1. Predictors of Success in Transition to Practice on New Graduate Registered Nurses in Critical Care: An Integrative Review of the Literature
Shekinah Akut
DePaul University
Methods
Background
Conclusion
The ongoing nursing shortage caused healthcare institutions to employ new graduate nurses (NGNs) in specialty care areas such as critical care. Transition to practice programs were implemented to effectively aid new graduates as they enter the practice, as well as improve their competency and retention. While these programs have been successful in accomplishing its purpose, there is lack of knowledge of the different factors that influence their effectiveness.
A search was conducted using the following databases: CINAHL, PubMed, PsycINFO and ProQuest
Keywords used: new graduate nurse, critical care, nurse residency programs, transition to practice programs , internship, externship and preceptorship. The research questions were used to evaluate each article
10 articles were analyzed in this review.
Knowledge of these factors may help improve the quality of current established programs and may provide essential information for future research related to the concept.
Major findings
Preceptor-resident relationship
Supported by 3 articles
Healthy preceptor relationship contributes to professional development of NGNs
Lack of preceptor preparedness and encouragement contributed to negative experiences during program
Positive preceptor-resident relationship helped improve NGNs knowledge and critical thinking skills in practice
Nature and length of program
Interactivity during courses, clinical scenario analysis and frequency of feedback increased confidence of NGNs
Online programs were valuable resource of critical knowledge and was conveniently accessible at bedside
Flexibility of length programs allowed more time for learning complex issues of critical care
Supportive Clinical Environment
Supported by 4 articles
Acknowledgement of improvements and accomplishments
Ongoing support from nursing management
Facilitation of feedback and appraisal between NGNs, preceptors and nurse managers
Results
Nursing Implications
Based on the analyses of each outcomes, 3 major factors that influenced successful transition to practice programs were preceptor-resident relationship, nature and length of program and a supportive clinical environment.
Conceptual Framework
Patricia Benner’s From Novice to Expert Theory (1984) explains that within the transition from novice to expert, there is relevant change in a nurse’s perception from fully relying on knowledge of abstract principles as a novice to utilizing both knowledge and experience as an expert. This theory provides foundation to analyze how transition to practice programs will aid the change in perception of novice and advanced beginner RNs to competent nurses in critical care.
This review will be beneficial in improvement of training programs in acute care settings
Implication for nursing practice involves continuous assessment of learning needs of NGNs in critical care and incorporating knowledge of influencing factors in training preceptors and mentors.
These factors positively influenced retention and competency because it is associated with new graduate nurses (NGNs) professional development and improvement of critical thinking skills
Future Research
Research Questions
What are the factors that influence the success of transition to practice programs on new graduate critical care RNs?
How do these factors affect a new nurse’s retention and competency in the critical care practice?
Future studies should identify learning needs of NGNs through identifying negative factors influencing their perception of transition to practice and how those factors affect retention rates of NGNs in critical care.