ABSTRACT
OBJECTIVE: To examine changes in new nurses' competencies across the 1st year of practice. BACKGROUND: Competency assessment is a challenge for nurse residency programs and often focuses on skills checklists and confidence self-reports. The Appraisal of Nursing Practice, an observational rating based on Quality and Safety in Nursing Education standards, was developed to help evaluate an RN residency program. METHODS: Preceptors, nurse educators, and/or unit managers from various units rated new nurse residents. Ratings were compared for 353 nurses at 3 points: within the 1st month in the program (T1), at 5 months (T2), and at month 11 (T3). RESULTS: Competency ratings increased significantly for all subscales from T1 to T2. Ratings continued to increase significantly from T2 to T3, although at a slightly slower rate. Teamwork and evidence-based practice increased the most. CONCLUSIONS: Future studies should explore factors affecting the trajectory in developing nursing competencies within various settings.
Subject(s)
Clinical Competence/standards , Employee Performance Appraisal/standards , Guidelines as Topic , Nursing Care/standards , Nursing Staff/standards , Adult , Female , Humans , Male , Middle Aged , Time Factors , United StatesABSTRACT
BACKGROUND: Simulation is increasingly used as a training tool for acute care medical-surgical nurses to improve patient safety outcomes. A synthesis of the evidence is needed to describe the characteristics of research studies about acute care nurse simulation trainings and patient safety. An additional purpose is to examine the effects of acute care registered nurse (RN) simulation trainings on patient safety outcomes. METHODS: Five Internet databases were searched for articles published on any date through October 2018 examining the effect of RN simulation trainings on patient safety outcomes in the adult acute care setting. SAMPLE: N = 12 articles represented 844 RNs of varying experience levels and 271 interprofessional participants. RESULTS: Nine studies (75%) used high-fidelity scenarios developed locally about high risk but infrequent events. Five studies (42%) incorporated interdisciplinary team members in the scenarios and/or outcome evaluations. Outcome measures were self-reported, direct observation, or clinical indicators. All studies in this review achieved improved patient safety outcomes. It is unknown how outcomes vary for different groups of RNs because of insufficient gender, ethnicity/race, and age reporting. LINKING EVIDENCE TO ACTION: Findings support the design of simulation training research studies for patient safety outcomes and use of simulation training and research in acute care RNs. Additional high-quality research is needed to support this field. Future studies should include descriptors that characterize the sample (i.e., age, gender, education level, type of nursing degree, ethnicity or race, or years of experience); incorporate interdisciplinary teams; evaluate a combination of outcome measure types (i.e., self-report, direct observation, and clinical outcomes) both proximal and distal to the simulation; and that utilize standardized scenarios, validated outcome measure instruments, and standardized debriefing tools.
Subject(s)
Education, Nursing, Continuing/standards , Patient Safety/standards , Simulation Training/standards , Clinical Competence/standards , Education, Nursing, Continuing/methods , Humans , Outcome Assessment, Health Care/standards , Simulation Training/methodsABSTRACT
OBJECTIVE: We describe the development of the Appraisal of Nursing Practice (ANP) and present initial psychometric data. BACKGROUND: Although measures of new nurses' confidence in clinical practice exist, psychometrically sound observational tools that assess a broad range of nursing competencies are needed. METHODS: Based on the Quality and Safety Education for Nurses competencies, the 37-item ANP covers person-centered care, teamwork and collaboration, evidence-based practice/quality improvement, safety, informatics, professionalism, and overall satisfaction (with the new nurse's functioning). Cognitive interviewing was used to refine the items. Assessment of interrater reliability and a field test in a new nurse residency program were conducted. RESULTS: Interrater reliability and internal consistency reliability were generally acceptable. Scores increased significantly for nurses as they moved through a nurse residency program. CONCLUSIONS: The ANP can help nursing administrators identify areas where nurse residents are building needed competencies versus areas that need more work to achieve desired competency outcomes.
