Nurse Orientation Program Research Articles

An Educational Intervention to Improve Simulation Facilitation by Nurse Educators in a Large Canadian Academic Hospital: A Mixed Methods Evaluation

BackgroundBest practices in simulation-based education indicate that sessions should be facilitated by a trained simulation instructor. A large academic Canadian hospital required instructors to facilitate simulation-based education in a corporate nursing orientation program. MethodThe Plan-Do-Study-Act framework was used to develop a simulation facilitation curriculum using mixed methods to evaluate the program. ResultsThe mean scores on the Observational Structured Assessment of Debriefing tool were greater than the target of three out of five. Themes identified from the qualitative analysis focused on a safe learning environment and use of a framework for debriefing. ConclusionA simulation faculty development curriculum for nurse educators with support from peers improved the quality of debriefing in a corporate nursing orientation program.

Using action research to evaluate a nursing orientation program in a multicultural acute healthcare setting

ObjectivesCompetence motivates newly employed nurses to provide high-quality care, which leads to appropriate patient care and satisfaction. A nursing orientation program can have a positive impact on new nurses who are joining healthcare organizations. The research examined the orientation program for new nurses in a multicultural setting to redesign the program. MethodsThe study was carried out in a multicultural tertiary setting. Action research was used as a research strategy with qualitative content analysis and quantitative evaluation. Seventy nurses were part of the orientation program. The competence of the nurses was assessed using the Nurse Competence Scale. Focus-group discussions were also conducted to find the views of the beneficiaries about the program. ResultsThe study revealed that the overall competence was high, and there was an overall gain in the competence score (5.48%) among the nurses. Among their competence in different dimensions, new nurses had a maximum gain in competence for the dimension of ensuring quality. However, they showed low competence gain in teaching coaching. The results show that the difference in the overall pre- and post-test scores was statistically significant (P < 0.05) in all dimensions except teaching coaching and managing situations, and the program was effective. However, a few challenges were identified in the program. ConclusionsNew nurses were found to be competent, and the orientation program had a significant impact on the competence of the nurses. The findings emphasized the need for modification of some content and strategy for future programs. The strategies developed from the findings were presented. This helps hospitals to consider examining specific aspects of the orientation program and redesigning it so it can enrich the experiences of new nurses.

FACTORS AFFECTING NURSING STAFF COMMITMENT AT GENERAL HOSPITALS IN DAMIETTA CITY

Background: Commitment represent a strong desire to maintain nursing staff of an organization, it reflects nursing staff to achieve the organization's goals and values, a desire to stay with the organization and willingness to exert much effort to organization. Aim: assess the factors affecting nursing staff commitment at general hospitals in Damietta city. Methods and methods: A descriptive design was utilized with a sample of 421 nursing staff working at all inpatient units at Damietta general hospitals. Tools of data collection: The study tool consists of three parts ; part (I) :personal characteristicsincluded personal and job characteristics , part (II) :Three-component organizational commitment questionnaire to measure types of nurses' commitment and the degree of nurses' commitment to their work, part (III) :factors affecting nurse's commitment questionnaire to assess the factors affecting nurses' commitment at workplace. Results: More than two thirds 70.5% of nursing staff had moderate total commitment. Conclusion: Revealed that the highest percentage among factor affecting commitment was feeling their place of work is equitable and the lowest one was for voice concern. Therefore, the study Recommendations: Orientation program for new nurses to know the goals, policies, objectives and regulation of the organization and evaluate the training needs of nursing staff periodically to develop their skill and information, regular meeting between hospital administrations, nursing administrator and nursing staff to express their concerns, and opinions and discuss their work problem and solve it.

