Evaluation of the induction programme for newly qualified radiographers: A survey study

INTRODUCTION

The role of radiographers is continuously expanding and holds a key position in the healthcare system due to the increasing complexity in patient care and support. Therefore, with a rise of demand for increasingly specialized and advanced skills, it is important to provide newly hired professionals with structured induction programs. This study proposes to explore the perceptions of newly qualified radiographers who have already experienced transition into practice.

METHODS

A survey was distributed to newly qualified radiographers hired in a large university hospital in Italy. The questionnaire includes demographic data, sentences on patient management, decision-making, work organisation, development of self-confidence and relationships with other team members.

RESULTS

The survey was completed by 22 newly qualified radiographers. Among the participants, 32 % graduated within the last year, and 46 % indicated that they had their first experience in a healthcare setting. Using a 5-point Linkert scale, only 10 out of 29 sentences received a score of 4 or higher, indicating agreement. Sentences on the perception of self-confidence in they work skills after the induction programme show higher scores among participants with more than one work experience, while sentences about support by management show discrepancy favouring participants with no work experience.

CONCLUSION

Radiographers included in the study believe they are adequately ready and well prepared for clinical practice after the induction programme, despite some differences between radiographers with different levels of experiences.

IMPLICATION FOR PRACTICE

A successful induction programme for newly qualified radiographers is crucial for developing a proactive approach, appropriate working methods, positive attitudes and a good work ethic, but also plays a role in reducing stress and worker turnover, ensuring a high quality of patient care.

Mentoring New Graduates to Voice Safety Concerns: An Evidence Review

New graduate nurses often lack professional confidence to voice safety concerns. An evidence review was conducted to determine how participating in a mentorship program impacts the development of assertive communication during the first year of practice. Evidence indicates that providing a supportive environment, with physical and emotional access to mentors, should be used to increase new graduate nurses' self-perceived ability and willingness to voice safety concerns.

Transition Into Practice: Beyond Hospital Walls

BACKGROUND

Historically, evidence has shown the importance of nurse residency programs, yet few organizations have implemented them outside of hospital settings. This article shares nurses' experiences and outcomes in an out-of-hospital nurse residency program that transitioned bachelor of science in nursing graduates through an academic-practice partnership.

METHOD

A mixed methods design was used that consisted of qualitative interviews (pre- and postresidency) and quantitative surveys (Casey-Fink Graduate Nurse Experience Survey, a job satisfaction survey, and a preceptee evaluation survey).

RESULTS

Forty-four nurses participated. Qualitative findings were supported by the quantitative data. Results showed that confidence, competence, job satisfaction, and retention improved with an out-of-hospital residency program.

CONCLUSION

Ensuring that every new graduate is afforded a nurse residency should be the goal, regardless of setting, to reduce turnover, ensure workforce stability, and ultimately improve patient outcomes. Academic-practice partnerships can help build resource capacity, especially in these settings, to achieve this goal. [J Contin Educ Nurs. 2023;54(7):327-336.].

Academic-Clinical Collaborations to Build Undergraduate Nursing Education in Hospice and Palliative Care

With the current shortage of hospice/palliative care (HPC) workforce, there is an urgent need to train a generation of nurses with clinical competency in HPC to ensure equitable access and optimal care for patients living with serious illness or at the end of life. The recent demand for HPC teaching in nursing education calls for innovation in establishing clinical placements. Palliative care nursing experts in New York State were surveyed between June and August 2022 about facilitators of academic-clinical partnerships between nursing schools and clinical settings. Inductive content analysis of open-ended responses revealed six major interconnected themes: (a) Increase Awareness of HPC in the Nursing Program, (b) Build a Relationship With Administrators, (c) Look Beyond Acute Care Partnerships, (d) Offer Incentives, (e) Develop Direct Care Experiential Opportunities, and (f) Develop Non-Direct Care Experiential Opportunities. Findings provide rich insights into key considerations for successful collaboration between nursing schools and clinical sites. [Journal of Gerontological Nursing, 49(6), 13-18.].

Evaluation of the feasibility of an Education-Career pathway in Healthcare for Older People (ECHO) for early career nurses

BACKGROUND

Rapid population ageing is driving demand for qualified gerontological nurses. Yet, early career nurse attrition and limited focus on retention in the speciality limits supply.

