New Graduate Nurse Residency: Taking Rehabilitation Nurses' Transition to Practice to a New Level.

ABSTRACT: It began with a challenge from our Chief Nursing Officer. As a Magnet hospital, it was time for our nurse residency program to be recognized as an accredited program for new graduate nurses. This article shares our experience using the Association of Rehabilitation Nurses competency statements in a creative way when applying for recognition as the first American Nurses Credentialing Center-accredited specialty hospital nurse residency program. Although these competency statements were used initially to meet the requirements of the accreditation application process, they also led to the creation of a document that serves two purposes. First, it can be used to instruct new graduate nurses on the structure and processes of a nurse residency program in which competency statements are used to guide curriculum development. Second, it can be used to inform nurse residency program managers on new graduate nurses' progress throughout the nurse residency program by tracking competency completion. The end result of this accredited program is a new graduate nurse who understands not only what it means to be a nurse but also what it means to be a rehabilitation specialty nurse.

The Impact of Education on Certified Nursing Assistants' Identification of Strategies to Manage Behaviors Associated With Dementia.

The nursing care of hospitalized patients with dementia is planned and supervised by registered nurses. This care is delivered using a team approach, including certified nursing assistants, who may lack the knowledge and skills to properly provide care and manage the challenging behaviors associated with dementia. This article describes an innovative, multimodal education program designed to help certified nursing assistants acquire this knowledge and skill. Use of post-then-pre evaluation showed the positive results of this program.

Implementation of unit-based interventions to improve teamwork and patient safety on a medical service.

In a prior study involving 2 medical units, Structured Interdisciplinary Rounds (SIDRs) improved teamwork and reduced adverse events (AEs). SIDR was implemented on 5 additional units, and a pre- versus postintervention comparison was performed. SIDR combined a structured format for communication with daily interprofessional meetings. Teamwork was assessed using the Safety Attitudes Questionnaire (score range = 0-100), and AEs were identified using queries of information systems confirmed by 2 physician researchers. Paired analyses for 82 professionals completing surveys both pre and post implementation revealed improved teamwork (mean 76.8 ± 14.3 vs 80.5 ± 11.6; P = .02), which was driven mainly by nurses (76.4 ± 14.1 vs 80.8 ± 10.4; P = .009). The AE rate was similar across study periods (3.90 vs 4.07 per 100 patient days; adjusted IRR = 1.08; P = .60). SIDR improved teamwork yet did not reduce AEs. Higher baseline teamwork scores and lower AE rates than the prior study may reflect a positive cultural shift that began prior to the current study.

Outcome evaluation of a new model of critical care orientation.

BACKGROUND: 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. OBJECTIVES: 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. METHODS: A prospective, quasi-experimental design with both quantitative and qualitative methods. RESULTS: 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. CONCLUSIONS: 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.