An Interprofessional Simulation-Based Orientation Program for Transitioning Novice Nurses to Critical Care Roles in the Emergency Department: Pilot Implementation and Evaluation

The emergency department (ED) relies on high-functioning teams to deliver consistent and safe patient care. Experts recommend that both emergency physicians and ED nurses participate in team training. However, there are currently no nationally accepted curricula for either profession to embed this training in their professional development, particularly for health workers who are novice or transitioning into critical care roles. An interprofessional educator team designed and embedded a series of simulation scenarios within a novel orientation program for novice nurses transitioning to critical care roles in the ED to teach clinical and teamwork skills for conjoint groups of resident physician and novice nurse learners. The team created four interprofessional simulations to represent the acuity and breadth of patient populations in the ED critical care bays. To date, the team has conducted 24 two-week orientation sessions for 48 nurses and 51 resident physicians. Overall mean scores for the Debriefing Assessment for Simulation in Healthcare (DASH) instrument from nursing participants in the first 18 sessions were high. Qualitative evaluation data from both nurses and physicians demonstrated a positive impact of the simulations and provided insight into respective roles, identities, and priorities across professions. Participant feedback led to iterative steps in refinement of the simulations, including adjustments in debriefings and logistics of the orientation program. A team-based interprofessional simulation program was found to be feasible and acceptable for practicing novice physicians and nurses as part of a nursing critical care orientation program in the ED. Future work will assess the program's long-term impact on teamwork and safety in the actual clinical environment.

Increasing Confidence Through the Development of a Transition-to-Practice Orientation Program for the Experienced Nurse.

A formalized orientation program for experienced nurses was modeled after a program for new graduate nurses. Within a year, experienced nurses rotated through teaching stations, including simulations of shock and respiratory failure. Participants completed pre- and postsurveys and scored self-confidence on a Likert scale. Surveys showed a significant increase in participants' confidence related to elements in their new role. Future plans include a retention rate comparison of participants in this program versus nonparticipants.

Hemşirelerin oryantasyon programında kullanılan kardiyovasküler modül eğitiminin etkinliği

Amaç: Oryantasyon amacıyla yapılan eğitim; kurumda yeni işe başlayan veya çalıştığı alandan farklı bir bölümde görevlendirilen bireylere, çalışacakları alana özgü bilgi, beceri ve tutum kazandırmak için planlanan eğitimlerdir. Çalışma, hemşirelik oryantasyon programı dahilinde gerçekleştirilen kardiyovasküler modül eğitiminin etkinliğini değerlendirmek amacıyla yapıldı. Yöntem: Tanımlayıcı ve retrospektif olarak tasarlanan araştırmanın evrenini 138 hemşirenin veri kayıtları oluşturdu. Çalışma, JCI standartları doğrultusunda hazırlanmış bir hastanenin oryantasyon programı dahilinde gerçekleştirildi. Hemşirelere ait demografik veriler kurum kayıtlardan elde edilirken, hemşirelerin eğitim öncesi ve sonrası kardiyovasküler bilgi düzeyi ise 25 soruyu içeren ön test-son test puanlarından hesaplandı. Her soru dört puan üzerinden toplam 100 puan olarak değerlendirildi. Veriler SPSS 17.0 programında, tanımlayıcı istatistik, ANOVA ve bağımlı örneklerde t testi kullanılarak belirlendi. Bulgular: Çalışmaya dahil edilen hemşirelerin yaş ortalaması 24.0±3.1 (19-37 yaş) bulundu. Çalışmaya katılanların %68.1’ini (n=94) lisans mezunu hemşireler oluştururken, %55.1’i (n=76) daha önce herhangi bir kurumda çalışmadığını bildirdi. Ön testten alınan puanların ortalaması 58.5±15.1 iken, son test puanlarının ortalaması 89.4±10.3 olarak saptandı. Alt gruplara göre yapılan analizlerin tamamında kardiyovasküler modül eğitimin etkili olduğu belirlendi. Sonuç: Oryantasyon programlarında yer alan kardiyovasküler modül eğitimlerin kardiyovasküler kliniklerde (yetişkin ve pediatrik) görev alacak hemşirelerin eğitim düzeyini arttırdığı görüldü.

Building an Endoscopy Nurse Orientation Program.

Building an Endoscopy Nurse Orientation Program.

Developing and Standardizing an Orientation for Outpatient Charge Nurses.

