Almost 30% of new nurse graduates leave the position within the first year of practice, and almost 60% leave within 2 years. When new nurse graduates do not effectively transition into practice, nursing satisfaction is affected, and additional costs are incurred by their organizations through continual hiring of nurses. The purpose of this project was to develop a comprehensive, evidence-based nurse residency program (NRP) for new nurse graduates working in a 16-bed intensive care unit (ICU) of a 160-bed community hospital in the mid-Atlantic region of the United States. Using a team approach, Rosswurm and Larrabee's model of evidence-based practice was used to guide the project design, which included a pretest followed by 10 educational sessions. The plan concluded with a posttest to assess knowledge gained. The curriculum focused on 3 key areas identified by the Commission on Collegiate Nursing Education: leadership, patient outcomes, and the professional role of the nurse. Evaluation of the curriculum was completed by 3 Master of Science in Nursing-prepared content experts using a dichotomous scale. An average score revealed that the content met the objectives of each session. The experts also conducted a content validation index (CVI) of each pretest/posttest item using a Likert scale that ranged from 1 (not relevant) to 4 (highly relevant). The scale-CVI average, or the average CVI of all items, was .99; the universal agreement scale-CVI, or universal agreement of all items was .98, meaning there was high agreement across raters. Nurses who participate in the nurse residency program will be better able to transition into practice in the ICU as they provide care for today's complex patients, thereby positively impacting social change in their role as nurses as well as impacting patient, family, and organizational outcomes.

Graduate nurses beginning their nursing career require a collaborative relationship with an expert nurse mentor to make this transition successful. However, high turnover among these experienced nurse mentors is causing a problematic gap in knowledge transfer, experience, and expertise in the nursing workforce. This project investigated whether nurse mentors who mentored in a Nurse Residency Program (NRP) remained with the organization longer and were more satisfied with their mentoring experience than nurse mentors who mentored outside of a NRP. The diffusion of innovations theory was used to support the project and process of dispersing information on the outcome of the project. Sources of evidence for the project included case-cohort studies, systematic reviews obtained via an exhaustive literature review, and the collection of nurse mentor retention and satisfaction data through the use of a cross-sectional survey. Data were assessed from 214 registered nurses at a hospital in Rapid City, South Dakota and divided into 2 groups: nurse mentor and NRP mentor. When compared to nurse mentors, 10% more NRP mentors reported being employed in their current position with the intent to remain employed for 10 or more years as well as being very satisfied with their mentorship experience, supporting the project question. This project substantiates the need for experienced nurse mentors to prepare new graduate nurses coming into the profession. Contribution to positive social change is as a result of mentorship in nursing that functions as a means of retaining both new graduate and experienced nurses simultaneously.

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No description available.

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The importance of nurse residency programs is addressed in the literature; however, a review of residency program outcomes and effectiveness is needed. Guided by Roy's adaptation model and Deming's plan-do-check-act model, the purpose of this quality improvement project was to assess the current state of a longstanding critical care nurse residency program in meeting organizational goals and objectives and to recommend modifications to the program related to external factors, internal challenges, and educational deficits of nurses entering the program. A review of the evidence-based literature and feedback from focus groups of leadership stakeholders were used to develop recommendations for residency program improvement. Using qualitative analysis of the focus group data, three common themes emerged related to external factors: financial resources, patient acuity, and generational differences that influence nurse satisfaction with the residency program. Three additional themes emerged related to organizational barriers to satisfaction with the program: preceptor availability and development, limited training hours due to productivity standards, and leader time to support novice nurses. Reality shock when starting to practice in the high acuity critical care area was the most frequently reported educational deficit among new nurses. Recommendations for program improvement included obtaining feedback from residency program participants and preceptors, initiating preceptor development pathways, reinstituting a dedicated cost center for nurse residents' training, and using competency assessment tools to customize training plans for residency program participants. This project has the potential for social change by increasing job satisfaction and retention of new nurses and improving health outcomes in critical care patients.

Information from anecdotal interviews at a practicum site indicated a lack of training for advanced practice providers (APPs) in core competencies critical for effective practice in a heart failure (HF) unit. The goal of this project was to assess the APPs' verbal reports and develop HF unit-specific training for APPs. The practice-focused question examined whether unit-specific training for HF APPs improved knowledge and skills in HF management. The Johns Hopkins nursing evidence-based practice model and Knowles's adult learning theory were used to create a survey, a focus group, and a pre/posttest assessment of knowledge and skills gap. Descriptive and inferential statistics could be used to analyze pre/post survey data, and thematic analysis could be used to analyze focus group data. Assessment data could be used to develop a targeted HF program based on identified skill deficiencies. The implications of this project related to social change are the potential to increase APPs' knowledge, job engagement, and retention. The program could affect length of stay and 30-day readmission of patients in the HF unit.

