Transforming the journey for newly licensed registered nurses

Newly licensed nurses entering into practice experience stressors related to daily challenges. This evidence-based practice project implemented a nurse residency program designed to ease the transition during the first year of practice. Newly licensed nurses at a Midwestern health care organization were enrolled in a yearlong nurse residency program and were required to attend one 4-hour session monthly. Program outcomes included a decrease in turnover and improved confidence.     

The technical competence of registered nurses in the administration of oral medications

An individual who desires to become a registered nurse (RN) may choose from three types of education: associate degree, diploma, and baccalaureate degree programs. The dilemma of this decision is heightened by the strong disagreement within the nursing profession regarding which of the three modes best prepares a nurse to become a competent practitioner. The purpose of this study was to examine variables which might explain variance in the technical competence of RNs as evidenced by skill in administering oral medications. Six variables were investigated as possible predictors of the variance in oral medication administration procedure, i.e., basic nursing education, drug knowledge, age, previous RN experience, previous nursing experience, and highest nursing education completed. Sixty volunteer RNs in a Baltimore community hospital (252 beds) were observed twice each as they administered two oral medications to a patient. A Technical Competence Tool (TCT) was used to record performance of the 16 critical behaviors deemed essential for safe and accurate drug administration. The total scores from observation one and two were summed to obtain a total competence score. Each nurse also completed a 14-item Drug Knowledge Profile (DKP) and Demographic Data Sheet (DDS). Although there was a wide range of total competence scores, only three percent of the variance was explained by the six predictor variables. It was concluded that the selected variables were not significant predictors of the technical competence of RNs in the administration of oral medications.(ABSTRACT TRUNCATED AT 250 WORDS)     

Report of survey results for newly licensed registered nurses in Washington state

Current projections for the need for nurses in Washington state are based on an increase in the need for health care, the aging of the population, and the inability of the nursing educational institutions to supply adequate numbers of graduates. Yet many new graduates are providing anecdotal evidence that they cannot find a job in nursing. This study gathered information regarding the employment of newly licensed registered nurses in Washington between May 2009 and August 2010. Questionnaires were administered to a randomly selected sample of 2,200 newly licensed nurses; 532 responses were returned. Nearly 81% reported current employment as a registered nurse and 69.5% reported that they were very or somewhat satisfied with their employment situation. The job search strategies, type of job sought, and factors contributing to their success are reported. Factors contributing to the success of their job search and to job dissatisfaction are explored.     

Essential clinical skills for beginning registered nurses

A research project investigating the identification of essential clinical skills for registered nurses in their first year of practice was undertaken in a number of Sydney metropolitan hospitals in Australia. Using an adaptation of the Williams & Brammer (1996) study, 206 beginning registered nurses were surveyed to determine the clinical skills they performed frequently in their daily routine, and those they considered essential. One hundred and thirty two questionnaires were returned and the responses were analysed for frequency of clinical skill performance and essential rating. The clinical skills rated as most frequently performed related to universal precautions for infection control, vital sign assessment, management of intravenous therapy, administration of all forms of medication and a wide range of patient hygiene related skills. Many clinical skills rated as essential by these nurses were not rated as performed frequently, which may indicate concern for the need to draw upon less frequently performed skills during emergency situations and thus they rate these skills as essential. This study clearly identified the clinical skills rated as performed frequently by beginning registered nurses and identified those clinical skills deemed essential to beginning nursing practice by novice nurses. A larger sample size would strengthen the reliability of these findings.     

Evaluation of an educational intervention to increase cultural competence among registered nurses

The purpose of this two group intervention study (N = 94) was to determine if RNs who participated in "culture school" improved levels of cultural competence to a greater extent than RNs who attended nursing informatics classes. The Giger and Davidhizar Transcultural Assessment Model/Theory (GDTAMT) was the study's theoretical foundation (Giger & Davidhizar, 1995). A sample of 94 participants, was identified from a randomized group of all Jefferson County, Alabama RNs. Randomly assigned participants (stratified by race) experienced 8.5 hours of either culture school or nursing informatics classes and completed survey tools in three phases (pre-intervention, immediate post intervention, three week follow-up). The Cultural Self-Efficacy Scale (CSES) by Bernal and Froman (1987), knowledge base questions by Rooda (1990), and demographic profiles were used. Concepts empirically measured using these tools were analyzed by transcultural nursing experts for their congruence with GDTAMT. Using repeated measures analyses of convariance (race), significant differences between groups for both scales were found. Culture school participants demonstrated significantly more cultural self-efficacy and cultural knowledge, and these improvements remained during phase three. Further research is recommended to allow for greater generalizability of findings, an examination of client perceptions, and actual nurse behaviors.     

Measuring the use of intuition by registered nurses in clinical practice

AIM: To administer the Smith Intuition Instrument to a sample of registered nurses to clarify its factors and test convergent validity. METHODS: The Smith Intuition Instrument (27 items), a subscale of the Miller Intuitiveness Instrument (18 items), and demographic questions, were posted to 1,000 registered nurses in January 2006. RESULTS: With a response rate of 79% (n=79), the findings are preliminary. Principal component factor analysis with orthogonal varimax rotation resulted in four factors accounting for 70.8% of variance: spiritual connections (373%), reassuring feelings (14.6%), physical sensations (12.5%) and bad feelings (6.2%). Eigenvalues ranged from 1.1 to 6.7 and factor loadings ranged from 0.705 to 0.887 An 18-item instrument emerged with a Cronbach's alpha of 0.896 and a range of 0.806 to 0.892 for each factor. Pearson's correlation between the two intuition measures was 0.520. CONCLUSION: Psychometric evaluation demonstrated construct validity, convergent validity and reliability, and clarified the factors. The Smith Intuition Instrument is a valid and reliable tool for measuring nurses' use of intuition in clinical practice.