New Graduate Nurse Work-Life Assessment for Job Selection: Observational Study to Validate the Nursing Environment Fit Index Instrument.

New graduate nurses (NGNs) are a precious resource, but their development from advanced beginners to competent nurses is challenging. This qualitative descriptive study explored NGNs' perceptions of strategies that influenced their development in the first 2 years of employment. Semistructured interviews were conducted with a sample of 13 nurses. The study revealed that NGNs learn to master aspects of the nursing role as they construct a professional identity. They identified organizational, educational, and personal strategies as being important to their development, including tailored orientation, opportunities for skill acquisition, and personal support. Few strategies supported the development of professional identity. Mastering the nursing role and constructing a professional identity is central to NGNs' development. Further attention from nursing leaders is needed to promote concurrent development in both dimensions. Nurses with a strong professional identity are more likely to remain in the profession.

Background & objectives:Assessing healthcare seeking behaviour (HSB), healthcare utilization and related out-of-pocket expenditures of Particularly Vulnerable Tribal Groups (PVTGs) of India through a prism of the health system may help to achieve equitable health outcomes. Therefore, this comprehensive study was envisaged to examine these issues among PVTGs of Odisha, India. However, there exists no validated questionnaire to measure these variables among PVTGs. Therefore, a study questionnaire was developed for this purpose and validated.Methods:Questionnaire was constructed in four phases: questionnaire development, validity assessment, pilot testing and reliability assessment. Nine domain experts face validated questionnaire in two rounds, followed by a single round of quantitative content validity. Next, the questionnaire was pretested in three rounds using cognitive interviews and pilot-tested among 335 and 100 eligible individuals for the two sections healthcare seeking behaviour (HSB-Q) and maternal and child healthcare service utilization (MCHSU-Q). Internal consistency reliability was assessed for de novo HSB-Q.Results:On two rounds of expert-driven face validity, 55 items were eliminated from 200 items. Questionnaire showed moderate to high content validity (item-level content validity index range: 0.78 to 1, scale-level content validity index/universal agreement: 0.73; scale-level content validity index/average: 0.96 and multirater kappa statistics range: 0.6 to 1). During the pre-test, items were altered until saturation was achieved. Pilot testing helped to refine interview modalities. The Cronbach alpha and McDonald’s omega assessing internal consistency of HSB-Q were 0.8 and 0.85, respectively.Interpretation & conclusions:The questionnaire was found to be valid and reliable to explore healthcare seeking behaviour, maternal and child healthcare utilization and related out-of-pocket expenditure incurred by PVTGs of Odisha, India.

New graduate nurses have difficulty recognizing and managing the early signs of clinical decline, resulting in a Failure to Rescue (FTR) event and preventable patient death. To address this gap, Garvey developed a series of Clinical Warning Curves as an instructional tool for new graduate nurses in an academic medical center. The Garvey Clinical Warning Curve models depict the progression of clinical changes in six body systems that occur before cardiac arrest. The purpose of this study was to establish the content validity, reliability, and usability of the Garvey Clinical Warning Curves among healthcare experts and new-graduate nurses. The current study was a cross-sectional, observational, validation survey design. Content experts used the content validity index (CVI) to evaluate the Curves. All but the temperature curves were rated as "acceptable" (CVI >0.60) for relevance, clarity, and ambiguity. The new graduate nurses who reviewed the case studies and placed patients onto the Clinical Warning Curves did so similarly, generating high intraclass correlation (ICC) scores. The usability survey components measured the perceptions of acceptability, appropriateness, and feasibility for the use of the six Clinical Warning Curves in practice settings. All components of the Curves had an average score of 4.0 or greater except for the level of complexity which scored 3.88. The Garvey Clinical Warning Curves emerged as valid and reliable tools that aid new graduate nurses in recognizing subtle signs of clinical decline. Because timely recognition and communication of clinical decline are key to preventing FTR events and avoiding patient deaths, it would be beneficial to provide the Clinical Warning Curves as a bedside resource for new graduate nurses during their orientation to the unit or within a nurse residency program.

<p>The COVID-19 pandemic has magnified the growing issue of nurse turnover, especially among new graduate nurses (NGNs). The purpose of this study was to describe, compare, and examine the mentorship relationships of NGNs in Ontario across multiple healthcare settings, and to investigate the relationships between mentorship quality (MQ), occupational coping self-efficacy (OCSE), and turnover intention (TI). A descriptive cross-sectional design was utilized with a sample of 128 NGNs employed in long-term care, community care, and hospital settings </p> <p>The COVID-19 pandemic has magnified the growing issue of nurse turnover, especially among new graduate nurses (NGNs). The purpose of this study was to describe, compare, and examine the mentorship relationships of NGNs in Ontario across multiple healthcare settings, and to investigate the relationships between mentorship quality (MQ), occupational coping self-efficacy (OCSE), and turnover intention (TI). A descriptive cross-sectional design was utilized with a sample of 128 NGNs employed in long-term care, community care, and hospital settings. Data collected using an online survey were analyzed using SPSS version 27. The PROCESS macro was used to test a hypothesized mediation relationship between MQ and TI through OCSE. MQ was found to be the most statistically significant predictor of both OCSE and TI, with no significant mediation effect found. Managers, educators, and policymakers should develop strategies to optimize NGNs’ access to high-quality mentorship experiences, to mitigate negative outcomes associated with NGN turnover.. Data collected using an online survey were analyzed using SPSS version 27. The PROCESS macro was used to test a hypothesized mediation relationship between MQ and TI through OCSE. MQ was found to be the most statistically significant predictor of both OCSE and TI, with no significant mediation effect found. Managers, educators, and policymakers should develop strategies to optimize NGNs’ access to high-quality mentorship experiences, to mitigate negative outcomes associated with NGN turnover.</p>

