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
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.