Shortage Of Critical Care Nurses Research Articles

Improving Staffing in the ICU with New Graduate Nurses: A Novel Critical Care Fellowship Program

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.

Staff shortages in critical care units: Critical care nurses experiences

IntroductionThe nursing activities in critical care units globally and in Namibia are influenced by a shortage of critical care nurses. This shortage led to hospitals resorting to a variety of staffing strategies such as a team nursing model, variable staffing, the use of agency nurses and float staff to achieve the recommended nurse to ratio of 1:1 or 1:2. AimThe purpose of the study was to explore the experiences of critical care nurses regarding staff shortages in critical care units. MethodsA descriptive qualitative design was applied. Purposive sampling was used to select a sample from a total population of 18 critical care nurses. Data saturation was reached by the 11th participant, leading to a final sample of 11. Data were collected through individual interviews using a semi-structured interview guide. Data were analysed manually using the approach described by Creswell and Creswell (2018). FindingsSix themes emerged from the data analysis, i.e., critical care work environment, quality of care, workforce planning, staffing strategies, job satisfaction and continuous professional development. Findings from the study revealed that participants worked with an increased nurse to patient ratio that consequently influenced the quality of care rendered to patients. ConclusionThe staff shortages influenced the number of patients that was assigned per nurse. Accordingly, each nurse had to care for more than two patients. The subsequent increased workload influenced the provision of quality nursing care.

Factors influencing nurses' intentions to leave adult critical care settings.

The shortage of critical care and specialist nurses has been an ongoing issue for many decades. Although all areas of nursing are affected, critical care areas are especially vulnerable to recruitment and retention problems. High nursing turnover in critical care areas is evident; however, research into the factors that influence nurses' intentions to leave adult critical care areas is limited. To explore factors that may influence nurses' intentions to leave adult critical care areas. To appraise existing evidence and highlight gaps in knowledge regarding factors that may influence nurses' intentions to leave adult critical care areas. A systematic mixed-method literature review was conducted. The search strategy was developed using the List, Keep and Delete approach, a framework used to identify search terms for systematic health care reviews. The following key words were used: intentions to leave, nurses, adult and critical care. The databases searched were BNI, CINAHL, PubMed, PsycINFO, Embase and Health B Elite from 2005 to 2016. Primary data from non-critical care areas and neonatal and paediatric critical care areas were excluded. Comprehensive supplementary searching was performed. Papers were critically appraised using the NICE (2012) checklists. Data were analysed using the Braun and Clarke (2006) thematic framework. A total of 15 studies, including 13 cross-sectional studies and 2 qualitative studies, were reviewed. Three main themes emerged following data analysis. These themes were quality of the work environment, nature of working relationships and traumatic/stressful workplace experiences. The literature review highlighted the need for further research and greater understanding of how these themes may impact critical care nurses. Nurse managers and leaders should consider these findings when developing strategies to improve nurse retention. The shortage of critical care nurses is currently a global issue impacting costs and quality of patient care.

Identifying the key predictors for retention in critical care nurses.

The aim of this study was to explore the key predictors of retention in nurses working in critical care areas. The shortage of critical care nurses is reaching crisis proportions in Canada and throughout the industrialized world. Identifying the key influencing (i.e. person and organizational) factors and intermediary factors (i.e. job satisfaction, engagement, professional quality of life and caring) that affect intent to leave is central to developing optimal retention strategies for critical care nurses. As part of a larger mixed-methods study, we used a quantitative, cross-sectional research design. A novel framework: the Conceptual Framework for Predicting Nurse Retention was used to guide this study. On-line survey data were collected from on a convenience sample of 188 registered nurses working in critical care areas of hospitals in the province of Manitoba, CANADA in 2011. Twenty-four per cent of the respondents reported that they would probably/definitely leave critical care in the next year. Based on bivariate and regression analyses, the key influencing factors that were significantly related to the intermediary factors and intent to leave critical care and nursing included: professional practice, management, physician/nurse collaboration, nurse competence, control/responsibility and autonomy. Of the intermediary factors, all but compassion satisfaction were related to intent to leave both critical care and nursing. This study highlights the importance of exploring multiple organizational and intermediary factors to determine strategies to retain critical care nurses. The findings also support the Conceptual Framework for Predicting Nurse Retention as a theoretical basis for further research.