<p>The COVID-19 pandemic has magnified the growing issue of nurse turnover, especially among new graduate nurses (NGNs). The purpose of this study was to describe, compare, and examine the mentorship relationships of NGNs in Ontario across multiple healthcare settings, and to investigate the relationships between mentorship quality (MQ), occupational coping self-efficacy (OCSE), and turnover intention (TI). A descriptive cross-sectional design was utilized with a sample of 128 NGNs employed in long-term care, community care, and hospital settings </p> <p>The COVID-19 pandemic has magnified the growing issue of nurse turnover, especially among new graduate nurses (NGNs). The purpose of this study was to describe, compare, and examine the mentorship relationships of NGNs in Ontario across multiple healthcare settings, and to investigate the relationships between mentorship quality (MQ), occupational coping self-efficacy (OCSE), and turnover intention (TI). A descriptive cross-sectional design was utilized with a sample of 128 NGNs employed in long-term care, community care, and hospital settings. Data collected using an online survey were analyzed using SPSS version 27. The PROCESS macro was used to test a hypothesized mediation relationship between MQ and TI through OCSE. MQ was found to be the most statistically significant predictor of both OCSE and TI, with no significant mediation effect found. Managers, educators, and policymakers should develop strategies to optimize NGNs’ access to high-quality mentorship experiences, to mitigate negative outcomes associated with NGN turnover.. Data collected using an online survey were analyzed using SPSS version 27. The PROCESS macro was used to test a hypothesized mediation relationship between MQ and TI through OCSE. MQ was found to be the most statistically significant predictor of both OCSE and TI, with no significant mediation effect found. Managers, educators, and policymakers should develop strategies to optimize NGNs’ access to high-quality mentorship experiences, to mitigate negative outcomes associated with NGN turnover.</p>

How do new graduated nurses from a competency-based program demonstrate their competencies? A focused ethnography of acute care settings

The cause of constipation is multifactorial and common problem for patients on hemodialysis. A lack of strong evidence on suitable treatment strategies means there is an unorganized approach to selecting therapies, which can exacerbate constipation or worsen symptoms. Clinicians and patients would benefit from a content and face validated treatment algorithm for treating constipation. In this study, our objective was to develop and content and face validate a constipation treatment toolkit for patients on hemodialysis, consisting of treatment algorithm, and patient information tools (pamphlet and video). Literature searches were performed to develop an initial toolkit using Lynn's method for developing content-valid clinical tools. Content and face validity were evaluated as per Lynn's method for determining content validity; the algorithm was evaluated by Canadian nephrology clinicians, while patient information tools were evaluated by clinicians and patients. Components were rated on a Likert scale for content relevance and on a 5-point scale for face validity. After each round, the content validity index (CVI) score was calculated and revisions were made based on feedback. A total of 23 clinicians and 15 patients were interviewed across three validation rounds. After three rounds, the treatment algorithm achieved content (overall CVI=0.93) and face (91% agreement) validity. Our patient information tools achieved content and face validity (pamphlet overall CVI=0.99, 85.5% agreement; video overall CVI=0.99, 90.5% agreement). A treatment algorithm and patient information toolkit for the treatment of constipation in patients on hemodialysis were content and face validated via expert review. Further research will be needed to ascertain the effectiveness and implementation of this toolkit.

Development of a situational initiation training program for preceptors to retain new graduate nurses: Process and initial outcomes

New graduate nurses (NGN) are the future of healthcare organizations where a shortage of nurses will soon be reality. The transition from a student to a registered nurse can be a demanding and challenging time, and in order to retain new graduate nurses, the transition should be as smooth as possible. The aim of this study was to examine preceptors' education intervention's impact on NGNs' orientation period and their clinical learning environment from NGNs' point of view. This survey was a part of a longitudinal quasi-experimental intervention study. Participating units were randomized into intervention group and control group. The intervention group's preceptors (n=174)were provided a face-to-face education about orientation. NGNs (n=72) were relatively satisfied with the received orientation. However, intervention group was more discontented with their orientation experiences than the control group. The control group's NGNs had longer orientation periods and more feedback discussions. They were also more satisfied with their preceptor's orientation skills and their working environment was more responsive. Even though the impact of the intervention was inconclusive, this study provided us important information about NGNs' first steps towards the nursing profession by giving us clear improvement targets. We need a culture of feedback, individualized orientation and understanding that orientation should be our common interest. Investing in orientation is investing for the future. This study indicated that the increase in knowledge did not translate into everyday practice. This finding will hopefully give rise to discussion within organizations on how to utilize employees' gained knowledge more effectively.