Charge nurses often act as the eyes and ears of the unit. They are leaders, clinical experts, educators, policy enforcers, and patient advocates. They ensure patients and caregivers receive high-quality, safe, and evidence-based care. With the shift in health care from the in-patient to outpatient setting, patients are becoming more acute and complex for staff nurses. Charge nurses are pivotal in the successful care and management of these patients. Unfortunately, charge nurses often receive minimal training and are placed in this role with inadequate preparation and support. This can lead to feelings of anxiety, stress, and dissatisfaction with their job. Providing nurses with structured education about this role can create a safer and more positive work environment. This article discusses the development, implementation, and evaluation of a charge nurse orientation program in the outpatient infusion setting. [J Contin Educ Nurs. 2019;50(11):517-521.].

Progressive care orientation: Incorporating a program that supports transition to practice

Objective: Progressive care units (PCUs), also sometimes called intermediate care units, improve the utilization of beds within intensive care units while adjusting the workload of the nurse. PCUs encompass a scope of care between the critically ill patient and the acute care patient. Owing to the advanced skills set needed, nurses with limited experience in this setting may benefit from an orientation course in addition to on-the-job training. The purpose of this project was to develop and evaluate an orientation program for nurses working in progressive care settings at a multi-site hospital system.Methods: Kolb’s experiential learning theory and adult learning theory were used as a framework to plan and design a 2-day instructional program that addressed the cognitive, psychomotor, and affective aspects of learning needs.Results: A total of 244 participants completed the 2-day program. The teaching strategies were shown to be effective, as indicated by survey results reporting a mean score of 4.36 on a 1-5 Likert scale (with a score of 1 indicating the presenter did not clearly articulate the subject and 5 indicating that the presenter clearly articulated the subject). The participants stated that they intended to make changes in practice and identified changes to improve the program (e.g., inclusion of high-fidelity manikins, patient-controlled anesthesia).Conclusions: Incorporating a specialized training program for newly licensed nurses and nurses transitioning to the PCU with less than 2 years’ experience in this setting may improve the nurse’s confidence and performance of patient care skills in this highly acute environment.

Registered Nurses’ Perception about Pain Management of Hospitalized Patients in One of the Governmental Hospitals in Dubai, UAE: A Cross-Sectional Study

Background: Chronic and acute pain are highly prevalent, especially among hospitalized surgical patients, patients with cancer, and general medical inpatients. More than 50% of patients experience significant pain. Health professionals’ knowledge and attitude concerning pain management have often been referred to as insufficient. This study explored the attitudes and knowledge of nurses working in one of the government hospitals in the UAE, with regard to pain management. Methods: A quantitative, descriptive, cross-sectional design was used to examine nurses’ perception (knowledge and attitude) about pain using the Nurses’ Knowledge and Attitudes Survey Regarding Pain (NKASRP). We targeted the nursing field in order to assess nurses’ perceptions of pain management. A convenience sample of 200 nurses working at one of the government hospitals in the UAE participated in this study. Results: Participants who scored <75% were considered to have poor knowledge and a nonstandard attitude. Participants who scored >75% were considered to have adequate knowledge and a positive attitude. The study revealed that the knowledge and attitude percentage means of correct answers about pain management was 61% (SD: ±11.97%; 95% CI 59.33–62.6%). Inadequate knowledge and attitude featured in 89.5% and adequate knowledge and attitude in 10.5% of all participants. Previous pain management education experience was statistically significant p < 0.05. Conclusion and Recommendation: This study showed that nurses reflected an inadequate knowledge and attitude regarding pain management. Nurses’ perception about pain management was higher among younger staff than those with longer experience. Pain management education has an impact on knowledge and attitude. There is a need to follow innovative approaches in training. Pain management education is an essential part of the nursing orientation program and should be conducted throughout the year to target all nurses. New evidence-based approaches to pain management among nurses should be explored and tested, using the NKASRP as a baseline and follow-up measure.

