Overview

Nurses have the distinct honor of caring for patients as they enter this world, when they leave this world, and at multiple points in between. Throughout all of these patient care experiences, one common theme is essential, patient safety. At this time in nursing, with the looming nursing shortage, more and more new graduates are being hired into a variety of different health care roles and are expected to provide safe patient care while juggling multiple patient assignments. Although placed into these roles, many nurse graduates report that they don't feel prepared to transition to practice and provide safe patient care. The stress felt by these new graduate nurses can lead to decreased satisfaction, comfort, and confidence, all of which can lead to increased problems with patient safety. Due to the fact that new graduate nurses may not be prepared to provide safe patient care, transition programs are being utilized to assist in the transition from school to practice.

Education Category: Management
Release Date: 04/29/2024
Expiration Date: 04/28/2027

Table of Contents

Audience

This course is designed for new nurses and members of the nursing team responsible for helping integrate new nurses into practice.

Accreditations & Approvals

In support of improving patient care, TRC Healthcare/NetCE is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. NetCE is accredited by the International Accreditors for Continuing Education and Training (IACET). NetCE complies with the ANSI/IACET Standard, which is recognized internationally as a standard of excellence in instructional practices. As a result of this accreditation, NetCE is authorized to issue the IACET CEU.

Designations of Credit

NetCE designates this continuing education activity for 1 ANCC contact hour(s). NetCE designates this continuing education activity for 1.2 hours for Alabama nurses. AACN Synergy CERP Category C. NetCE is authorized by IACET to offer 0.1 CEU(s) for this program.

Individual State Nursing Approvals

In addition to states that accept ANCC, NetCE is approved as a provider of continuing education in nursing by: Alabama, Provider #ABNP0353, (valid through July 29, 2025); Arkansas, Provider #50-2405; California, BRN Provider #CEP9784; California, LVN Provider #V10662; California, PT Provider #V10842; District of Columbia, Provider #50-2405; Florida, Provider #50-2405; Georgia, Provider #50-2405; Kentucky, Provider #7-0054 through 12/31/2025; South Carolina, Provider #50-2405; West Virginia RN and APRN, Provider #50-2405.

Course Objective

The purpose of this course is to provide new nurses, nurse managers, leaders, and educators with information about transition to practice programs, including how to implement these programs in the healthcare setting, in order to improve care and safety.

Learning Objectives

Upon completion of this course, you should be able to:

  1. Explain the purpose of transition to practice programs for new graduate nurses.
  2. Identify the consequences associated with poor transition to practice.
  3. Discuss Patricia Benner's novice to expert theory.
  4. List the essential components of transition to practice programs.
  5. Explain the significance of the preceptor in transition to practice programs.
  6. Explain how to implement a transition to practice program.
  7. Identify resources available for managers, leaders, and educators.
  8. Consider implications for the future of transition to practice programs.

Faculty

Amanda Perkins, MSN, DNP, is a DNP-prepared registered nurse with a focus in healthcare leadership. Prior to obtaining her DNP, she obtained an MSN with a focus on nursing education. She currently works full-time as an Associate Professor of Nursing at Vermont Tech and per-diem at Gifford Medical Center on the medical-surgical unit and in the long-term care facility. Dr. Perkins also sits on the editorial board, writes, and peer-reviews for the journal Nursing Made Incredibly Easy! She has experience in a variety of settings, including long-term care, residential care, medical-surgical, women and children, intensive care, and inpatient psychiatric units.

Faculty Disclosure

Contributing faculty, Amanda Perkins, MSN, DNP, has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

Division Planner

Mary Franks, MSN, APRN, FNP-C

Division Planner Disclosure

The division planner has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

Director of Development and Academic Affairs

Sarah Campbell

Director Disclosure Statement

The Director of Development and Academic Affairs has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

About the Sponsor

The purpose of NetCE is to provide challenging curricula to assist healthcare professionals to raise their levels of expertise while fulfilling their continuing education requirements, thereby improving the quality of healthcare.

Our contributing faculty members have taken care to ensure that the information and recommendations are accurate and compatible with the standards generally accepted at the time of publication. The publisher disclaims any liability, loss or damage incurred as a consequence, directly or indirectly, of the use and application of any of the contents. Participants are cautioned about the potential risk of using limited knowledge when integrating new techniques into practice.

Disclosure Statement

It is the policy of NetCE not to accept commercial support. Furthermore, commercial interests are prohibited from distributing or providing access to this activity to learners.

