A bachelor's degree for entering the nursing profession: A scoping review for supporting informed health care policies

Supporting professional practice transition in undergraduate nursing education: a scoping review protocol

OBJECTIVE

This scoping review will describe educational programming that supports undergraduate student nurses' transition to practice and/or enhances practice readiness.

INTRODUCTION

The period of transition from nursing student to professional nurse is fraught with challenges stemming from the evolving role and the increasing demands of independent practice. While transition-to-practice programming exists for new graduate nurses, there is less focus on preparing students in their final year of education. A scoping review will identify educational programming delivered to nursing students approaching graduation that facilitates transition-to-practice success and/or improves practice readiness.

INCLUSION CRITERIA

This review will consider literature describing educational programming that supports transition-to-practice success and/or practice readiness and that demonstrates evidence of evaluation. Studies that involve primarily pre-licensure, undergraduate, or baccalaureate nursing students will be included. Reports of primary studies, reviews, dissertations and theses, conference proceedings, and nursing trade publications that describe quantitative, qualitative, or mixed methods designs will be included.

METHODS

The proposed review will adhere to the JBI methodology for scoping reviews. A comprehensive search will be conducted in CINAHL (EBSCOhost), MEDLINE (Ovid), Healthstar (Ovid), and Nursing and Allied Health (ProQuest) using a search strategy developed in consultation with an expert university librarian. Two independent reviewers will screen articles by title and abstract and assess the full text of each selected citation against inclusion criteria. Quantitative methods (descriptive statistics) and basic qualitative content analysis will be used to analyze the data, and results will be reported in narrative and graphic formats.

REVIEW REGISTRATION

Open Science Framework https://osf.io/2vsbq/.

Factors associated with mental health disorders in undergraduate students: A meta-analysis

Mental health disorders are a significant issue, yet there is currently no consistent data regarding the factors that may contribute to their occurrence. The aim of this study was to identify the factors that may influence the occurrence of mental health disorders in the undergraduate student population. This meta-analysis, registered in PROSPERO, was conducted as of September 5, 2024. The systematic searches were conducted on three databases (Scopus, Embase, and PubMed). Data on factors related to the occurrence of mental health disorders in undergraduate students were collected to calculate pooled point estimates using the Mantel-Haenszel test. Out of 6,837 articles, 16 articles were included in the analysis. Our findings revealed that female students had a higher chance of experiencing mental health disorders compared to male students (OR: 1.43; 95%CI: 1.14-1.80; p-Egger of 0.1041; p-Heterogeneity of <0.0001; p = 0.0020). The chance of having mental health disorders was also higher among single students compared to those in relationships (OR: 1.20; 95%CI: 1.02-1.43; p-Egger of 0.0535; p-Heterogeneity of 0.1130; p = 0.0180). This study did not find any associations between age group, family income, smoking, living arrangements, years of study, or regularity of physical activity with the occurrence of mental health disorders. These findings could serve as a basis for improving policies aimed at reducing the rates of mental health disorders in undergraduate students.

Enhancing work environments and reducing turnover intention: a multicenter longitudinal cohort study on differentiated nursing practices in Dutch hospitals

BACKGROUND

Addressing the growing challenge of nurse retention requires coordinated actions at national and global levels to improve recruitment, retention policies, and investments in the nursing work environment. The nursing work environment, defined as the "organizational characteristics of a work setting that facilitate or constrain professional nursing practice", is critical in influencing whether nurses decide to leave their jobs. This study investigates the impact of differentiated nursing practices - which involved tailoring roles and responsibilities based on nurses' training, skills, and experience in Dutch hospitals - and investigated their impact on the nursing work environment and turnover intention (i.e., nurses' intentions to leave their organization). We also explored whether the work environment mediates this relationship.

METHODS

A multicenter longitudinal cohort study was conducted across 19 Dutch hospitals between 2019 and 2023. Nursing professionals participated via digital surveys administered before (T0) and after (T1) differentiated nursing practices were introduced. The nursing work environment was assessed using the Practice Environment Scale of the Nursing Work Index. A multilevel analysis with a random intercept and fixed slope was used to evaluate the impact of differentiated nursing practices on the work environment and on nurses' turnover intentions.

RESULTS

We received 5411 responses to our questionnaire - 4259 at T0 and 1152 at T1. Results showed that, while the overall work environment improved, particularly in the dimensions of staffing and resource adequacy, collegial nurse-physician relationships, and participation in hospital affairs, there were no significant improvements in nursing foundation for quality of care or nurse managers' ability, leadership, and support of nurses. Additionally, differentiated nursing practices did not significantly impact turnover intention, nor did the work environment mediate this relationship.

CONCLUSIONS

This study is the first to explore the unique effects of practice differentiation on turnover intention mediated by the work environment. The findings suggest that, while differentiated practices can enhance certain aspects of the work environment, a more systemic and integrated approach is required for sustained improvements. Future research should include longer term studies to fully understand the complex relationship and accompanying mechanisms between differentiated nursing practices, the nursing work environment, and turnover intention.

TRIAL REGISTRATION

Clinical trial number not applicable.

Factors associated with practice readiness among newly qualified nurses in their first two years of practice

BACKGROUND

Newly graduated nurses undergo stress and role adjustment as they transition into practice during the first year and continue to struggle beyond the first year. Determining their practice readiness can aid in the development of interventions to facilitate workplace readiness for nurses in their first two years entering the nursing profession.

OBJECTIVES

To examine (i) extent of practice readiness of new nurses in their role; and (ii) associations between nurses' practice readiness and demographic and occupational variables, and reasons for choosing nursing profession.

DESIGN

A cross-sectional study.

SETTINGS AND PARTICIPANTS

A total of 445 registered nurses who graduated within the last two years and working in an academic medical centre in Singapore.

METHODS

Participants completed an online questionnaire with questions from Casey-Fink Readiness for Practice Survey and questions related to key competencies for future practice.

RESULTS

More than half (57.5 %) identified at least three skills and procedures which they were uncomfortable performing independently as they transition into the clinical practice, including: (i) responding to emergency (ii) tracheostomy care; and (iii) chest tube care. The top three reasons for choosing nursing as a career were: (i) nursing is a stable industry (54.2 %); (ii) I want to help people (52.1 %); and (iii) able to work anywhere in the world (44.3 %). Nurses were most concerned with areas of trials and tribulations (42.5 %) and clinical competency (36.6 %). When compared to nurses in their first-year post-graduation, those working in their second year reported more confidence in the ability to problem solve (p = 0.003), care for a person who is dying (p = 0.004), and less difficulties in prioritizing care needs (p = 0.04). They also perceived themselves as a good problem solver (p = 0.03).

CONCLUSIONS

It is critical to continue supporting nurses' practice readiness beyond their first year of practice in their confidence and development of skills of higher complexity.