OBJECTIVES

To test the feasibility and acceptability of an Education-Career pathway in Healthcare for Older People (ECHO) intervention for early career nurses to improve retention and capability in gerontological nursing. ECHO is a multicomponent intervention with integrated education, career planning and coaching components, tested over two 6-month cycles.

METHODS

A feasibility study with a pre-post design using a multi-methods evaluation. Twenty-nine early career nurse participants were recruited from eight NHS acute and community care Trusts in England. ECHO participants completed online questionnaires at baseline (Time 1), 6-month (T2, end of intervention) and follow-up at 18 months from baseline (T3). Outcome measures were career intention, self-reported knowledge, career planning confidence, and burnout using the Maslach Burnout Inventory. Qualitative interviews were undertaken with participants (n = 23) and organizational stakeholders (n = 16) who facilitated ECHO. Data analysis used descriptive statistics and non-parametric tests for paired data and thematic analysis for qualitative data.

RESULTS

Overall, 19 of 29 participants (65%) completed all aspects of the intervention. The evaluation was completed by 23 participants. ECHO was well received by participants and stakeholders. At T3, the 23 participants were working in the speciality, though two had changed organizations. There was a significant improvement in self-reported gerontological knowledge, pre 87 (IQR 81-102), post 107 (IQR 98-112) p = 0.006, but no significant changes in other outcomes. In qualitative data, participants and organizational stakeholders held similar views, presented under four main themes: intended outcomes (personal and professional development, raise gerontological profile, expand horizons); nurse retention-a double-edged sword, ECHO logistics, and sustainability.

CONCLUSION

Education-Career pathway in Healthcare for Older People was feasible and may positively impact early career nurse retention, capability and socialization into gerontological nursing. ECHO requires further refinement and piloting, but learning can contribute to retention strategies.

IMPLICATIONS FOR PRACTICE

Attracting and retaining early-career nurses to the gerontological speciality requires greater innovation, organizational and senior nurse leadership.

Working Dynamics of Licensed Nurses and Nurse Aides in Nursing Homes: A Scoping Review

Collaboration between licensed nurses (LNs) and nurse aides (NAs) is critical in the provision of quality care for residents living in nursing homes (NHs). The current scoping review explores how working dynamics between LNs and NAs in the NH setting are researched and described in the literature. Thirty-five articles were identified and reviewed that address the LN/NA relationship in the context of (a) the LN role as a supervisor and leader; (b) variation in structure; (c) expanding, understanding, and supporting staff roles; and (d) communication. We found that the LN/NA relationship has been primarily explored through the LN lens and often studied in the context of role expansion and revision associated with new models of care. Our contribution to the literature includes the following main points: efforts to improve LN/NA collaboration may be hindered without substantial structural change; collaboration may be limited within the hierarchal LN/NA relationship; LNs and NAs in NHs need greater support, recognition, and empowerment; and NAs require a representative voice. [Journal of Gerontological Nursing, 48(5), 27-34.].

The Association Between new Nurses' Gerontological Education, Personal Attitudes Toward Older Adults, and Intentions to Work in Gerontological Care Settings in Ontario, Canada

Background

The older adult population in Canada is increasing, and many will require care within an acute geriatric unit (AGU) or long-term care facility (LTCF). However, the nursing workforce is not growing at the same pace as the population is aging. New graduate nurses may be able to fill this gap; therefore, it is important to understand their intentions of working in gerontological care settings (i.e., AGU or LTCF).

Aim

To examine if nursing education and personal attitudes toward older adults influence newly registered nurses’(RNs) intentions to work in a gerontological care setting.

Method

Nurses (n= 1,103) who registered with the College of Nurses of Ontario for the first time in 2018 were invited to complete a questionnaire.

Results

The majority of participants (n = 181) reported a positive attitude toward older adults. However, only 14% reported an intention to work in a gerontological care setting. Participants who completed multiple geriatric focused clinical placements were more likely to report an intention to work in these settings.

Conclusion

This study provides some information regarding the attitudes and intentions of newly RNs toward a career in gerontological care settings. Further research is needed to understand nurses’ intentions regarding working in AGUs or LTCFs.

