<p> Background and Purpose: The healthcare system is currently facing daunting challenges; to increase the number of new nurses needed to provide care to the burgeoning population of seniors, to provide primary care for individuals covered by the Affordable Care Act of 2010 and to fill the vacancies left by retiring nurses. Transition into practice programs are needed to help new graduate nurses develop comfort and confidence in the autonomous Registered professional nurse (RN) role. New graduate nurses are at risk for significant job stress, leading to rapid job turnover, putting patient safety at risk. Recent studies examining transition to practice programs include results and implications that are limited by the sampling of only baccalaureate prepared new graduate nurses enrolled in a structured nurse residency program. </p><p> The purpose of this study was to examine the effects of transition to practice programs on new graduate nurses regardless of transition to practice program type, length of program or degree upon initial entry to practice in the state of New Jersey. Research Question: What are the effects of transition to practice programs on new nurse comfort, confidence and RN role transition? </p><p> Design, methods and participants: The non-experimental, cross-sectional, correlational descriptive study utilized the Casey-Fink Graduate Nurse Experience Survey to examine new graduate nurses' comfort, confidence and RN role transition. The purposive convenience sample consisted of 182 RNs licensed in New Jersey, who were hired into their first nursing job between January 2012 and June 2014. </p><p> Results and implications: Data analysis revealed that there were no significant differences in new graduate comfort and confidence score regardless of length of transition to practice program or entry degree received. Approximately one-third of respondents felt that they were not able to complete their patient care assignment on time, had difficulty prioritizing and organizing patient care needs, and felt that they may harm a patient due to their lack of knowledge and experience. The results of this study indicate that up to one-third of new graduate nurses surveyed, who after completion of a TTP program, are often expected to care for a full assignment of high acuity patients comparable to a seasoned RN, lacked the comfort and confidence to do so. The study also indicates however, that those who participated in a longer TTP program fared best, reporting heightened comfort and confidence responses on the survey instrument.</p>

<p> In contemporary American society, the nursing profession is predominantly made up of white women. Currently, males make up only 6.8 percent of the three million nursing professionals in the U.S. and they are considered gender minorities within the nursing profession and within nursing education. As gender minorities, male students are identified as experiencing nursing programs and the practice of nursing differently than their female counterparts.</p><p> The purpose of this single instrumental, within site case study was to explore the learning environment for male nursing students and to investigate the nature of the interactions between nursing faculty and male undergraduate students in a Pacific Northwest medical university nursing program. Data was collected in the educational setting through observations, participant interviews, and document analysis. In addition, this study used Kanter's theoretical framework of tokenism to uncover if male nursing students were perceived as tokens in the educational environment. The findings showed that the faculty-student interactions were largely positive; they also revealed that having other males in the class was an instrumental factor in their positive perception of their educational experience. However, the male nursing students also identified areas of discomfort in the educational setting, specifically when practicing clinical skills with female peers, feeling pressured to volunteer and to expose skin during in-class demonstrations, and anticipating that they would be excluded from certain clinical situations. This research indicated that gender differences are present within nursing education and contributed to instances of discomfort for male students. Specific barriers occurred most often when men engaged with female peers and were in clinical settings. These findings provide new insight into when and where men begin to experience gender barriers in the educational environment and are pertinent to understanding the educational environment for men in nursing. Recommendations specifically geared towards assisting students in their first term are suggested for nursing faculty and administrators to ensure that the learning environment is welcoming for men. These recommendations include consciously placing males together in cohort groups and in clinical experiences, reducing instances of visibility and pressure on men in the clinical setting, building faculty awareness of perceived and real barriers for men in the educational setting, and providing faculty with tools to assess and address barriers that are present in the classroom environment. </p>

<p> This mixed methods participatory action research study investigated student perceptions of stress within the context of a high stakes testing environment. Participants were prelicensure baccalaureate nursing students enrolled in the final semester of their nursing program. The quantitative method, a prospective correlational research design using the Student Nurse Stress Index (SNSI) provided a quantitative measure of stress. Phenomenography, the qualitative method, was used in order to capture the various ways students experience stress. The combination of these two methods provided a rich understanding of student perspectives regarding the use of high stakes testing nursing as a measure of progression toward graduation. Analysis of the research findings revealed all students experience stress while preparing for high stakes testing. However, students perceived the experience of stress in a myriad of ways suggesting that students view high stakes testing as a threat rather than a challenge.</p>