Effective orientation programs for new graduate nurses: A systematic review

To determine the most effective orientation program for new graduate nurses (NGNs) in hospital settings. A systematic review of existing literature was conducted following a search of the electronic databases Science Direct, PubMed, EBSCOhost, ProQuest, and Wiley Online (2008-2018). Searches utilized the following keywords nurse orientation, new nurse orientation, practical orientation, nurse transition, and nurse transition program. A total of fourteen studies met our review criteria. Evidence from these studies showed that current orientation protocols consist of preceptorship, classes, and simulations of patient care. The most efficacious orientations had well-established goals and utilized proven learning materials, support systems such as preceptorship and mentorship, learning methods, and evaluation instruments within the organization. Well-designed orientation programs will result in positive effects on NGNs and patient care in the hospital.

Millennial School Nurses: A Roundtable Discussion.

School nurses are proportionally older in age as compared to the overall U.S. nursing workforce. In anticipation of a school nurse workforce shortage in the next few years, we must focus our attention on developing and implementing orientation and transition programs for new school nurses, many of whom represent the millennial generation. Formative experiences are thought to create specific characteristics and difference between generations; yet, stereotypes are sometimes present in defining generations. The NASN School Nurse Editorial Advisory Board interviewed four millennial school nurses to highlight the need to embrace this new generation as they enter the specialty practice of school nursing.

Disparities in the delivery of pediatric oncology nursing care by country income classification: International survey results.

In 2014, a task force of the International Society of Paediatric Oncology (SIOP) Paediatric Oncology in Developing Countries Nursing Workgroup published six baseline standards to provide a framework for pediatric oncology nursing care in low- and lower-middle income countries (L/LMIC). We conducted an international survey in 2016-2017 to examine the association between country income level and nurses' resporting of conformity to the standards at their respective institutions. Data from a cross-sectional web-based survey completed by nurses representing 54 countries were analyzed (N=101). Responses were clustered by relevance to each standard and compared according to the 2017 World Bank-defined country income classification (CIC) of hospitals. CIC and nurse-to-patient ratios in inpatient wards were strongly associated (P<0.0001). Nurses in L/LMIC prepared chemotherapy more often (P<0.0001) yet were less likely to have access to personal protective equipment such as nitrile gloves (P=0.0007) and fluid-resistant gowns (P=0.011) than nurses in high-resource settings. Nurses in L/LMIC were excluded more often from physician/caregiver meetings to discuss treatment options (P=0.04) and at the time of diagnosis (P=0.002). Key educational topics were missing from nursing orientation programs across all CICs. An association between CIC and the availability of written policies (P=0.009) was found. CIC and the ability to conform to pediatric oncology baseline nursing standards were significantly associated in numerous elements of the baseline standards, a likely contributor to suboptimal patient outcomes in L/LMIC. To achieve the goal of high-quality cancer care for children worldwide, nursing disparities must be addressed.

Playing the game: A grounded theory of the integration of international nurses

BackgroundMigration trends to Australia have seen an increase in international nurses, with twenty-nine percent of current registered nurses having received their first nursing qualification outside of Australia. The process international and local nurses navigate to enable successful integration into the Australian healthcare system is unclear. AimTo explore how international nurses and Australian nurses adapt to work together in the Australian healthcare system and to develop a theory that explains this process. MethodsGrounded theory methodology was used. Concurrent data collection/generation and analysis of online-survey data (n = 186) and in-depth interviews (n = 15) was undertaken. Storyline was used as a technique of analysis to develop, construct and present the theory. Focus groups (n = 9 + 7) were conducted to confirm the relevance of the theory. FindingsNurses work together to enable successful integration of international nurses. Four phases underpin this adaptation to the cultural norms of the workplace: (i) Joining the game; (ii) Learning the game, (iii) Playing by the rules, and (iv) The end game. These phases comprise the grounded theory Playing the game: Integration of internationally qualified registered nurses in the Australian healthcare system. DiscussionAdditional orientation programs and collegiate support for international nurses were significant factors influencing successful adaption to the cultural context of the work environment. Defining the role and scope of practice of the registered nurse in the Australian context provided challenges. ConclusionSupportive colleagues were critical to successful integration and retention of experienced nurses irrespective of where nurses obtain their nursing qualification. Additional orientation programs for international nurses could improve the experience of nurses migrating to work in Australia.

Optimized Radiation Oncology Nurse Orientation Program

Optimized Radiation Oncology Nurse Orientation Program

Precepting: A literature review.

