transition-to-practice

  • 文章类型: Journal Article
    什么是已知的主题?:由于课程稀释等几个原因,招募护士进入心理健康存在重大问题,过渡计划为进入心理健康的护士提供方向,学术和临床技能,和知识。论文对现有知识有什么帮助?:过渡计划需要与专业领域(例如社区)进行细致入微,以确保护士得到必要的支持,以继续在该领域工作。由于生活或个人经验,许多护士选择从事心理健康工作,因此加强对过渡护士的健康支持是保留的重要作用。实践的含义是什么?:量身定制的过渡计划可以帮助加强心理健康护士角色的清晰度,并支持保留员工。过渡计划应该是心理健康护理正式研究生学习的一部分,以加强专业实践和护士的保留。
    介绍:全球,有一致的问题招募员工进入心理健康护理队伍。在澳大利亚,最近扩大劳动力的努力包括招聘更广泛的护士,除了新毕业生进入心理健康过渡到实践计划。了解护士进入该领域的职业动机是招聘和保留的重要因素。
    目的:描述护士对其心理健康过渡计划的满意度,并确定影响其选择心理健康作为职业的因素。
    方法:一项关于计划满意度和职业选择问题的在线横断面调查由参加心理健康过渡计划的55名注册和注册护士回答。
    结果:护士报告对他们的项目总体满意度很高,并确定增加了职业发展的时间释放,并在必要时增加了额外的数量以支持角色发展。近25%的护士报告说,精神疾病的个人经历是选择心理健康职业的影响因素。
    结论:心理健康过渡计划在招聘和保留方面很重要,需要根据广泛的护士的需求量身定制,并包括对员工福利的支持。
    结论:量身定制的过渡计划有助于增强角色清晰度,并支持保留员工。
    WHAT IS KNOWN ON THE SUBJECT?: There are significant issues recruiting nurses into mental health due to several reasons such as dilution of curriculum, and mental health being an unpopular career choice Transition programs provide nurses entering mental health with orientation, academic and clinical skills, and knowledge. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Transition programs need to be nuanced to specialty areas (e.g. community) to ensure nurses are given the support necessary to remain working in the field. Many nurses choose to work in mental health due to a lived or personal experience and as such strengthening wellbeing supports for transitioning nurses is an important role in retention. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Tailored transition programs can help strengthen mental health nurse role clarity, and support staff retention. Transition programs should be a segue to formal postgraduate studies in mental health nursing to strengthen professional practice and retention of nurses.
    UNASSIGNED: INTRODUCTION: Globally, there are consistent issues recruiting staff into the mental health nursing workforce. In Australia, recent efforts to expand the workforce include recruitment of a wider range of nurses in addition to new graduates into mental health transition-to-practice programs. Understanding the career motivations of nurses entering the field is an important element of recruitment and retention.
    OBJECTIVE: To describe nurses\' satisfaction with their mental health transition program and identify factors influencing their choice of mental health as a career.
    METHODS: An online cross-sectional survey with questions on program satisfaction and career choice was responded to by n = 55 enrolled and registered nurses in a mental health transition program.
    RESULTS: Nurses reported overall high satisfaction with their program and identified increased time release for professional development and being supernumerary as necessary to support role development. Almost 25% of nurses reported personal experience of mental illness as an influence in choosing a mental health career.
    CONCLUSIONS: Mental health transition programs are important in recruitment and retention and need to be tailored to the needs of a wide range of nurses and include support for staff wellbeing.
    CONCLUSIONS: Tailored transition programs can help strengthen role clarity, and support staff retention.
