Insights of the Critical Care Nurses - Research Proposal Example

Insights of the critical care nurses to complete the CCNRP in relation to their training for taking care of critical patients Name Affiliation Table of Contents Table of Contents 2 Introduction 3 Problem 3 Reviewing the literature 4 Formulating a Nursing Placement Program 4 Nurse Placement Programs 5 Evaluation of Current Nurse Residency Programs 6 Identifying gaps 7 Formulating the research question 7 Specifying the significance 8 References 9 Introduction There is a world nursing shortage. This shortage is expected to increase in the next decade. As projected by American Association of college nursing, there will be a shortage of more than 700,000 registered nurses by the year 2025. The shortage is generated by aging baby boomers as their health needs also increases, as well as the increase in number of the registered nurses expecting to retire. This shortage is high to those areas calling for specialties. The number of critical nurses account for almost 40% of all the nurses practicing in a hospital setting. Despite the fact that technology if providing room to accommodate more critical patients it also creates a demand for critical care nurses, but this bunch of nurses are retiring (Kowalski & Cross, 2010). This making it hard for hospitals to fill this position with experience nurses thus linking to the shortage of these important personnel. As a result of this shortage hospitals are forced to hire from new graduates though nursing transition from educational program to practicing has been cited as a time of stress, reality shock and role adjustment. Problem The problem of nursing shortage has an impact to both patient care and safe staffing. Though the hospitals have a minimal effect on the rates of retirement, the can impact the retention rates by using other related programs that they offer to support nurses like spend more on new graduate nurses so as to make sure the attain the best critical care standards. As from June 2008 to September, a magazine published by critical care nurses had several articles bearing different types of programs that hospitals may use as orientation models for new graduate nurses. This is a clear reflection on how education as well as other orientation programs may be able to turn the new graduates to competent critical care nurses. One of the well known measures of new CCNRP is the nursing retention rates in critical care settings in hospitals. Despite the methods used in evaluation, there is no data that can show the rate of Jib satisfaction as well as perception of nurses towards working in such critical care areas. Since this is an important factor in nursing practice it is also important to evaluate it as well. Reviewing the literature Formulating a Nursing Placement Program From the literature search it was noted that there are several approaches to the formulation of programs designed to help and prepare new graduates for critical care practice. A common term from both discussion and research articles was that orientation program was wanting to new graduate nurse (Bratt & Felzer, 2011). New graduate are not competent enough to handle job in critical care setting. New graduate nurses require experience support and education to be successful in the nursing career most specifically in the clinical area. It was also noted in many articles that a team of experts or other stakeholders are important in defining the needed curriculum and theoretical base for orientation program. It was emphasized that theoretical base was significant in setting up a learning structure thus, it was vital to include experts or stakeholders-managers, administration and nursing staff to increase the programs commitment (Beyea et al. 2010). Innovation strategies for practice and integrating theory, organized placement program, preceptor growth and development and administrative support are important components needed when setting up a placement program for new graduates. For the case of facilities that had new orientation programs that were not working properly ought to redesign their programs to change to the contemporary orientation programs. Redesigning an orientation program improves a program curriculum that can favor new nurses. Nurse Placement Programs It is noted that the current new nurse placement program are highly inconsistent in content, resource and structure requirements. These requirements are also defined by the program and hospital setting. This program bears several names such a nurse internship or nurse residency. The inconsistent structure of nurse internship program fell under several names: competency based orientation program, staged orientation, Post baccalaureate program, graduate internship, shared leadership model, evidence based model as well as preceptor program (Kramer et al. 2012). Post baccalaureate program by a task force comprising of American Association of College of Nursing and University Health System Consortium. The program was design to meet the increased number of Nurses in the workforce. This was intended to increase the retention of supported and satisfied nurses. In addition, it was intended to offer uniform and consistent transition into nursing practice. Competency based program is an educational system that emphasizes on learners ability to show proficiency to a given task or career. To nurses competency means that a care giver can be able to use skills, personal attributes and knowledge time and again in practice so as to meet the expected standards of performance. According to AACN standards and scope for critical care nursing practice, nurses are needed to have competence to offer care to critical patients. While handling or managing a competency program individualization of an orientation program is important in meeting the learner’s needs. The focus for each program was subjected to specific requirements for each departments and the training required. A staged orientation program was also important program for nursing transition for critical care nurses. The program covered the redesign of the current program to through implementation of a staged program. Staged program was designed to address the short fall and inconsistence of the previous program that had problem with its content. Through its positive feedback the program stages paved way for provision of constant curriculum to the new nurses. The other program was preceptor program. It indicated that