Student nurses in critical care: benefits and challenges of critical care as a learning environment for student nurses

This article is a literature view of student nurses' experiences of critical care and the value of their experience to the nursing community. To explore the literature in relation to the value of critical care as a learning environment, the experiences and perceptions of student nurses in critical care and the impact of mentors on the experience. The shortage of critical care nurses and increasing numbers of acutely ill patients being cared for outside critical care areas has highlighted the importance of nurses being equipped with appropriate knowledge and skills to care for such patients. Student nurses have been experiencing critical care for many years and though it is accepted that it can be a stressful environment, there has been little empirical evidence of this. As anxiety has been said to interfere with learning, how much of an impact can this have and can anything be done about it? Using Medline, CINAHL and British Nursing Index (BNI) and search terms including nursing students or student nurses, critical or intensive care and perceptions, expectations or pre-conceptions, a literature search was carried out. Some articles explored registered nurses experiences, despite the titles, so this was set as an exclusion criteria. Critical care offers a wealth of learning opportunities which are only available in high acuity areas. Though students can be very anxious before commencing their placements, mentors and higher education play an important part in helping them overcome this. The challenge is how to work together to provide effective support systems for the benefit of the students.

A Second Set of Eyes: An Introduction to Tele-ICU

A Second Set of Eyes: An Introduction to Tele-ICU

Outcome Evaluation of a New Model of Critical Care Orientation

The shortage of critical care nurses and the service expansion of 2 intensive care units provided a unique opportunity to create a new model of critical care orientation. The goal was to design a program that assessed critical thinking, validated competence, and provided learning pathways that accommodated diverse experience. To determine the effect of a new model of critical care orientation on satisfaction, retention, turnover, vacancy, preparedness to manage patient care assignment, length of orientation, and cost of orientation. A prospective, quasi-experimental design with both quantitative and qualitative methods. The new model improved satisfaction scores, retention rates, and recruitment of critical care nurses. Length of orientation was unchanged. Cost was increased, primarily because a full-time education consultant was added. A new model for nurse orientation that was focused on critical thinking and competence validation improved retention and satisfaction and serves as a template for orientation of nurses throughout the medical center.

Evaluation of the 12-hour Shift Trial in a Regional Intensive Care Unit

Given the shortage of critical care nurses, emphasis has been placed upon improving their working lives through the implementation of flexible work hours. This descriptive exploratory study evaluated the effects of the implementation of the 12-hour roster in a regional intensive care unit (ICU). Staff (n = 19) completed a survey 12 weeks following the implementation of the 12-hour roster. The study demonstrated widespread acceptance (92%) positive impact on physical and psychological well-being and increased work satisfaction (58%) for the nursing participants. Similarly, nurses working both the 8- and 12-hour rosters (75%), the doctors and allied health care workers all identified increased continuity of patient care as an outcome of the 12-hour shift. Participants strongly agreed that 12-hour rostering was a good recruitment (67%) and retention (75%) strategy. In an environment with considerable shortages of experienced critical care nurses, the use of flexible shift patterns such as the 12-hour roster was a positive recruitment and recruitment strategy.

Need critical care nurses? Inquire within

A serious shortage of critical care nurses encouraged a nurse-manager to develop intensive care unit nurses through an innovative preceptor program.