Access to health care in rural communities is challenged by workforce shortages. Nurse practitioners (NPs) have been filling the gap created by physician migration into specialty areas. Flex hospital legislation allows critical access hospitals (CAHs) to staff the emergency department with NPs without on-site physicians. NP education often lacks emergency and trauma curriculum, resulting in gaps in practice expectations and significant role transition stress and turnover. The purpose of this project was to construct from the scholarly literature a transition-to-practice residency program to support NP's in providing emergency department care in the CAH. The limbo to legitimacy theory guided the design and implementation of this project. Expected outcomes from this project include increased quality of care, increased patient safety, increased NP job satisfaction, and decreased turnover. The quality improvement initiative engaged an interprofessional team of 8 institutional leaders who designed the residency program and curriculum modules and the secondary products necessary to implement and evaluate the project. The project expands the understanding of the on-boarding needs of rural NPs and produces outcome data to evaluate results. Recommendations include collaboration between health care organizations and institutions of higher learning to promote postgraduate emergency care education leading to post-masters certificate or Doctor of Nursing Practice with emergency care subspecialization.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2017-07-25T13:29:51Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) DISSERTAÇÃO RAQUEL BARROS ANDRADE MOTA CFCH MPPP.pdf: 1224882 bytes, checksum: e5effed97534653009dacbe1531ede27 (MD5) / Made available in DSpace on 2017-07-25T13:29:51Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) DISSERTAÇÃO RAQUEL BARROS ANDRADE MOTA CFCH MPPP.pdf: 1224882 bytes, checksum: e5effed97534653009dacbe1531ede27 (MD5) Previous issue date: 2017-10-07 / Um dos principais objetivos dos Programas de Residência é formar profissionais para atuarem nas áreas consideradas prioritárias do SUS, em uma clara preocupação do legislador da Política de Educação Permanente em Saúde em garantir para a saúde pública o desenvolvimento de profissionais especializados nas clínicas de interesse para a população em geral. Nesse sentido, a política em questão se importa com o retorno social da política pública ao investir na qualificação de profissionais que possam, posteriormente, atuar nas áreas de atenção à saúde de maior relevância pública e maior interesse social. Assim, a presente pesquisa pretendeu avaliar como a inserção dos residentes egressos do Programa de Residência Multiprofissional Integrada em Saúde do HC/UFPE no mercado de trabalho reflete o objetivo da Política Nacional de Educação Permanente em Saúde em formar profissionais especializados para o SUS. Metodologicamente, este trabalho constituiu-se de três momentos: pesquisa bibliográfica, pesquisa documental e estudo de caso. Os dados foram colhidos por meio de questionário eletrônico, respondido por residentes egressos que concluíram o referido Programa de Residência entre 2012 e 2015. Concluiu-se que o Programa em questão trouxe ganhos para seus egressos, expressos especialmente pela possibilidade de inserção no mercado de trabalho, ao possibilitar rever os caminhos para a formação profissional, na perspectiva de um trabalho mais integrado, com trocas de saberes, e, sobretudo, com maiores possibilidades de inserção no mundo do trabalho de profissionais aptos a oferecerem atenção à saúde qualificada. A atuação profissional dos residentes egressos do Programa de Residência Multiprofissional Integrada em Saúde do HC/UFPE na especialidade adquirida varia em função das demandas do mercado de trabalho, com os egressos permanecendo em ambientes multiprofissionais, porém atuando em diversos tipos de função, como, por exemplo, a gerência e a docência. Eles são absorvidos, em sua maioria, pelas vagas ofertadas pelo SUS, que ainda se apresenta como o maior empregador na área de saúde, mesmo que oferecendo vínculos de forma precária tendo em vista que a maioria dos egressos encontra-se sob o regime celetista. / One of the main goals of the residency programs is to train professionals to work in the priority areas of SUS in a clear concern of the legislature of Permanent Health Education Policy to ensure public health professionals to develop their practice in clinics of interest to the general population. In this sense, the policy in question cares about the social return of public policy investment in the qualification of professionals who can later act in the health care areas wich has most public relevance and greater social interest. Thus, the present study intended to assess how the integration of graduated residents of the Integrated Multidisciplinary Health Residency Program from HC/UFPE in the labor market reflects the objective of the National Policy of Permanent Health Education to train professionals for the SUS. Methodologically, this work is consisted of three stages: bibliographical research, documentary research and study case. Data were collected through an electronic questionnaire, answered by graduated residents who completed the Residency Program between 2012 and 2015. It was concluded that the program in question brought gains for its graduates, especially expressed by the possibility of insertion in the job market by enabling review the avenues for vocational training with a view to a more integrated work, knowledge exchange, and, above all, greater ability to enter the world of work professionals able to offer attention to qualified health. The professional performance of graduated residents of Integrated Multidisciplinary Health Residency Program HC/UFPE in the acquired specialty varies depending on the demands of the job market with graduates remaining in multidisciplinary environments, but acting on different types of function, for example, management and teaching. They are absorbed mostly by the vacancies offered by the SUS, which still presents itself as the largest employer in the healthy area, even offering precariously bonds given that most of the graduates is under the CLT regime.

Recruitment and retention of professional nurses are crucial issues for hospital departments of nursing. Recognizing the necessity to bridge the gap that persists between nursing education and nursing services, hospitals have designed programs to assist new nurses make the transition to current nursing practice. By helping individuals make the transition to current nursing practice it is hoped that staff nurses will be retained.