Caring self-efficacy of direct care workers in residential aged care settings: A mixed methods scoping review

The caring self-efficacy of direct care workers in residential aged care has been explored in the literature mostly as a predictor rather than the focus of interest. This scoping review aimed to provide an overview of the existing literature on aged care workers' caring self-efficacy and factors that influence it. A systematic search was performed in six electronic databases. All primary studies were included. A total of 41 studies met the inclusion criteria. Caring self-efficacy was most often described by aged care workers as their capacity to deal with difficult situations. The self-efficacy scores of direct care workers were high across studies. Self-efficacy was positively influenced by access to resources, relationships with residents and their families, the support of supervisors and co-workers, job satisfaction, and training opportunities, and negatively affected by work pressure and burnout. Findings indicate possible avenues for intervention to improve direct care workers' self-efficacy in aged care.

Individual and organizational factors of nurses' job satisfaction in long-term care: A systematic review

BACKGROUND

In long-term care facilities, nurses' job satisfaction predicts staff turnover, which adversely affects resident outcomes. Thus, it is important to develop a comprehensive understanding of factors affecting nurses' job satisfaction in long-term care facilities.

OBJECTIVES

To analyze factors associated with job satisfaction among nurses in nursing homes from individual and organizational perspectives utilizing a deductive approach.

DESIGN

Systematic literature review SETTING: Nursing homes.

PARTICIPANTS

Registered nurses and licensed practical nurses in nursing homes.

METHODS

A systematic literature review of seven online databases (EMBASE, CINAHL, PsychINFO, MEDLINE, PubMed, Scopus, and Web of Science) to July 23, 2020 was conducted. Studies were included if they examined factors associated job satisfaction in the target population and setting. Decision rules on how to determine factors important to nurse job satisfaction were developed a priori. Two team members independently screened the publications for inclusion, extracted data, and assessed included publications for methodological quality; conflicts were resolved through a consensus process and consultation of the third senior team member when needed.

RESULTS

Twenty-eight studies were included. Of these, 20 studies were quantitative, 6 were qualitative, and 2 were mixed methods. Factors associated with job satisfaction were grouped into two categories: individual and organizational. Individual factors significantly associated with job satisfaction were age, health status, self-determination/autonomy, psychological empowerment, job involvement, work exhaustion, and work stress. Individual factors identified as not important or equivocal were gender and experience as a nurse/in aged care. No organizational factors were identified as important for nurses' job satisfaction. Facility ownership, supervisor/manager support, resources, staffing level, and social relationships were identified as equivocal or not important. Findings from qualitative studies identified relationship with residents as an important factor for job satisfaction.

CONCLUSIONS/IMPLICATIONS

Factors identified as important to nurses' job satisfaction differ from those reported among care aides in nursing homes and nurses employed in acute care settings, suggesting that there is a need for unique approaches to enhance nurses' job satisfaction in nursing homes.

Development of a Long-Term Care Nurse Residency Program

Nurses working in the long-term care (LTC) setting provide increasingly complex patient care, often without formal training on the specific needs of LTC patients, which can lead to burnout and high turnover rates. Nurse residency programs (NRPs) have been used effectively to orient novice RNs to their work setting, address transition-to-practice challenges, and promote retention, yet few LTC NRPs have been developed. The University of Utah Geriatric Education Consortium Geriatric Workforce Enhancement Program created an online LTC NRP to provide LTC nurses with the knowledge and skills to succeed in the LTC environment. RNs with <1 year of LTC experience were paired with experienced nurse mentors working within the same LTC facility. Synchronous and asynchronous curricular modules addressed leadership and communication, caring for older adult patients, quality improvement, and the LTC regulatory environment. A distance-based LTC NRP allows nurses flexibility in gaining gerontological nursing and leadership expertise that supports their professional goals. [Journal of Gerontological Nursing, 47(2), 37-43.].

Student perceptions of older adults after a music intervention: A mixed approach

AIMS

The aims of this project were to investigate changes in nursing students' attitudes and perceptions of older adults after implementing individualized Music and Memory© playlists. In addition, the inquiry sought to compare pre and post survey responses for changes in rankings of caring for the older adult as a career choice. The qualitative inquiry sought to explore students' perceptions of their experience through narrative journaling for a better understanding of the experience.

DESIGN

This study used an explanatory sequential mixed design.

METHODS

A pre post-intervention approach was used for quantitative data collection along with a ranking item for career choices. Journal narratives completed within one week following the experience were explored for qualitative themes to better understand students' experiences. Attitudes and perceptions of students (N = 44) were measured by two tools before and after implementation of Music and Memory© Interventions during a 7-week clinical experience. Student journals were analyzed for themes.