Technical Requirements

Supported browsers for Windows include Microsoft Internet Explorer 9.0 and up, Mozilla Firefox 3.0 and up, Opera 9.0 and up, and Google Chrome. Supported browsers for Macintosh include Safari, Mozilla Firefox 3.0 and up, Opera 9.0 and up, and Google Chrome. Other operating systems and browsers that include complete implementations of ECMAScript edition 3 and CSS 2.0 may work, but are not supported. Supported browsers must utilize the TLS encryption protocol v1.1 or v1.2 in order to connect to pages that require a secured HTTPS connection. TLS v1.0 is not supported.

Implicit Bias in Health Care

The role of implicit biases on healthcare outcomes has become a concern, as there is some evidence that implicit biases contribute to health disparities, professionals' attitudes toward and interactions with patients, quality of care, diagnoses, and treatment decisions. This may produce differences in help-seeking, diagnoses, and ultimately treatments and interventions. Implicit biases may also unwittingly produce professional behaviors, attitudes, and interactions that reduce patients' trust and comfort with their provider, leading to earlier termination of visits and/or reduced adherence and follow-up. Disadvantaged groups are marginalized in the healthcare system and vulnerable on multiple levels; health professionals' implicit biases can further exacerbate these existing disadvantages.

Interventions or strategies designed to reduce implicit bias may be categorized as change-based or control-based. Change-based interventions focus on reducing or changing cognitive associations underlying implicit biases. These interventions might include challenging stereotypes. Conversely, control-based interventions involve reducing the effects of the implicit bias on the individual's behaviors. These strategies include increasing awareness of biased thoughts and responses. The two types of interventions are not mutually exclusive and may be used synergistically.

#31060: Transitioning New Graduate Nurses to Practice

INTRODUCTION

Nurses play an essential role in the healthcare field, especially when it comes to patient care. Nurses have the distinct honor of caring for patients as they enter this world, when they leave this world, and at multiple points in between. Throughout all of these patient care experiences, one common theme is essential: patient safety. Nurses are responsible for promoting and maintaining patient safety, in addition to creating changes that improve patient safety, when needed. At this time in nursing, with the looming nursing shortage, more and more new graduates are being hired into a variety of different nursing roles and are expected to provide safe patient care while juggling multiple patient assignments. Although placed into these roles and expected to provide safe patient care, many nurse graduates report that they do not feel prepared to transition to practice and provide safe patient care upon graduation. The stress felt by these new graduate nurses can lead to decreased satisfaction, comfort, and confidence, all of which can lead to increased problems with patient safety.

Due to the fact that new graduate nurses may not be prepared to provide safe patient care upon graduation, transition-to-practice programs are being utilized to assist in the transition from school to practice. The purpose of this course is to provide nurse managers, leaders, and educators with information about transition-to-practice programs, including how to implement these programs in healthcare settings.

WEBINAR

Learners should engage with the webinar, below, and the provided resources to explore the topics covered in this course.

RESOURCES

Implicit bias and culturally responsive health care are complex subjects. The following resources are provided in the event that you are interested in further exploring the topic, or even trying some of the approaches discussed in this webinar.

UC Health
https://www.uchealth.org
American Nurses Association
https://www.nursingworld.org
American Association of Colleges of Nursing
https://www.aacnnursing.org
Casey Fink Surveys
https://www.caseyfinksurveys.com
National League for Nursing
https://www.nln.org
Institute of Medicine
The Future of Nursing: Leading Change, Advancing Health
https://www.ncbi.nlm.nih.gov/books/NBK209880

References

1. American Nurses Association. Workforce. Available at https://www.nursingworld.org/practice-policy/workforce. Last accessed April 26, 2024.

2. American Association of Colleges of Nursing. Nursing Fact Sheet. Available at https://www.aacnnursing.org/News-information/Fact-Sheets/Nursing-Fact-Sheet. Lsat accessed April 26, 2024.

3. American Association of Colleges of Nursing. Nursing Shortage. Available at https://www.aacnnursing.org/News-information/Fact-Sheets/Nursing-Shortage. Last accessed April 26, 2024.

4. Anderson G, Hair C, Todero C. Nurse residency programs: an evidence-based review of theory, process, and outcomes. J Prof Nurs. 2012;28(4):203-212.

5. Barnett JS, Minnick AF, Norman LD. A description of U.S. post-graduation nurse residency programs. Nurse Outlook. 2014;62:174-184.

6. Benner P. From Novice to Expert: Excellence and Power in Clinical Nursing Practice. Berkeley, CA: Addison-Wesley Publishing Company; 1984.

7. Blegen MA, Spector N, Lynn MR, Barnsteiner J, Ulrich BT. Newly licensed RN retention: hospital and nurse characteristics. J Nurs Adm. 2017;47(10):508-514.

8. Blegen MA, Spector N, Ulrich BT, Lynn MR, Barnsteiner J, Silvestre J. Preceptor support in hospital transition to practice programs. J Nurs Adm. 2015;45(12):642-649.

