Kathy L. Rush

Orientation and transition programme component predictors of new graduate workplace integration.

AIM To examine the relationships between selected components of new graduate nurse transition programmes and transition experiences. BACKGROUND Transition support for new graduates is growing increasingly multifaceted; however, an investigation of the effectiveness of the constituent components of the transition process is lacking. METHODS An online survey was disseminated to new graduates working in acute care settings and included questions related to new graduate transition programmes. The Casey Fink Graduate Nurse Experience Survey was used to quantify the transition experience. RESULTS New graduate nurses who participated in a formal new graduate (NG) transition programme had significantly higher total transition scores than non-programme nurses. The orientation length and the average number of hours worked in a two week period were significant predictors of transition; the percentage of preceptored shifts was statistically insignificant. CONCLUSIONS New graduate transition is enhanced with participation in a formal transition programme. Orientation should be at least four weeks in length, and new graduates should work at least 49 hours in a two week period. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers are in key positions to advocate for new graduate nurse transition programmes with adequate resources to support a four week orientation phase and shift scheduling to ensure an adequate number of hours over two week periods to facilitate transition.

Critical Thinking Among Rn-to-Bsn Distance Students Participating in Human Patient Simulation

Simulation is a strategy increasingly being used to promote critical thinking skills among baccalaureate nursing (BSN) students. It has been used to a limited extent with RN-to-BSN students, many of whom take their educational program through distance delivery. The purpose of this qualitative study was to understand the critical thinking of distance RN-to-BSN students who participated in a simulation designed with interactive questions. Students taking the program, either by live televised broadcast (educational television [ETV]) or by online instruction, participated in the simulation. The ETV student simulation was facilitated from a broadcast studio by faculty, whereas Internet students completed the simulation by DVD. Postsimulation students participated in debriefing sessions, which were audiotaped by ETV students and completed by Internet students using a Blackboard discussion board. Data were analyzed using Scheffer and Rubenfelds conceptualization of critical thinking. Findings revealed that simulation used by distance delivery cultivated critical thinking in RN-to-BSN students.

Evaluating first-year nursing students' ability to self-assess psychomotor skills using videotape.

&NA; Developing confidence in self-assessment is an important skill in becoming a self-regulated learner. This article describes the process undertaken by a group of educators of incorporating self-assessment in combination with psychomotor skill development with freshman students. Students were videotaped performing a wound-dressing change; the videotaping was immediately followed by a self-assessment of their performance using a faculty-generated checklist. Comparison of faculty and student ratings revealed the tendency for students to overrate their performance and identified discordance between students and faculty on several steps of the procedure. These evaluation findings are discussed and future directions explored.

New graduate nurse transition programs: Relationships with bullying and access to support

Abstract New graduate nurses are often targets of bullying and horizontal violence. The support offered by new graduate nurse transition programs may moderate the effects of bullying and limit its negative impact on new graduate nurse transition. This study examined the relationships between access to support, workplace bullying and new graduate nurse transition within the context of new graduate transition programs. As part of a mixed methods study, an online survey was administered to new graduates (N = 245) approximately a year from starting employment. Bullied new graduate nurses were less able to access support when needed and had poorer transition experiences than their non-bullied peers. Participation in a formal transition program improved access to support and transition for bullied new graduate nurses. People supports within transition programs positively influenced the new graduate nurse transition experience. Formal transition programs provide support that attenuates the impact of bullying on new graduate nurses and improves transition.

Mobility Adaptations of Older Adults: A Secondary Analysis

The purpose of this secondary study was to describe the mobility adaptations of community—living older adults. The primary study, designed to understand weakness and aging from the perspective of older adults, revealed that older adults viewed weakness as a progression from inability to an end point of ‘giving up,’ which prompted the use of adaptation strategies to preserve mobility and to counter a self-identity of being weak. A qualitative descriptive design guided the primary study of 15 community—living older adults, who participated in in-depth interviews. A systematic secondary analysis using Baltes and Baltes’ theory of Selective Optimization with Compensation (SOC) showed that older adults used selection, optimization, and compensation adaptations across a range of mobility behaviors. The SOC model offered a framework for profiling older adults’ agency and motivations in meeting mobility challenges as they age and provided the basis for targeted interventions to maximize mobility with aging.