if the preceptors completed a strong training program then they could offer an orientation program that fits the new graduates. Preceptors are significant part of a new graduate as it plays the role of a teacher mentor, role model as well as offers assistance in socialization. Some articles addressed the nurse internship programs that covered both system implementation and single facility implementation. The program has two branches: critical care nurse residency and trauma nurse and critical care internship. Evaluation of Current Nurse Residency Programs Based on the purpose of evaluation some of the facilities were able to evaluate different programs. The tools used for measurement depended on the functions of the program as well as the cost of evaluations. Performance based evaluation system was used to measure interpersonal skills and critical thinking. American society of Training and Development Evaluation Tools was mostly used to evaluate the effectiveness of program training to the new graduates. The tools used 13 question survey that asked general questions (Capella et al. 2010). When evaluating thinking skills, a professional Judgment rating form was used. Staff Development Effectiveness Evaluation tools was used to evaluate individual components of a program as well as undertaking a summary of the program. This tool only covered cost effectiveness of a program. Identifying gaps Several issues were indentified from literature that showed the need for changes to improve the quality of CCNRP (Budin et al. 2012). The following are the issue prominent from literature: the time needed for one to complete the Basics of critical care orientation program, centralizing the program basing the experience of the new graduate nurse, the timing of the program in relation to critical care clinical time, increasing the critical time within the critical care units, addition of more specific topics to every critical care unit and addition of new sessions to in the critical care phase (Park, & Jones, 2010). These findings are important to be reached with the critical care program nurse manager so that the program could be adjusted to meet the demands of the new graduates. It is projected that through these changes, the concerns about the critical Care Nurse residency Program would be improved (Ulrich et al. 2010). These changes will be implemented with the other nurses. After the implementation of the new changes an evaluation will be conducted using several evaluation tools to determine the effectiveness of the program but the next cohort of nurses will be subjected to the changed program so that the transition phase is well defined. Attention should be give to the time that the critical care nurses will be subjected to transition. Formulating the research question What are the insights of the critical care nurses to complete the CCNRP in relation to their training for taking care of critical patients? It is objected that within the question, the various apparatus of the nursing internship or residency might me highlighted during the interviews and then contrasted to the nurse expectations and needs. Does the critical nurse Program meet the training and educational needs of the new critical care nurse to equip them to handle work in the critical care unit? Interview comments may show the effectiveness and efficiency as well as the weaknesses and strengths of the nurse internship or residency program, and evaluate the unmet needs. This can lead to changes in the program making it a better program that will lead to good and unmet needs of the new critical care nurse. Specifying the significance The shortage is generated by aging baby boomers as their health needs also increases, as well as the increase in number of the registered nurses expecting to retire. This shortage is high to those areas calling for specialties. The number of critical nurses account for almost 40% of all the nurses practicing in a hospital setting. Despite the fact that technology if providing room to accommodate more critical patients it also creates a demand for critical care nurses, but this bunch of nurses are retiring. With this in mind the study will seek to identify various way of making programs that will be used in evaluation of the level of nursing training and education to meet the demands of the nurse shortage in the sector. Proper consideration of the number of nurses in a critical care unit is significant as it results to better provision of nursing care to critically ill patients in any health care setting. As a result this makes leads to the undertaking of this research project so that it findings could be used by health care settings as well as the government to make changes to its critical care nurse transition phase to curb the shortage of nurses as well as make use of the old and retired nurses as experts. References Beyea, S. C., Slattery, M. J., & von Reyn, L. J. (2010). Outcomes of a simulation-based nurse residency program. Clinical Simulation in Nursing, 6(5), e169-e175. Bratt, M. M., & Felzer, H. M. (2011). Perceptions of professional practice and work environment of new graduates in a nurse residency program. Journal of continuing education in nursing, 42(12), 559. Capella, J., Smith, S., Philp, A., Putnam, T., Gilbert, C., Fry, W., ... & ReMine, S. (2010). Teamwork training improves the clinical care of trauma patients. Journal of surgical education, 67(6), 439-443. Kowalski, S., & Cross, C. L. (2010). Preliminary outcomes of a local residency programme for new graduate registered nurses. Journal of nursing management, 18(1), 96-104. Kramer, M., Halfer, D., Maguire, P., & Schmalenberg, C. (2012). Impact of healthy work environments and multistage nurse residency programs on retention of newly licensed RNs. Journal of Nursing Administration, 42(3), 148-159. Kramer, M., Maguire, P., Halfer, D., Budin, W. C., Hall, D. S., Goodloe, L., & Lemke, J. (2012). The organizational transformative power of nurse residency programs. Nursing Administration Quarterly, 36(2), 155-168. Park, M., & Jones, C. B. (2010). A retention strategy for newly graduated nurses: an integrative review of orientation programs. Journal for Nurses in Staff Development, 26(4), 142-149. Ulrich, B., Krozek, C., Early, S., Ashlock, C. H., Africa, L. M., & Carman, M. L. (2010). Improving retention, confidence, and competence of new graduate nurses: results from a 10-year longitudinal database. Nursing economics, 28(6), 363-375. Read More