A qualitative study of the Victorian critical care nurse labour force

A perceived shortage of critical care nurses in Victorian public and private hospitals, largely attributed to an increase in attrition from critical care areas and a failure to attract sufficient replacement for those who leave, served as the impetus for this project, which explored registered nurses’ (RNs’) attraction to and attrition from critical care practice areas. Multiple sources of data were utilised, including a series of individual interviews and focus group discussions with critical care students and past and current critical care nurses, telephone interviews with RNs who had completed a critical care re-entry course, interviews with key informants and an analysis of applications to study in a critical care postgraduate nursing course. Results revealed that the challenge of the work, intel-lectual stimulation, the high level of autonomy, use of increased knowledge and career development were primary motivators for RNs to engage in critical care practice. Limitations to lifestyle choices, practice demands, political changes within critical care arenas, inap-propriate remuneration and a lack of career structure and opportunity were salient features of why employment was discontinued within the critical care practice areas.

Satisfaction with a new model of professional practice in critical care.

Although only a moderately severe general nursing shortage exists at this time, the shortage of critical care nurses remains severe. Innovative administrators across the country are trying new professional practice models aimed at maximizing autonomy and freeing nurses from mundane tasks with the hopes of retaining experienced clinicians. We implemented a professional practice model in which unlicensed assistive personnel were trained to assist registered nurses in patient care. Monies saved by increasing nurse-patient ratios were distributed to staff nurses. Acuity-based staffing was maintained and professional practice encouraged through self-scheduling and elimination of hierarchical relationships. Satisfaction among nurses working in the program increased in terms of coworkers and supervision. Patient satisfaction with the quality of care provided did not change during the course of the program. Data from interviews demonstrated that staff were satisfied with the quality of care provided by the assistants, but the changes in the staffing ratios coupled with the increased responsibility for overseeing the assistants caused stress in the nurses. We conclude that a professional practice model in which critical care assistants are added to the work force is a viable option, but creative methods of addressing the stress of increased workload are needed.

Computerized clinical simulations: a strategy for staff development in critical care

Identifying the learning needs of employees and evaluating the results of staff development offerings are essential elements of the responsibilities of the staff development educator. High patient acuity, the shortage of critical care nurses, and rapidly changing technology within the critical care environment demand the provision of staff development offerings that are appropriate for the learning needs of critical care nurses and the evaluation of the effect of programs on critical care nursing practice. The purposes of this descriptive, correlational study were to compare the ability of a knowledge test, a self-evaluation tool, and computerized clinical simulations to discriminate between nurses with varied levels of knowledge and experience, and to compare the learning needs identified from the three types of evaluative instruments. Each subject (n = 142) completed the Basic Knowledge Assessment Tool for Critical Care, Cardiovascular Self-Evaluation Tool, and four computerized clinical simulations. Both the Basic Knowledge Assessment Tool and the Cardiovascular Self-Evaluation Tool discriminated between experienced/inexperienced and Advanced Cardiac Life Support-certified/noncertified critical care nurses. The computerized clinical simulations discriminated according to Advanced Cardiac Life Support certification, but not between experienced and inexperienced critical care nurses. The computerized clinical simulations identified more specific learning needs than did the Basic Knowledge Assessment Tool or Cardiovascular Self-Evaluation Tool. The evidence for discriminant validity, adequate internal consistency reliability, and ease of administration supports the continued use of these two tools as methods for critical care staff development needs assessment and evaluation. In addition, the study findings support the use of computerized clinical simulations as an adjunct to other needs assessment and evaluation methods in nursing staff development.

The shortage of critical care nurses: readership survey results

Articles| June 01 1988 The shortage of critical care nurses: readership survey results JG Alspach JG Alspach Search for other works by this author on: This Site PubMed Google Scholar Crit Care Nurse (1988) 8 (3): 14–15. https://doi.org/10.4037/ccn1988.8.3.14 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Cite Icon Cite Get Permissions Citation JG Alspach; The shortage of critical care nurses: readership survey results. Crit Care Nurse 1 June 1988; 8 (3): 14–15. doi: https://doi.org/10.4037/ccn1988.8.3.14 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentCritical Care Nurse Search Advanced Search You do not currently have access to this content.