The purpose of this literature review is to examine studies evaluating preceptorships within nursing orientation or education programs. Nursing education in the classroom focuses on the theoretical aspect of nursing care as opposed to the clinical experience of nursing education that allows for the hands-on practical experience of nursing. The clinical experience is an integral part of the education process for both students and experienced nurses at various career transitions. Quality clinical experiences require practice partnerships, particularly in the form of preceptorships. Using data reported in previous studies, we examined preceptor selection criteria and responsibilities, motivators to encourage nurses to serve as preceptors, and preceptors' and preceptees' perceptions about the preceptor role. By synthesizing the literature describing previous orientation programs, we underscore the importance of the preceptor in the precepting process associated with orientation or clinical education programs. This review culminates with an evidence-based design for devising policy governing preceptor programs. Specifically, suggestions are forwarded for (1) preceptor selection, preparation, responsibilities, support, and workload and (2) preceptee preparation and support.

Abstract No. 438 - Creation and implementation of the first graduate nurse orientation program specifically designed for IR at UVA: process, template, and lessons learned

Abstract No. 438 - Creation and implementation of the first graduate nurse orientation program specifically designed for IR at UVA: process, template, and lessons learned

A Newly Licensed Nurse Orientation Program Evaluation: Focus on Outcomes

The aim of this project was to evaluate the effectiveness and outcomes of a redesigned newly licensed nurse orientation program. A unique aspect of this program was an end-of-orientation simulated four-patient assignment that was designed to assess five categories of critical thinking: prioritization and delegation, problem recognition, clinical decision making, clinical implementation, and reflection. Newly licensed nurses' critical thinking was measured by the Advisory Board's Critical Thinking Diagnostic tool at 10 weeks, 6 months, and 12 months. Findings showed that in all five categories of critical thinking, a significant increase was found between the 10-week and 6-month evaluation. Two of the categories-prioritization and delegation, and problem recognition-were found to have a significant increase from the 6-month evaluation to the 12-month evaluation. In addition, newly licensed nurses reported improvement in their confidence and in their preparation to work independently. J Contin Educ Nurs. 2017;48(1):22-28.

Facilitating a Major Staffing Transition in a State Psychiatric Hospital With Changes to Nursing Orientation.

A large state psychiatric hospital experienced a state-mandated Reduction in Force that resulted in the abrupt loss and rapid turnover of more than 40% of its nursing and paraprofessional staff. The change exemplified current national trends toward downsizing and facility closure. This article describes revisions to the nursing orientation program that supported cost containment and fidelity to mission and clinical practices during the transition. An existing nursing orientation program was reconfigured in alignment with principles of rational instructional design and a core-competencies model of curriculum development, evidence-based practices that provided tactical clarity and commonality of purpose during a complex and emotionally charged transition period. Program redesign enabled efficiencies that facilitated the transition, with no evidence of associated negative effects. The process described here offers an example for hospitals facing similar workforce reorganization in an era of public sector downsizing.

Development and application of an ICU new nurses orientation program based on the Miller pyramid competency model

Objective To develop and apply an ICU orientation program based on the Miller pyramid competency model. Methods 45 new ICU nurses in 2013 and 2014 were selected as the experimental group. The experimental group was oriented by the new program,including the orientation of preceptors, workshop-centered orientation courses, checklists-precepting and comprehensive competency evaluation methods. 39 new ICU nurses in 2011 and 2012 were selected as the control group. The control group was oriented by the conventional program, including focused theory classes and traditional precepting.New nurses' satisfaction with the orientation and the competency were analyzed before and after intervention in two groups. Results Satisfaction with the orientation, self-evaluated competency and peer-evaluated competency in the experimental group were(16.71±1.19) scores, (126.52±3.31) scores and (90.00±2.68) scores respectively, which were much better than the control group and had statistically significant difference in two groups. Conclusions The ICU new nurse orientation program based on the Miller pyramid competency model can improve the new nurses' satisfaction with the orientation and the competency after the orientation. Key words: Miller; Competency; Intensive care unit; Orientation