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  • 文章类型: Journal Article
    全球认识到心理健康护理可能会带来压力,并对护士的健康和保留产生不利影响。由于严重的护理短缺,迫切需要吸引和留住护士来维持这种劳动力并提供有效的精神保健。心理健康过渡计划提供重要的招聘途径,并支持新手注册护士,注册护士和经验丰富的注册通才护士进入这一领域。几乎没有证据,然而,关于幸福,弹性,以及护士过渡到心理健康的保留。这项横断面研究的主要目的是描述人口统计学特征,感知压力,幸福,弹性,精神疾病的污名态度,工作满意度,进入心理健康过渡计划的四个护士队列的离职意向:通才注册护士,研究生和研究生注册护士,和登记护士;探索这些变量之间的关系;并探索这四个护士队列之间的差异。研究结果(n=87)包括总体中度感知压力,适度的幸福感和韧性,工作满意度高,低柱头,和低离职意向。较高的离职倾向与较低的年龄和工作满意度相关,和更高的感知压力。通才RN的压力和污名化态度明显高于注册护士。对幸福感得分的二次分析确定了14名护士的得分表明抑郁,弹性和工作满意度明显较低,和显著高于样品的其余部分的应力。为了帮助防止自然减员,至关重要的是,精神卫生服务应在过渡期间提供量身定制的福祉举措,并尽早进行干预,为精神困扰的护士提供支持。
    There is global recognition that mental health nursing can be stressful and have detrimental effects on nurses\' well-being and retention. With substantial nursing shortages, there is an urgent need to attract and retain nurses to sustain this workforce and provide effective mental healthcare. Mental health transition programs provide vital recruitment pathways and support novice registered nurses, enrolled nurses and experienced registered generalist nurses moving into this field. There is little evidence, however, on the well-being, resilience, and retention of nurses transitioning into mental health. The primary aims for this cross-sectional study were to describe demographic characteristics, perceived stress, well-being, resilience, mental illness stigma attitudes, work satisfaction, and turnover intention of four nurse cohorts entering mental health transition programs: generalist registered nurses, graduate and post-graduate registered nurses, and enrolled nurses; to explore relationships between these variables; and explore differences between these four nurse cohorts. Findings (n = 87) included overall moderate perceived stress, moderate well-being and resilience, high work satisfaction, low stigma, and low turnover intention. Higher turnover intention was associated with lower age and work satisfaction, and higher perceived stress. Generalist RNs had significantly higher stress and stigmatizing attitudes than Enrolled Nurses. Secondary analysis of well-being scores identified 14 nurses with scores indicating depression, with significantly lower resilience and work satisfaction, and significantly higher stress than the rest of the sample. To help prevent attrition, it is vital that mental health services provide tailored well-being initiatives during transition and intervene early to provide support for nurses with mental distress.
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  • 文章类型: Journal Article
    背景:根据过渡冲击理论,新注册护士在执业的第一年内面临着巨大的障碍。然而,对新注册精神科护士进入劳动力市场的经验知之甚少。
    目的:目的是探索护理学和精神科护理学的新毕业生如何经历他们过渡到工作场所的过程,其中包括确定在过渡过程中帮助或挑战这些入门级专业人员的中介因素。
    方法:由Charmaz开发的建构主义扎根理论方法被用来探索使用基于艺术的方法的第一年过渡期。
    方法:在加拿大西部省份招募了13名注册护士和注册精神科护士的新毕业生参加了这项研究。三个以艺术为基础的研讨会在四点举行,八,从2020年秋季开始到2021年春季的12个月,在新型冠状病毒大流行期间,随后的成员检查将在2022年春季进行。
    方法:共收集38个访谈和焦点组数据。以艺术为基础的活动包括沙盘和小雕像物体练习,拼贴,反思和主题写作,以及组概念图。通过使用Charmaz的方法论共同创造知识,参与者在研究人员的指导下,在过渡的第一年中选择了主要主题。使用恒定的比较分析方法对每个车间的艺术创作进行数据分析,讨论,和参与者产生的叙述性反思性写作作品。
    结果:参与者处于个人和职业自我成长的基本心理社会过程中。通过与参与者共同构建知识,确定了三个实质性的相互联系的类别:(1)被扔进火中;(2)调整和适应团队环境;(3)培养自我和他人。
    结论:研究结果为雇主招聘新毕业生和护理教育计划提供了许多建议,使毕业生为实践舞台做好准备。
    BACKGROUND: According to the Transition Shock theory, new Registered Nurses face formidable obstacles within their first year of practice. However, little is known about the experience of new Registered Psychiatric Nurses entering the workforce.