<p> Health literacy has been identified as a significant factor in health care disparity and access to health care, and must be addressed in health care reform. Although patient education has long been considered an independent role of nursing, nurses often lack the knowledge and skills needed to be effective educators. Nursing as a profession is poised to assume a leadership role in health care reform and in promoting the national goals of health promotion and disease prevention of Healthy People 2020. The purpose of this quasi-experimental quantitative study is to determine if a formal course of education and learning theory in undergraduate pre-licensure nursing programs increases knowledge of health literacy and self-efficacy related to patient teaching. A sample size of 322 senior level undergraduate nursing students from a multi-campus private undergraduate baccalaureate school of nursing were surveyed to assess their knowledge of health literacy and their self-efficacy related to patient education. A 38-item multiple choice questionnaire with a Likert-type scale was utilized to measure the health literacy knowledge and experiences of participants, and a multi-item Likert-type scale measures nursing process steps of self-efficacy related to patient education. In this study, the experimental group had completed a formal course of educational and learning theory, while the control group had not. The experimental group demonstrated more knowledge about health literacy, however, the difference was not statistically significant. They did, however, demonstrate statistically significantly more self-efficacy related to patient health education activities in some areas compared to the control group, but not in all areas of the teaching and learning process. Recommendations for further studies are to conduct the study earlier in the nursing program, before the students complete multiple clinical courses, which require patient education activities, and to expand the study to multiple nursing programs in the region teaching a formal course in education and learning theory for patient education to see if results are consistent regionally.</p>

<p> This quantitative, retrospective, multivariate, non-experimental study examined the first-time performance of 2,673 academic nurse educators who took the CNE examination between September 28, 2005 and September 30, 2011. Post-positivism and Abbott's system of the professions theory served as the philosophical and theoretical underpinnings of this original research which attempted to determine if a relationship existed between educational preparation or years of full-time faculty employment (independent variables) and first-time pass/fail performance on the CNE examination and in each of content areas (dependent variables). The Chi-square test of independence revealed the lack of a statistically significant relationship between educational preparation and first-time pass/fail performance on the CNE examination. Independent t-tests revealed a statistically significant relationship between Option B study participants and content area three (use assessment and evaluation strategies), (<i> t</i>[2,671] = -2.20, <i>p</i> = .03); four (participate in curriculum design and evaluation of program outcomes), (<i>t</i>[2,671] = -2.06, <i>p</i> = .04); and six (engage in scholarship, service, and leadership), (<i>t</i>[2,671] = -2.34, <i>p</i> = .02). Binary logistic regression revealed that a one year increase in full-time employment resulted in a 1.05 times greater likelihood of passing the CNE examination (OR = 1.05; 95% CI 1.03, 1.06; <i>p</i> = .00). Last, simple linear regression revealed that years of full-time faculty employment contributed to 3.2% of the variability within content area four, 2.8% within content area six, and 2.1% within content area three. The results of this study provide insight about faculty development and mentoring needs, present evidence to policy makers and nursing education leaders, and offer guidance to curricula developers.</p>

<p> Professional confidence is an essential trait for new graduate nurses to possess in order to provide safe and effective patient care in today's complex hospital setting. However, many new graduate nurses are entering the workforce with a lack of professional confidence and it was unclear why this is so. The purpose of this basic qualitative study was to find out and understand how new graduate nurses accounted for their lack of professional confidence during their first year of practice in the hospital setting. The primary research question asked about new graduate nurses' experiences during their first year of practice related to the development of professional confidence in the hospital setting. Two sub-questions were used to address circumstances that hindered and promoted the development of professional confidence. Data collection involved two individual, semi-structured, audio recorded interviews which were transcribed verbatim. Each transcript was analyzed through a manual content analysis approach and ultimately, seven themes emerged which answered the research questions. Findings confirmed that seven themes related to a lack of professional confidence in new graduate nurses' experiences: (a) "communication is huge," (b) "making mistakes," (c) "disconnect between school and practice," (d) " independence," (e) "relationship building," (f) "positive feedback is important," and (g) "gaining experience." These findings revealed that new graduate nurses lacked professional confidence upon entry into practice which had implications for both undergraduate nursing education programs and workplace support for new graduate nurses in the hospital setting. Undergraduate nursing education programs may have a duty to improve strategies that prepare graduates for entry into professional practice. Nurse leaders in practice, specifically, nurse managers and preceptors must be mindful of the fact that new graduate nurses are entering the workforce with a lack of professional confidence and that it is in their power to promote the development of professional confidence during the first year of practice.</p>