The academic librarian as co-investigator on an interprofessional primary research team: a case study

OBJECTIVE The objective of this study was to explore the role librarians play on research teams. The experiences of a librarian and a faculty member are situated within the wider literature addressing collaborations between health science librarians and research faculty. METHODS A case study approach is used to outline the involvement of a librarian on a team created to investigate the best practices for integrating nurses into the workplace during their first year of practice. RESULTS Librarians contribute to research teams including expertise in the entire process of knowledge development and dissemination including the ability to navigate issues related to copyright and open access policies of funding agencies. DISCUSSION The librarian reviews the various tasks performed as part of the research team ranging from the grant application, to working on the initial literature review as well as the subsequent manuscripts that emerged from the primary research. The motivations for joining the research team, including authorship and relationship building, are also discussed. Recommendations are also made in terms of how librarians could increase their participation on research teams. CONCLUSION The study shows that librarians can play a key role on interprofessional primary research teams.

Intensive Care Unit Patients in the Postanesthesia Care Unit: A Case Study Exploring Nurses' Experiences

PURPOSE The purpose of this study was to understand the experiences of postanesthesia nurses caring for intensive care unit (ICU) patients in the postanesthesia care unit (PACU). DESIGN Qualitative interpretive description. METHODS Six PACU nurses participated in semi-structured interviews. Interviews were digitally recorded, transcribed verbatim, and analyzed using constant comparative analysis. Quality of the data collection and analysis process was maintained through constructing codes and themes jointly by several investigators and taking interpretive accounts back to participants. FINDING Three main themes were constructed: expert mind-set, specialty practice, and identity and relationships. The expert mind-set described knowing but not doing and straddling concurrent foci and duties. Specialty practice entailed doing but not knowing and the unsupportive context that perpetuated this. Identity and relationships described the lost identity of postanesthesia nursing and tension in the relationships with ICU. CONCLUSIONS Findings illuminate the challenges expert nurses face when an unplanned practice change is implemented.

The Stressors and Coping Strategies of Older Adults With Persistent Atrial Fibrillation Prior to and Following Direct Current Cardioversion.

Objective:The purpose of this study was to explore the stressors and coping strategies of older adults with persistent atrial fibrillation (AF) before and after direct current cardioversion. Method: The study used a qualitative descriptive design. Sixteen patients were recruited through an AF clinic to participate in individual interviews prior to the cardioversion and at 6 and 12 weeks post procedure. Results: Pre-cardioversion, older adults experienced symptom and health care–related stressors superimposed on existing non-AF stressors. They used a range of emotion and problem-focused coping. Non-AF stressors increased post procedure at the same time that participants perceived less need for coping strategies with a return to regular rhythm. Discussion: There was a shift from AF to non-AF related stressors following the cardioversion but a decrease in coping strategies. Older adults with AF should be encouraged to maintain use of coping strategies to manage ongoing stress and reduce the risk of AF recurrence.

The Helpfulness and Timing of Transition Program Education

The purpose of this study was to examine relationships between transition program education and new graduate nurse transition. Although new graduates preferred hands-on learning, the helpfulness of workshops was associated with better transition. New graduates, many of whom were from the Millennial Generation, liked a variety of educational modalities. Access to support was better for nurse graduates who received education delivered throughout the first year of transition.

The efficacy of telehealth delivered educational approaches for patients with chronic diseases: A systematic review

OBJECTIVE The virtual delivery of patient education and other forms of telehealth have been proposed as alternatives to providing needed care for patients with chronic diseases. The purpose of this systematic review was to compare the efficacy of virtual education delivery on patient outcomes compared with usual care. METHODS The review examined citations from 3 databases, MEDLINE, CINAHL, and EMBASE using the search words telehealth, chronic disease, patient education, and related concepts. From 2447 records published between 2006 and 2017, 16 high to moderate quality studies were selected for review. Eligible papers compared virtual education to usual care using designs allowing for assessment of causality. RESULTS Telehealth modalities included the web, telephone, videoconference, and television delivered to patients with diabetes, chronic obstructive pulmonary disease, irritable bowel syndrome and heart failure. In 11 of 16 studies, virtually delivered interventions significantly improved outcomes compared to control conditions. In the remaining 5 studies, virtual education showed comparable outcomes to the control conditions. CONCLUSIONS Findings demonstrated that virtual education delivered to patients with chronic diseases was comparable, or more effective, than usual care. RESEARCH IMPLICATIONS Despite its benefits, there is potential for further research into the individual components which improve effectiveness of virtually delivered interventions.