Abstract：
BACKGROUND: Many transition-to-practice programs have been developed to support novice nurses during their first years into practice. These programs report improvements in retention, wellbeing and clinical competence, but the driving mechanisms of these interventions remain largely unclear.
OBJECTIVE: To identify how transition-to-practice programs for novice nurses work and in what contexts they work successfully.
METHODS: A realist review was conducted. Eligibility criteria included intervention studies aimed at novice nurses in their first two years of practice that reported outcomes on organizational or individual nurse level. The underlying theory of included transition-to-practice programs was extracted, and relevant contextual factors, mechanisms and outcomes were explored and synthesized into context-mechanism-outcome (CMO) configurations. The search was limited to studies between 2000 and 2023.
RESULTS: A total of 32 studies were included, evaluating 30 different transition-to-practice programs with a wide range of intervention components including stress management, clinical education, professional and peer support, and ward rotations. Transition-to-practice programs were often designed without a theoretical foundation. Driving mechanisms behind the programs pertained to psychological, professional, and social development. Contextual factors that activated the mechanisms were enabling conditions for mentors and novice nurses, selection and motivation of novice nurses and organizational culture.
CONCLUSIONS: Current transition-to-practice programs primarily focus on the individual and professional development of nurses. However, transition to practice can benefit from a systemic approach that includes development initiatives on the organizational level.
BACKGROUND: PROSPERO ID CRD42021268080, August 15, 2021.
CONCLUSIONS: Context and mechanisms determine successful implementation of transition to practice programs for novice nurses. @transitiontopractice @nurseworkforce.
OBJECTIVE: To identify how transition-to-practice programs for novice nurses work and in what contexts they work successfully.
METHODS: A realist review was conducted. Eligibility criteria included intervention studies aimed at novice nurses in their first two years of practice that reported outcomes on organizational or individual nurse level. The underlying theory of included transition-to-practice programs was extracted, and relevant contextual factors, mechanisms and outcomes were explored and synthesized into context-mechanism-outcome (CMO) configurations. The search was limited to studies between 2000 and 2023.
RESULTS: A total of 32 studies were included, evaluating 30 different transition-to-practice programs with a wide range of intervention components including stress management, clinical education, professional and peer support, and ward rotations. Transition-to-practice programs were often designed without a theoretical foundation. Driving mechanisms behind the programs pertained to psychological, professional, and social development. Contextual factors that activated the mechanisms were enabling conditions for mentors and novice nurses, selection and motivation of novice nurses and organizational culture.
CONCLUSIONS: Current transition-to-practice programs primarily focus on the individual and professional development of nurses. However, transition to practice can benefit from a systemic approach that includes development initiatives on the organizational level.
BACKGROUND: PROSPERO ID CRD42021268080, August 15, 2021.
CONCLUSIONS: Context and mechanisms determine successful implementation of transition to practice programs for novice nurses. @transitiontopractice @nurseworkforce.
摘要：
背景：已经开发了许多过渡到实践计划，以支持新手护士在开始实践的第一年。这些程序报告了保留方面的改进，福祉和临床能力，但这些干预措施的驱动机制仍不清楚.
目的：确定新手护士的过渡到实践计划是如何工作的，以及在哪些情况下成功地工作。
方法：进行了现实性综述。资格标准包括针对新手护士的干预研究，这些研究在头两年的实践中报告了组织或个人护士水平的结果。提取了纳入过渡到实践计划的基础理论，和相关的环境因素，对机制和结果进行了探索，并将其合成为上下文-机制-结果(CMO)配置。搜索仅限于2000年至2023年之间的研究。
结果：共纳入32项研究，评估30种不同的过渡到实践计划，包括压力管理，临床教育，专业和同行支持，和病房轮换。过渡到实践计划通常是在没有理论基础的情况下设计的。项目背后的驱动机制与心理有关，专业,和社会发展。激活机制的情境因素为导师和新手护士提供了有利条件，新手护士的选择和动机与组织文化。
结论：目前的过渡到实践计划主要侧重于护士的个人和专业发展。然而,过渡到实践可以受益于包括组织层面的发展举措在内的系统方法。
背景：PROSPEROIDCRD42021268080，2021年8月15日。
结论：背景和机制决定了新手护士向实践计划过渡的成功实施。@transitiontopractice@nurseforce。
目的：确定新手护士的过渡到实践计划是如何工作的，以及在哪些情况下成功地工作。
方法：进行了现实性综述。资格标准包括针对新手护士的干预研究，这些研究在头两年的实践中报告了组织或个人护士水平的结果。提取了纳入过渡到实践计划的基础理论，和相关的环境因素，对机制和结果进行了探索，并将其合成为上下文-机制-结果(CMO)配置。搜索仅限于2000年至2023年之间的研究。
结果：共纳入32项研究，评估30种不同的过渡到实践计划，包括压力管理，临床教育，专业和同行支持，和病房轮换。过渡到实践计划通常是在没有理论基础的情况下设计的。项目背后的驱动机制与心理有关，专业,和社会发展。激活机制的情境因素为导师和新手护士提供了有利条件，新手护士的选择和动机与组织文化。
结论：目前的过渡到实践计划主要侧重于护士的个人和专业发展。然而,过渡到实践可以受益于包括组织层面的发展举措在内的系统方法。
背景：PROSPEROIDCRD42021268080，2021年8月15日。
结论：背景和机制决定了新手护士向实践计划过渡的成功实施。@transitiontopractice@nurseforce。