    OBJECTIVE: The aim was to explore how new graduates from nursing and psychiatric nursing experience their transition into the workplace that included identifying mediating factors that assist or challenge these entry-level professionals within their transition.
    METHODS: Constructivist grounded theory methodology developed by Charmaz was utilized to explore the first-year transition period using art-based methods.
    METHODS: A total of 13 new graduates practicing as Registered Nurses and Registered Psychiatric Nurse in a western Canadian province were recruited to participate in the study. Three art-based workshops occurred at four, eight, and 12-months starting in the fall of 2020 through the Spring of 2021 during the novel coronavirus pandemic with subsequent member checks in the Spring of 2022.
    METHODS: A total of 38 interview and focus group data were collected. Art-based activities included sand tray and figurine object exercises, collaging, reflective and thematic writing, as well as group concept mapping. Through co-creation of knowledge using Charmaz\'s methodology, participants selected the major themes throughout their first year of transition with guided researcher facilitation. Data were analyzed using the constant comparative method of analysis for each workshop drawing on the art creations, discussion, and narrative reflective writing pieces generated by participants.
    RESULTS: Participants were in a basic psychosocial process of growing personal and professional self. Through co-construction of knowledge with the participants, three substantive interconnected categories were identified: (1) Being thrown into the fire; (2) Adjusting and adapting to the team environment; and (3) Nurturing self and others.
    CONCLUSIONS: The findings revealed many recommendations for employers hiring new graduates and nursing education programs preparing graduates for the practice arena.
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  • 文章类型: Journal Article
    尽管美国的医师助理(PA)和执业护士研究生住院医师/奖学金专业培训计划的数量迅速增加,这些项目的自愿认证是一个相对较新的现象。很少有研究研究哪些因素可能是PA和执业护士(NP)研究生课程中采用认证的预测因素。因此,这项研究的主要目的是调查哪些激励因素影响研究生课程选择是否追求认证。方法一项由10个问题组成的描述性横断面调查分发给56名研究生急诊医学和骨科手术PA,NP,并在2022年11月至2023年2月之间通过电子邮件联合PA/NP居留/研究金计划。进行描述性统计。结果19个研究生项目对调查做出了回应。两个项目提交了不完整的调查,其中完成的项目不足50%。数据分析中省略了部分完成的调查。最终反应率为30%(17/56)。在回应的节目中,47%(8/17)提供双PA和NP培训,和53%(9/17)仅PA。虽然88%(15/17)的研究生课程已经与他们的赞助机构讨论了认证资金,只有76%的人计划这样做或正在追求认证的过程中。追求认证的两个最常见的原因是课程验证和教育质量评估59%(10/17)和申请人竞争24%(4/17)。然而,磁铁医院指定,赞助机构的要求,或雇主的要求并不是决定是否寻求认证的因素。不追求认证的原因包括认证成本高18%(3/17),缺乏认可的感知价值6%(1/17),缺乏保护时间来追求认证6%(1/17)。结论虽然关于PA和NP研究生课程认证的有效性和影响的文献仍然缺乏,这项罕见的研究结果表明,研究生课程是追求认证的动机。对于认证机构来说,向项目及其赞助机构传达项目级别认证的效用和其他增值收益是很重要的。需要进一步的工作来更好地理解外部验证的价值,用于验证的特定驱动程序,以及影响这些研究生课程认证采用的障碍。
    Although there has been a rapid increase in the number of physician assistant (PA) and nurse practitioner postgraduate residency/fellowship specialty training programs in the United States, voluntary accreditation of these programs is a relatively new phenomenon. There is little research examining which factors may be predictors of accreditation adoption among PA and nurse practitioner (NP) postgraduate programs. Therefore, the primary aim of this study was to investigate which motivating factors influence postgraduate programs choice on whether to pursue accreditation. Methodology A descriptive cross-sectional survey consisting of 10 questions was distributed to 56 postgraduate emergency medicine and orthopedic surgery PA, NP, and joint PA/NP residency/fellowship programs via email between November 2022 and February 2023. Descriptive statistics were performed. Results Nineteen postgraduate programs responded to the survey. Two programs submitted