education, Manor House, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Headley Way, Oxford, OX3 9DU, UK
| | - Helen Green
- Oxford Health NHS Foundation Trust, Unipart House, Garsington Road, Oxford, OX4 2PG, UK
| | - Liz Westcott
- Faculty of Health & Life Sciences, Oxford Brookes University, Oxford, OX3 0BP, UK
| | - Helen Aveyard
- OxINMAHR, Faculty of Health & Life Sciences, Oxford Brookes University, Oxford, OX3 0BP, UK
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Chen SH, Chen SC, Lee SC, Chang YL, Yeh KY. Impact of interactive situated and simulated teaching program on novice nursing practitioners' clinical competence, confidence, and stress. NURSE EDUCATION TODAY 2017; 55:11-16. [PMID: 28505519 DOI: 10.1016/j.nedt.2017.04.025] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 03/21/2017] [Accepted: 04/28/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Novice nursing practitioners (NNPs) often struggle to make the transition to fully competent professionals. We sought to determine the impact of an interactive, situated learning workshop on a participant's clinical competence. OBJECTIVES This work aimed to improve the clinical competence, promote the self-confidence, and reduce the number of work-related stressors of NNPs. METHODS We randomly allocated 31 newly graduated NNPs into interactive situated and simulated teaching (ISST) and non-ISST groups, which were perceived as the homogeneity of the 2 groups based upon no significant difference at age, education level and work units. The ISST program comprised six follow-up interactive face-to-face support sessions over a three-month period following the standard orientation training course. We assessed the participants' competency, stress, and confidence levels in professional competence before and at the end of the study. RESULTS At the end of the three-month study period, the ISST group demonstrated superior nursing competency (p=0.001), as well as reported lower stress levels (p=0.011), and increased confidence in professional competence (p=0.026) as compared with those in the control group. A multiple regression analysis revealed that clinical nursing competence was positively correlated with the use of ISST (p=0.02) and negatively correlated with stress (p=0.03). CONCLUSIONS The ISST program for NNPs significantly improved their clinical competence. It may be helpful to ensure that new trainees have access to training programs that can facilitate their acclimation to their new working environments at the beginning of their careers.
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Affiliation(s)
- Sue-Hsien Chen
- Chang Gung Medical Education Research Centre, CG-MERC, Gueishan, Taoyuan, Taiwan; Department of Nursing, Chang Gung Memorial Hospital, Keelung, Taiwan; School of Nursing, Chang Gung University and Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Shu-Ching Chen
- Department of Medical Research, National Taiwan University Hospital, Taiwan
| | - Shu-Chiou Lee
- Department of Nursing, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Yi-Ling Chang
- Department of Nursing, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Kun-Yun Yeh
- Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, and Chang Gung University, Taiwan.
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