RESULTS

In the two-tailed paired t-test, nursing students' attitudes and perceptions of caring for older adults were analyzed for differences. Significance improvement was found in students' reported interaction scores and other constructs (p ≤ .01). Mean ranking of caring for the older adult improved from 7.6 to 7.0 in the post intervention analysis. Student journals reported the activity as worthwhile and time consuming.

CONCLUSIONS

As the baby boomer generation ages the need for residential long-term care is projected to increase significantly. Recruiting and retaining nurses to care for this vulnerable population is challenging. Music and Memory© Interventions have the potential to change student attitudes and perceptions of the older adult that could improve caring for the older adult as a career choice.

Why Do They Stay? Intention to Stay among Registered Nurses in Nursing Homes

Purpose: The purpose of this study was to examine the factors associated with nursing home (NH) registered nurses’ (RNs’) intention to stay in their workplace. Methods: A cross-sectional questionnaire survey was used in this study. Organizational NH data were acquired from the administrators of 56 NHs. Individual RN data were acquired from 189 RNs in 56 NHs across Korea. The questionnaire assessed RNs’ intention to stay in their workplace as well as potential associated factors, including individual and organizational factors. Multilevel regression analysis was used to determine which factors explain RNs’ intention to stay in their workplace. Findings: NH RNs’ intention to stay was positively associated with RNs’ years of experience in NHs, career promotion opportunities, and perceptions of NH resident safety culture. At the organizational level, no factors were found to significantly relate to the intention to stay of NH RNs. Conclusions: Although this study found that organizational factors have no statistically significant relationship with RNs’ intention to stay, organizational support must precede changes in individual factors that have significant relationships. Clinical Relevance: Organizational (NH) and individual (RN) efforts must be made to enhance RNs’ intention to stay because individual factors can change after implementing efforts such as providing educational programs, promotional opportunities, and forming a positive resident safety culture at an organizational level.

Preceptor Criteria Revisited

BACKGROUND

Preceptor selection criteria based on demographic data has been shown to yield inconsistent degrees of success in the role. The purpose of this mixed-methods study was to determine if preceptors with different levels of innovativeness identified different benefits and challenges when implementing the preceptor role.

METHOD

A mixed-methods study was conducted using online surveys to determine each participants' individual level of innovativeness. Interviews were conducted with preceptors from each innovator category to identify benefits and challenges in implementing the preceptor role.

RESULTS

Preceptors who scored lower in innovativeness identified challenges that were not discussed by preceptors who scored higher in innovativeness. Conversely, preceptors who scored higher in innovativeness identified benefits that were not common to preceptors with lower levels of innovativeness.

CONCLUSION

Opportunities for nurse educators and facility nurse leaders were presented to meet the diverse needs of the preceptor and provide for more consistent implementation of the preceptor role. [J Contin Educ Nurs. 2020;51(9):425-432.].

Measuring Preceptor Selection in Long-Term Care

Orienting new nursing staff is costly for health care organizations. Identifying preceptor characteristics and structuring preceptor education to support those characteristics may improve the orientation process and decrease orientation cost. A descriptive, observational study identified preferred characteristics of potential preceptors (N = 39) in a long-term care/subacute facility. Results showed that mean ranks of three items on the preceptor instrument were significant, thus providing insight regarding content and desired outcome of preceptor education. [J Contin Educ Nurs. 2019;50(10):455-462.].

The impact of nurse residency programs in the United States on improving retention and satisfaction of new nurse hires: An evidence-based literature review

Entry into practice for newly graduated nurses can be a demanding and overwhelming experience. These stressful work conditions have contributed to decreased retention and satisfaction amongst new nurse hires. The aim of this literature review is to answer the following question: in newly hired BSN graduates, how would the use of a one-year nurse residency program compared to a traditional orientation affect turnover rates and reported satisfaction of the new nurse hires over a one-year period? Peer-reviewed research and systematic reviews between the years of 2012-2017 found on the Medline, Nursing & Allied health, and CINHAL were used. Inclusion criteria were peer-reviewed literature that addressed the impact of one-year NRPs on nurse retention or nurse satisfaction. Exclusion criteria were articles that addressed NRPs without discussing retention or satisfaction. The JHEBP Appraisal Tools were used to extract and appraise evidence. Use of NRPs showed increased satisfaction and retention of new nurse graduates over a one-year period, leading to the conceptualization that this is a more effective method than traditional orientations for new nurse hires.