<p> The focus of recent attention in healthcare is the increasing population of people with chronic condition and the increasing cost of managing the health of this population. To improve care outcomes and increase cost effectiveness of managing the health of these patients their care needs to be directed by evidence-based approaches. One of these approaches could be wellness health coaching directed toward helping patients self-manage their chronic condition. The problem however, is that the research on the role of wellness health coaches with helping patients self-manage their chronic condition is limited. Therefore, research that focuses on the role of wellness health coaches and their approaches to facilitate self-management are needed. </p><p> To gain understanding of the role and approaches of these wellness health coaches a phenomenological method was used. By personal interviews with six wellness health coaches, the researcher sought to answer the two research questions by describing their perceived role and their approaches to facilitate self-management of individuals with chronic conditions. </p><p> Wellness health coaches in this study perceived their roles as educators, motivators, guides, supporters, facilitator, collaborator, and coordinator. With all their clients they help set goals and develop a plan to meet their goals. The wellness health coaches' approaches to help improve their clients' self-management skills include providing them with written educational materials, resource information, and other tools such as websites on health information. All of these wellness health coaches' activities are aimed at empowering their clients to be able to improve their lifestyle and overall health.</p>

<p> This qualitative study was successful in utilization of grounded theory methodology to ascertain nurses' decision-making processes following their awareness of having made a medical error, as well as how and/or if they corrected and reported the error. Significant literature documents the existence of medical errors; however, this unique study interviewed thirty nurses from adult intensive care units seeking to discover through a detailed interview process their individual stories and experiences, which were then analyzed for common themes. Common themes led to the development of a theoretical model of thought processes regarding error reporting when nurses made an error. Within this theoretical model are multiple processes that outline a shared, time-orientated sequence of events nurses encounter before, during, and after an error. One common theme was the error occurred during a busy day when they had been doing something unfamiliar. Each nurse expressed personal anguish at the realization she had made an error, she sought to understand why the error happened and what corrective action was needed. Whether the error was reported on or told about depended on each unit's expectation and what needed to be done to protect the patient. If there was no perceived patient harm, errors were not reported. Even for reported errors, no one followed-up with the nurses in this study. Nurses were left on their own to reflect on what had happened and to consider what could be done to prevent error recurrence. The overall impact of the process of and the recovery from the error led to learning from the error that persisted throughout her nursing career. Findings from this study illuminate the unique viewpoint of licensed nurses' experiences with errors and have the potential to influence how the prevention of, notification about and resolution of errors are dealt with in the clinical setting. Further research is needed to answer multiple questions that will contribute to nursing knowledge about error reporting activities and the means to continue to improve error-reporting rates.</p>

<p> The purpose of this case study was to determine which activities factor into transformational learning that may occur as a result of completing a perioperative preparation program for registered nurses. Through the process of describing the lived experiences of the participants who have completed a perioperative nurse training program, it also assisted in informing pedagogical practice by helping to establish the extent of transformational learning that occurs. The role of a perioperative nurse is one that is demanding, knowledge intensive, and highly collaborative. Perioperative nurse educators need to understand the process of transformation in order to assist new perioperative nurses in successfully completing a perioperative nurse-training program. The Learning Activities Survey, a follow-up survey, and individual interviews were used to accomplish a mixed method sequential study design. The research established that half of the participants had experienced transformational learning while half did not.</p>

Thesis (Ph.D) -- University of Western Sydney, Hawkesbury, 1998. / Thesis submitted for the degree of Doctor of Philosophy. Includes bibliographical references (leaves475-497).