New graduate nurses’ understanding and attitudes about patient safety upon transition to practice

Abstract

Aims To explore the transition experiences of newly graduated registered nurses with particular attention to patient safety. Background New graduate registered nurses’ transition is accompanied by a degree of shock which may be in tune with the described theory–practice gap. The limited exposure to clinical settings and experiences leaves these nurses at risk of making errors and not recognising deterioration, prioritising time management and task completion over patient safety and care. Design Qualitative descriptive approach using semi‐structured interviews. Methods Data were collected during 2017–18 from 11 participants consenting to face‐to‐face or telephone semi‐structured interviews. Interviews were transcribed verbatim, and data were analysed using thematic analysis techniques assisted by Nvivo coding software. The study follows the COREQ guidelines for qualitative studies (see Supplementary File 1). Results Key themes isolated from the interview transcripts were as follows: patient safety and insights; time management; making a mistake; experiential learning; and transition. Medication administration was a significant cause of stress that adds to time management anguish. Although the new graduate registered nurses’ clinical acumen was improving, they still felt they were moving two steps forward, one step back with regards to their understanding of patient care and safety. Conclusion Transition shock leaves new graduate registered nurses’ focused on time management and task completion over patient safety and holistic care. Encouragement and support needed to foster a safety culture that foster safe practices in our new nurses. Relevance to practice Having an understanding of the new graduate registered nurses’ experiences and understanding of practice will assist Graduate Nurse Program coordinators, and senior nurses, to plan and provide the relevant information and education during these initial months of transition to help mitigate the risk of errors occurring during this time.

Analysis of Factors Influencing Safety Attitudes of Operating Room Nurses and Their Cognition and Attitudes toward Adverse Event Reporting

“…The key to maintaining patient safety lies in establishing a safety culture. Murray et al pointed out that the medical staff's safety attitudes toward patients are vital in the patient safety culture, and improved medical staff's attitudes to patient safety promote patient health and safety [ 9 ]. Haugen et al also proposed that the attitude and behavior of the surgical team reflected the development of safety procedures in the operating room [ 10 ].…”

Newly graduated nurses' clinical competencies and need for further training in acute care hospitals

“…It is concerning that research has shown that medication errors are frequent among nurses with less than five years of experience (Makary & Daniel, 2016; Treiber & Jones, 2018). It has also been reported that NGRNs experience the administration of medication as causing stress (Murray, Sundin, & Cope, 2019). Among NGRNs, medication errors are related to nursing care with heavy patient workloads and patients with complex medical diagnoses (Saintsing, Gibson, & Pennington, 2011).…”

“…It is concerning that research has shown that medication errors are frequent among nurses with less than five years of experience (Makary & Daniel, 2016;Treiber & Jones, 2018). It has also been reported that NGRNs experience the administration of medication as causing stress (Murray, Sundin, & Cope, 2019).…”

Newly graduated registered nurses' self‐assessed clinical competence and their need for further training

“…Being in a supportive atmosphere, positive socialization and being part of the team is important for NGRNs to reduce anxiety and enhance job satisfaction (van Rooyen, Jordan, ten Ham‐Baloyi, & Caka, ). It has, however, been reported that NGRNs are concerned that asking too many questions may be perceived as annoying and give the image that they do not have enough knowledge (Murray, Sundin, & Cope, ). Several studies have also noticed the importance of gaining clinical competence through support from and collaboration with experienced colleagues (Lima et al, ; Numminen, Ruoppa, et al, ; Pasila et al, ).…”

“…The NGRNs included in this study have assessed that they need further training in nursing interventions in association with direct patient care. Recent studies have shown that NGRNs are afraid to make mistakes regarding medication (Halpin, Terry, & Curzio, ) and that the administration of medication is a cause of stress among NGRNs as they have deficient knowledge of different types of medication and their interactions (Murray et al, ). It is reported that 55% of NGRNs have made errors with medication leading to feelings of fear and horror as they realized they might have harmed a patient (Treiber & Jones, ).…”