incomplete surveys where less than 50% of the total items were completed. The partially completed surveys were omitted from the data analysis. The final response rate was 30% (17/56). Among the responded programs, 47% (8/17) offer dual PA and NP training, and 53% (9/17) are PA only. Although 88% (15/17) of postgraduate programs have discussed accreditation funding with their sponsoring institution only 76% are planning to do so or are in the process of pursuing accreditation. The two most common reasons for pursuing accreditation are program validation and assessment of educational quality 59% (10/17) and competition for applicants 24% (4/17). However, Magnet hospital designation, requirement of the sponsoring institution, or demand from employers were not determining factors of whether to pursue accreditation or not. Reasons for not pursuing accreditation included high costs of accreditation 18% (3/17), lack of perceived value of accreditation 6% (1/17), and lack of protected time to pursue accreditation 6% (1/17). Conclusion Although literature is still lacking on the effectiveness and impact of PA and NP postgraduate program accreditation, the findings of this rare study indicate that postgraduate programs are motivated to pursue accreditation. It is important for accreditors to communicate the utility of program-level accreditation and other value-added benefits to programs and their sponsoring institutions. Further work is necessary to better understand the value of external validation, specific drivers for validation, and barriers that influence accreditation adoption among these postgraduate programs.
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  • 文章类型: Journal Article
    背景:COVID-19大流行扰乱了全球护理教育。大多数研究都集中在大流行如何影响学生。由于令人担忧的劳动力短缺,更好地了解大流行对新护士的影响对于积极制定策略以促进该行业最新成员的成功至关重要。
    目的:本研究探讨了教师对大流行对新护士的实践准备的影响的看法,以及促进有效过渡到实践的建议。
    方法:使用探索性描述定性方法和便利抽样,来自北卡罗来纳州的116名护士教师,美国在电子调查中回答了开放式问题。采用专题分析法对数据进行分析。
    结果:出现了四个主题:1)少动手,2)过渡到实践的机会,3)受体的关键作用,4)提供额外支持。
    结论:研究结果提供了临床护士和领导者可以实施的策略,以满足正在进行的大流行期间进入专业实践的新护士的需求。由于动手学习较少,大流行的毕业生可以受益于延长的时间与训练有素的导师和机会,专注于临床推理,管理多个患者,有效沟通,和安全的技能表现。进入临床环境后,大流行毕业生缺乏经验可能会增加转型冲击的可能性,需要多方面的方法来提供支持。
    BACKGROUND: The COVID-19 pandemic disrupted nursing education worldwide. Most studies have focused on how the pandemic affected students. With an alarming workforce shortage, a better understanding of the pandemic\'s impact on new nurses is vital to proactively develop strategies to promote success of the profession\'s newest members.
    OBJECTIVE: This study explored faculty perceptions of the pandemic\'s impact on new nurses\' practice preparedness and recommendations for promoting effective transition to practice.
    METHODS: Using an exploratory-descriptive qualitative approach and convenience sampling, 116 nurse faculty from across North Carolina, United States responded to open-ended questions within an electronic survey. Data were analyzed with thematic analysis.
    RESULTS: Four themes emerged: 1) Less Hands-On, 2) Transition-to-Practice Opportunities, 3) Key Role of Preceptors, and 4) Provide Additional Support.
    CONCLUSIONS: Findings provide strategies clinical nurses and leaders can implement to meet the needs of new nurses entering professional practice during the ongoing pandemic. Due to less hands-on learning, pandemic graduates may benefit from extended time with a trained preceptor and opportunities to focus on clinical reasoning, managing multiple patients, effective communication, and safe skill performance. Upon entering the clinical environment, pandemic graduates\' inexperience may increase the likelihood of transition shock, requiring multi-faceted approaches for providing support.