Objective/Background: The nursing shortage uniquely impacts rural communities as staffing issues often result in emergency department closures and leave communities without adequate healthcare. One contributing factor in this crisis is difficulty recruiting and retaining new graduate nurses (NGN) rurally. Improving transition to practice for NGNs is a potential solution to this problem. This study explores the new graduate nurses’ lived experience when transitioning to rural nursing practice.Methods: A descriptive phenomenological approach was used. Seven participants completed virtual surveys and virtual, semi-structured focus groups exploring the new graduate nurses transition to practice experience, underpinned by Patricia Benner’s From Novice to Expert model. Transcripts were analysed using thematic concept mapping.Results: Three themes were derived across the stages of transition to practice: education, mentorship and both intrinsic and extrinsic expectations on NGNs. Each phase in the first two years of practice had unique characteristics, most significantly, a six-month delay occurs to accommodate acquisition of non-nursing skills, which deviates from Benner’s model.Conclusions: This research emphasizes the importance of supporting NGNs during the first two years of transition to rural practice. The complex role of the rurally practicing registered nurse requires approximately six months more time than what is described in Benner’s model to develop competence. A focus on nursing education that begins at the undergraduate level and continues into practice is required. A shift to focus on supporting the wellbeing of the NGN is a key intervention; as well as improving mentorship and management support through education and policy change.

Face Validity

What influences new graduate nurses' core competencies transformation to clinical in China? A cross-sectional study

The Role of the Nurse Leader in Reversing the New Graduate Nurse Intent to Leave

Background: There is a growing shortage of critical care nurses. New graduate nurses (NGN) are increasingly hired into critical care settings, though NGN job turnover is estimated between 18-60% in the first year of practice. The COVID-19 pandemic exacerbated nurse turnover and the need to rapidly train new ICU nurses while also employing effective retention management strategies.
 Aim: To highlight the success of a NGN Critical Care Fellowship Program (CCFP) within the existing health system’s NGN Residency Program prior to and during the COVID-19 pandemic.
 Methods: The CCFP was launched in 2016 with 7 participating ICUs. The NGNs participate in the medical center’s existing 1-year NGN Residency Program and spend a total of 24 weeks orienting in 3 different ICUs. Orientation concludes based on a performance evaluation and readiness to work independently. NGNs are mentored and supported throughout their first year in practice through monthly debriefing of clinical and preceptor experiences.
 Results/Findings: Between 2016-2022, a total of 65 NGNs have participated in the CCFP. Sixty fellows completed orientation and were hired into an adult ICU during their orientation period. Retention of CCFP NGNs after 1 year was 96% (n=48/50), 2 years was 97% (n=33/34) and 3 years was 96% (n=23/24).
 Conclusions: Results demonstrate the development of an educationally robust, emotionally compassionate program, concentrated on the development, training and focused support of the NGN can be successfully implemented and sustained over time.

ObjectiveThis study aimed to assess the content and face validity index of the development of the understanding, attitude, practice and health literacy questionnaire on COVID-19 (MUAPHQ C-19) in the Malay language.MethodsThe development of the MUAPHQ C-19 was conducted in two stages. Stage I resulted in the generation of the instrument’s items (development), and stage II resulted in the performance of the instrument’s items (judgement and quantification). Six-panel experts related to the study field and ten general public participated to evaluate the validity of the MUAPHQ C-19. The content validity index (CVI), content validity ratio (CVR) and face validity index (FVI) were analysed using Microsoft Excel.ResultsThere were 54 items and four domains, namely the understanding, attitude, practice and health literacy towards COVID-19, identified in the MUAPHQ C-19 (Version 1.0). The scale-level CVI (S-CVI/Ave) for every domain was above 0.9, which is considered acceptable. The CVR for all items was above 0.7, except for one item in the health literacy domain. Ten items were revised to improve the item’s clarity, and two items were deleted due to the low CVR value and redundancy, respectively. The I-FVI exceeded the cut-off value of 0.83 except for five items from the attitude domain and four from the practice domains. Thus, seven of these items were revised to increase the clarity of items, while another two were deleted due to low I-FVI scores. Otherwise, the S-FVI/Ave for every domain exceeded the cut-off point of 0.9, which is considered acceptable. Thus, 50-item MUAPHQ C-19 (Version 3.0) was generated following the content and face validity analysis.ConclusionsThe questionnaire development, content validity, and face validity process are lengthy and iterative. The assessment of the instruments’ items by the content experts and the respondents is essential to guarantee the instrument’s validity. Our content and face validity study has finalised the MUAPHQ C-19 version that is ready for the next phase of questionnaire validation, using Exploratory and Confirmatory Factor Analysis.