9. Bortolotto SJ. Developing a comprehensive critical care orientation program for graduate nurses. J Nurses Prof Dev. 2015;31(4):203-210.

10. Brown RA, Crookes PA. What level of competency do experienced nurses expect from a newly graduated registered nurse? Results of an Australian modified Delphi study. BMC Nurs. 2016;15(45):1-8.

11. Casey K, Fink R, Krugman M, Propst J. The graduate nurse experience. J Nurs Adm. 2004;34(6):303-311.

12. Casey K, Fink R. Casey-Fink Graduate Nurse Experience Survey Reliability and Validity Issues. Available at https://www.uchealth.org/wp-content/uploads/2016/10/PROF-CF-reliability-and-validity-2014.pdf. Last accessed April 26, 2024.

13. Campbell H. Managing Organizational Change: A Practical Toolkit for Leaders. Philadelphia, PA: Kogan Page; 2014.

14. Cappel CA, Hoak PL, Karo PA. Nurse residency programs: what nurses need to know. Pennsylvania Nurse. 2013;68(4):22-28.

15. Chesak SS, Cutshall SM, Bowe CL, Montanari KM, Bhagra A. Stress management interventions for nurses. J Holist Nurs. 2019;37(3):288-295.

16. Cline D, La Frentz K, Fellman B, Summers B, Brassil K. Longitudinal outcomes of an institutionally developed nurse residency program. J Nurs Adm. 2017;47(7/8):384-390.

17. Davis A, Maisano P. Patricia Benner: Novice to expert: a concept whose time has come (again). Okla Nurse. 2016;(13-15).

18. Geyer K, Altman M. Want to create lasting change? It’s all about that base. Nurs Manage. 2016;47(3):34-38.

19. Haggerty C, Holloway K, Wilson D. Entry to nursing practice preceptor education and support: could we do better? Nurs Prax New Zeal. 2012;28(1):30-39.

20. Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press; 2011.

21. Kotter JP. Leading Change. Boston, MA: Harvard Business School Press; 1996.

22. Mbamalu G, Whiteman K. Vascular access team collaboration to decrease catheter rates in patients on hemodialysis: utilization of Kotter’s change process. Nephrol Nurs J. 2014;41(3):283-287.

23. Mellor P, Greenhill J. A patient safety focused registered nurse transition to practice program. Contemp Nurse. 2014;47(1-2):51-60.

24. National Council of State Boards of Nursing. Study Results. Available at https://www.ncsbn.org/6889.htm. Last accessed April 26, 2024.

25. National Council of State Boards of Nursing. Transition to Practice. Available at https://www.ncsbn.org/transition-to-practice.htm. Last accessed April 26, 2024.

26. Nilsson J, Johansson E, Egmar A, et al. Development and validation of a new tool measuring nurses self-reported professional competence: the nurse professional competence (NPC) scale. Nurse Educ Today. 2014;34:574-580.

27. Pfaff K, Baxter P, Jack S, Ploeg J. An integrative review of the factors influencing new graduate nurse engagement in interprofessional collaboration. J Adv Nurs. 2014;70(1):4-20.

28. Pittman P, Herrera C, Bass E, Thompson P. Residency programs for new nurse graduates: how widespread are they and what are the primary obstacles to further adoption? J Nurs Adm. 2013;43(11):597-602.

29. Rush KL, Adamack M, Gordon J, Lilly M, Janke R. Best practices of formal new graduate nurse transition programs: an integrative review. Int J Nurs Stud. 2013;50(3):345-356.

30. Silvestre JH, Ulrich BT, Johnson T, Spector N, Blegen MA. A multisite study on a new graduate registered nurse transition to practice program: return on investment. Nurs Econ. 2017;35(3):110-118.

31. Spector N. Are We Pushing Graduate Nurses Too Fast? Available at https://psnet.ahrq.gov/web-mm/are-we-pushing-graduate-nurses-too-fast. Last accessed April 26, 2024.

32. Spector N, Blegen MA, Silvestre J, et al. Transition to practice study in hospital settings. J Nurs Regul. 2015;5(4):24-38.

33. Spector N, Blegen MA, Silvestre J, Barnsteiner J, Lynn MR, Ulrich B. Transition to practice in nonhospital settings. J Nurs Regul. 2015;6(1):4-13.

34. Sterner A, Hagiwara MA, Ramstrand N, Palmer L. Factors developing nursing students and novice nurses' ability to provide care in acute situations. Nurse Educ Pract. 2019;35:135-140.

35. Thompson CS. Exploring teachers' perspectives on effective organizational change strategies. Educ Plan. 2019;26(2):13-28.


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