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  • 文章类型: Journal Article
    背景尽管对医师奖学金培训计划网站的大量研究表明,在可访问性和内容方面存在严重缺陷,关于美国医师助理/助理(PA)和执业护士(NP)骨科手术研究生住院医师/研究金计划的网站内容,目前尚无已发表的研究.因此,这项研究旨在进行基于网络的内容分析,以评估节目网站上的可用信息,并确定潜在的改进领域。方法本研究的方法是从先前对研究生医学教育(GME)网站的研究中复制的。2022年8月至9月,对22个PA和PA/NP骨科联合研究生住院医师/奖学金培训计划网站进行了评估。标准包括17个与研究生教育和招聘内容相关的项目。对所有计划网站进行了评估,以获取与申请骨科手术住院医师/奖学金计划的潜在申请人相关的内容。进行描述性统计。结果在22个PA和PA/NP联合骨科研究生网站中,都有一个功能性的网站链接。只有一个骨科手术研究生网站符合所有17个标准。所有评估的程序网站都包含程序描述和联系信息。网站上的其他信息包括95%的课程入学要求(21/22),工资/福利77%(17/22),面试要求73%(16/22),教师名单68%(15/22),杂志俱乐部59%(13/22),计划目标/目标59%(13/22),验收过程54%(12/22)。不到一半的计划网站包含以下信息:当前PA/NP研究生学员的列表,样品轮换时间表,定向活动,课程,健康/福祉战略,毕业和研究要求,并链接到程序手册。然而,与未经认可的计划相比,经认可的PA整形外科计划网站包含与潜在申请人相关的更多内容。结论这是第一项对PA和联合PA/NP研究生骨科手术住院医师/奖学金计划网站进行详细分析的研究。毫不奇怪,这些网站上的可用内容差异很大。研究结果提供了进一步的证据,以支持迫切需要改善计划网站内容的潜在申请人。
    Background Although considerable research on physician fellowship training program websites has demonstrated critical deficiencies in accessibility and content, there is no published study regarding the website content of physician assistant/associate (PA) and nurse practitioner (NP) orthopedic surgery postgraduate residency/fellowship programs in the United States. Therefore, this study aims to conduct a web-based content analysis to assess the available information on program websites and identify the potential areas for improvement. Methods The methodology for this study was replicated from prior research on graduate medical education (GME) websites. Twenty-two PA and joint PA/NP orthopedic surgery postgraduate residency/fellowship training program websites were assessed between August and September 2022. The criteria comprised 17 items related to postgraduate education and recruitment content. All program websites were evaluated for pertinent content relevant to prospective applicants applying to orthopedic surgery residency/fellowship programs. Descriptive statistics were performed. Results Out of the 22 PA and joint PA/NP orthopedic postgraduate websites evaluated, all had a functional website link. Only one orthopedic surgery postgraduate website met all 17 criteria. All program websites assessed contained program descriptions and contact information. Other information present on websites included program admission requirements 95% (21/22), salary/benefits 77% (17/22), interview requirement 73% (16/22), faculty listing 68% (15/22), journal club 59% (13/22), program objectives/goals 59% (13/22), and acceptance process 54% (12/22). Less than half of the program websites contained the following information: listing of current PA/NP postgraduate trainees, sample rotation schedule, orientation activities, curriculum, wellness/well-being strategy, graduation and research requirements, and link to program handbook. However, accredited PA orthopedic surgery program websites contained more content relevant to prospective applicants than non-accredited programs. Conclusion This is the first study to provide a detailed analysis of PA and joint PA/NP postgraduate orthopedic surgery residency/fellowship program websites. Not surprisingly, there is a wide variation in the available content on these websites. Study results provide further evidence to support the urgent need to improve program website content for prospective applicants.
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  • 文章类型: Journal Article
    背景:COVID-19大流行引起了护理教育的重大变化,即向远程学习的转变和临床实践经验的显著减少。目前尚不清楚这些变化将如何影响新的研究生护士过渡到实践。
    目标:为过渡到实践计划提供指导,这项研究定量描述并比较了在大流行前毕业的学生和在大流行期间即将毕业的学生中护士教师对执业准备的看法.
