The effectiveness of strategies and interventions that aim to assist the transition from student to newly qualified nurse.
The effectiveness of strategies and interventions that aim to assist the transition from student to newly qualified nurse.
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旨在帮助从学生过渡到新合格护士的策略和干预措施的有效性。
DOI：
10.11124/jbisrir-2009-497
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发表时间：
2011
期刊：
影响因子：
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通讯作者：
C. Rees
中科院分区：
文献类型：
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作者：
D. Edwards;C. Hawker;Judith Carrier;C. Rees
背景：从学生到新合格护士的过渡期，护士正在适应他们的新角色，巩固他们的知识和技能，这可能是有压力的。这是许多新获得资格的护士感到准备不足的时候。已经报告了各种缓解过渡过程的战略，其目的是增加新毕业生的信心、能力和归属感，改善征聘和留用，并减少更替成本。目的：综合现有的最佳证据支持策略和干预措施的有效性针对新合格的护士。方法：对主要电子数据库进行全面检索，以确定2000年至今已发表和未发表的研究。检索检索到的论文的参考文献并联系作者。只考虑以英语发表的定量研究。方法学质量和数据提取：两名审稿人独立评估方法学质量并从纳入的研究中提取数据。第三位审稿人通过讨论解决任何分歧。数据综合：本综述未发现可比较的随机对照试验（RCTs），因此对数据进行meta分析不合适。从纳入的研究中提取的数据被综合成一个叙述性的摘要。结果：共纳入33项研究：随机对照试验(1)、准实验研究(3)和观察/描述性研究（29）。原产国为：美国（25），澳大利亚(4)，英国(2)，新西兰(1)和泰国(1)。研究根据提供的项目类型或支持策略进行分类：护士实习/住院医师项目（14项）和研究生护士培训项目（7项），导师（4项），模拟（3项）和指导（2项），最后一年护理学生过渡项目（2项）和实习（1项）。结果被归类为对雇主（招聘、保留、流动率、能力、信心和成本）或对新毕业生（压力和焦虑减轻、工作满意度、知识/技能获取、批判性思维和人际交往能力、信心和专业护理行为）的重要程度。这些研究报告的结果范围很大，很难得出确定的结论。人们注意到自信水平普遍提高，压力和焦虑也有所减轻。据报道，在知识、批判性思维和工作满意度方面取得了一些成功。许多研究报告了自主性、工作满意度和职业过渡的V型模式（最初的高水平，在6个月后下降，然后恢复到基线水平）。关于提高留任率和减少人员流动率的研究一般都很差。无论采取何种干预措施，干预方案的总体影响似乎都是积极的。这可能表明，该组织对获得同事支持的新毕业护士的关注是重要的。导师/导师需要为这个角色做好充分的准备。对未来研究的启示未来的研究应建立在目前研究的优势和局限性的基础上。缺乏实验研究意味着对可能影响结果的其他变量通常很难控制。有必要使用更客观和可靠的测量方法进行更大规模的研究。
Executive Summary Background: The transition period from student to newly qualified nurse where nurses are adjusting to their new role and consolidating their knowledge and skills can be stressful. It is a time when many newly qualified nurses are left feeling inadequately prepared. A variety of strategies to ease the transition process have been reported, which aim to increase confidence, competence, sense of belonging of new graduates, improve recruitment and retention and reduce turnover costs. Objectives: To synthesise the best available evidence on the effectiveness of support strategies and interventions aimed for newly qualified nurses. Methods: A comprehensive search was undertaken on major electronic databases to identify both published and unpublished studies from 2000 to the present date. Reference lists of retrieved papers were searched and authors contacted. Only quantitative studies published in English language were considered. Methodological quality and data extraction: Two reviewers independently assessed methodological quality and extracted data from the included studies. A third reviewer resolved any disagreements through discussion. Data synthesis: The review did not identify comparable Randomised Controlled Trials (RCTs), and as such meta‐analysis of the data was not appropriate. The data extracted from the included studies were synthesized into a narrative summary. Results: Thirty three studies were included in the review: RCT (1), Quasi‐experimental (3) and observational/descriptive studies (29). Countries of origin were: USA (25), Australia (4), England (2), New Zealand (1) and Thailand (1). Studies were categorised according to the type of programme or support strategy provided: nurse internship/residency programmes (14) and graduate nurse orientation programmes (7), preceptorship (4), simulation (3) and mentoring (2), final year nursing students transition programs (2) and externship (1). Outcomes were categorised as being important to the employer (recruitment, retention, turnover rates, competence, confidence and costs), or to the new graduate (stress and anxiety reduction, job satisfaction, knowledge/skills acquisition, critical thinking and interpersonal skills, confidence and professional nursing behaviours). Conclusions The range of outcomes reported across the studies made it difficult to report firm conclusions. A general increase in level of confidence was noted, along with reduction in stress and anxiety. Some success in relation to increases in knowledge, critical thinking and levels of job satisfaction were reported. A number of studies reported a V shaped pattern (initial high levels, dipping at 6 months and then reverting to baseline levels) for autonomy, job satisfaction, and professional transition. Research relating to improvements in retention and reduction in turnover was generally poor. Implications for Practice The overall impact of intervention programmes appears positive, irrespective of the intervention. This may suggest that it is the organisation's focus on new graduate nurses with support from colleagues that is important. .Mentors/preceptors need to be adequately prepared for the role. Implications for Future Research Future research should build on the strengths and limitations of the current studies. A lack of experimental studies means there is commonly little control over other variables that might influence the outcome. There is a need for larger studies using more objective and reliable measures.
松岛芳晴：临床神经科学。6. 110-111 (1988)
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