通过过渡到急诊护理实践计划来提高新毕业护士的留用率。

Improving New Graduate Nurse Retention With a Transition to Emergency Nursing Practice Program.

出版信息

J Emerg Nurs. 2024 Mar;50(2):178-186. doi: 10.1016/j.jen.2023.11.003.

DOI:10.1016/j.jen.2023.11.003

Abstract

INTRODUCTION

Emergency department turnover rates increased at Sentara Northern Virginia Medical Center. Most applicants were new graduate registered nurses. A strength, weakness, opportunity, threat analysis revealed 3 weaknesses regarding new graduate registered nurses in emergency departments. Transition to practice program was necessary, new graduate registered nurse competency needed to progress rapidly, and retention rates needed improvement.

METHODS

The emergency department registered nurse transition to practice pathway was created to address these challenges. Retention statistics were garnered through new graduate registered nurses length of employment. Improving retention rates at Sentara Northern Virginia Medical Center led to expansion of the program to the other 11 hospitals in the system. Self-report surveys were created later to evaluate the new graduate registered nursess' satisfaction with the program and perception of clinical confidence.

RESULTS

Using the emergency department registered nurse transition to practice pathway, turnover rates at Sentara Northern Virginia Medical Center dropped from 46% to 5.1%. Post expansion, the overall program retention rates were 96% at 6 months, and 86% at 1 year. The 2-year retention rate prior to COVID-19 was 82%, afterward, it dropped to 65%. Most surveyed new graduate registered nurses had a confidence level of 25% or less on the first day. After their 17-week orientation, 54% reported confidence levels had risen to 75%. Within 6 months, 81% reported 75% confidence, at 1 year, 87% reported levels between 75% and 100%, and at 2 years, 100% reported a confidence level between 75% and 100%.

DISCUSSION

This development of the emergency department registered nurse transition to practice pathway resulted in improved emergency department registered nurse retention and confidence. Savings from reduced turnover and reduced temporary labor staffing were achieved with this program. Implementation takes careful resource management, ongoing analysis, and research to validate return on investment.

摘要

简介

森塔拉弗吉尼亚北部医疗中心的急诊部门周转率上升。大多数申请人都是新毕业的注册护士。通过强弱机遇威胁分析，发现急诊部门新毕业注册护士有 3 个弱点。有必要开展过渡到实践项目，新毕业注册护士的能力需要迅速提高，留用率需要提高。

方法

创建了急诊护士过渡到实践途径，以应对这些挑战。通过新毕业注册护士的工作长度来获取保留率统计数据。森塔拉弗吉尼亚北部医疗中心的留用率提高，导致该计划扩展到该系统中的其他 11 家医院。后来创建了自我报告调查，以评估新毕业注册护士对该计划的满意度和对临床信心的看法。

结果

使用急诊护士过渡到实践途径，森塔拉弗吉尼亚北部医疗中心的离职率从 46%降至 5.1%。扩展后，该计划的总体保留率为 6 个月时为 96%，1 年时为 86%。在 COVID-19 之前的 2 年保留率为 82%，之后降至 65%。大多数接受调查的新毕业注册护士在第一天的信心水平为 25%或以下。经过 17 周的培训，54%的人报告信心水平上升到 75%。在 6 个月内，81%的人报告信心水平为 75%，1 年后，87%的人报告信心水平在 75%至 100%之间，2 年后，100%的人报告信心水平在 75%至 100%之间。