    方法:北卡罗莱纳州116名护士教师的便利样本完成了在线调查。调查收集了人口统计信息,专业经验,以及在大流行期间经历的教学变化。护理实践准备工具用于衡量对实践准备的看法。
    结果:护士教师报告了由于大流行而引起的各种变化,在临床学习中普遍存在局限性。总量表的实践准备分数有统计学上的显着下降,六个分量表,和所有工具项目在p<0.001的所有配对比较。
    结论:虽然所有能力领域的分数总体上都有显著下降,对工具子量表和项目的进一步分析可以为与新毕业生一起工作的临床护士和与继续学生一起工作的护士教师提供指导。
    BACKGROUND: The COVID-19 pandemic caused major changes in nursing education, namely a shift to remote learning and significant reduction of clinical practice experience. It is not known how these changes will affect new graduate nurses transitioning to practice.
    OBJECTIVE: To provide guidance to transition-to-practice programs, this study quantitatively described and compared nurse faculty perceptions of readiness for practice among students who graduated pre-pandemic and those who will graduate during the pandemic.
    METHODS: A convenience sample of 116 nurse faculty across North Carolina completed surveys online. Surveys collected information on demographics, professional experience, and teaching changes experienced during the pandemic. The Nursing Practice Readiness Tool was used to measure perceptions of readiness for practice.
    RESULTS: Nurse faculty reported a wide range of changes due to the pandemic, with limitations in clinical learning prevalent. There was a statistically significant decrease in practice readiness scores for the total scale, six subscales, and all tool items at p < 0.001 for all paired comparisons.
    CONCLUSIONS: While there was an overall significant decrease in scores for all competency areas, further analysis of the tool subscales and items can provide guidance for clinical nurses working with new graduates and nurse faculty working with continuing students.
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  • 文章类型: Journal Article
    The transition from student to novice is a difficult time. Although the novice nurse is excited to start working, the nurse struggles with acclimating to a new role with new responsibilities and the need to reconcile disparities between what was taught in school and what is practiced in the real world. To lessen the impact of the transition experience, health care organizations have implemented transition-to-practice programs including orientations, preceptorships, and residencies. Despite these efforts, if the novice nurse does not find these programs helpful, there is still a risk that the transition experience will not conclude with successful results. This integrative review examined qualitative studies that explored the transition-to-practice experience of novice nurses who participated in a transition-to-practice program provided by their place of employment. Thirteen articles met the criteria for this integrative review; seven themes emerged from the commonalities in the studies: socialization, professional growth, feeling supported, transition challenges, reflections, transition shock, and feelings. Though the transition period includes unique experiences for each novice nurse, the common feelings and needs identified in these studies require nurse educators and the healthcare organizations to ensure that novice nurses are prepared and given the tools to successfully transition to professional nursing practice.
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  • 文章类型: Journal Article
    The transition period from student nurse to novice nurse is a stressful time. Patient outcomes, healthcare organizations, the new nurse, and the nursing profession can be negatively affected if the transition from nursing student to novice nurse is not a positive and successful experience. Currently, there are numerous interventions aimed at easing the transition for the new nurse with just as many instruments used to evaluate the success of the interventions in doing so. This integrative review examined quantitative studies that evaluated the outcomes of interventions implemented to ease the transition from student to professional nurse. The seven articles that met the criteria for this review discussed four types of programs and one curriculum revision and collectively used 14 instruments to measure a total of 18 concepts related to new nurse transition. Despite the significance of the studies\' results that indicate interventions to ease the transition-to-practice experience are beneficial and can have a positive impact on areas such as job satisfaction and retention, overall findings from this integrative review suggest the need for greater standardization of concepts that should be evaluated and the instruments used to determine if new nurses are successfully transitioning into professional nursing.
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    This article provides a narrative that describes the current state of medical errors and near misses in the general health care setting and for new graduate registered nurses specifically. It then proposes a \"wild idea\" to create a national database for the reporting of errors that would act as a call to action to change our current reporting system to one of transparency and shared information for the purpose of creating needed education in both academic and practice settings.
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