Transition support for new graduate and novice nurses in critical care settings: An integrative review of the literature

Abstract

Transition into critical care areas for new graduate nurses may be more difficult than transitioning into other areas due to the specialised knowledge needed. It is unknown which aspects of transition programs best support new graduate nurses improve competence and confidence to transition into critical care nursing specialties. Identifying these aspects would assist to design and implement best practice transition programs for new graduates in critical care areas. Themes identified in the literature include; having a designated resource person, workplace culture, socialisation, knowledge and skill acquisition, orientation, and rotation. Allocation of a quality resource person/s, supportive workplace culture, positive socialisation experiences, knowledge and skill acquisition and structured orientation based on new graduates' learning needs all positively supported increased confidence, competence and transition into nursing practice. Rotations between areas within graduate programs can potentially have both positive and negative impacts on the transition process. Negative impacts of including a rotation component in a transition program should be carefully considered alongside perceived benefits when designing new graduate nurse transition programs.

Transition experiences of newly graduated Filipino nurses in a resource‐scarce rural health care setting: A qualitative study

“…A comprehensive review of the existing literature yielded several strategies, programs, and interventions used to improve transition among new nurses, which were categorized into the following four groups: preceptorship/mentorship programs, nurse residency programs, new nurse orientation programs, simulation‐based programs, and multifaceted transition programs (Table ). Nurse residency and structured orientation programs were found to be effective in facilitating the new nurse's transition to work as well as transition and mentoring programs . In recent years, many health care institutions have adopted the use of simulation to enhance the readiness of new nurses for clinical practice .…”

Collaboration is key to success for transition of newly licensed nurses to specialty areas

“…Newly licensed nurses require specific knowledge and skills for practice in certain specialized areas like intensive care, progressive care, women's services, peri-operative service, and so on, which can best be provided by designing and implementing evidence-based specialty training programs. [6] Several authors share the importance of supporting newly licensed nurses in the transition to their professional roles and providing opportunities to learn the skills and knowledge required for their specific practice environment. Specialized training for the newly licensed nurse, utilizing various strategies, is required to promote confidence, skill acquisition, critical thinking, and positive outcomes.…”

Identifying, describing, and assessing interventions that support new graduate nurse transition into critical care nursing practice: a systematic review protocol

“…In 2017, the Canadian Institute for Health Information reported the first decline in new nurses entering the profession since 2008 [ 2 ]. In an effort to mitigate shortages and maintain sufficient human resources at the point of care, critical care settings, specifically intensive care units (ICU) and emergency departments (ED), are now routinely employing new graduate nurses (NGNs) in many hospitals [ 3 , 4 ]. Today, nurses working in these critical care settings comprise the second largest body of nurses (15.7%) in a particular domain of practice [ 5 ].…”

“…The conclusion drawn that transitional support strategies generally for NGNs are beneficial positions our systematic review as relevant as we look specifically to the critical care setting. A more recent integrative study by Innes and Calleja [ 3 ] aimed to develop an understanding of the strategies that may inform the creation of an educational program to support the transition of nurses to critical care [ 3 ]. A constant comparison approach to thematic analysis of the data was used to develop six themes: having a designated resource person, workplace culture, socialization, knowledge and skill acquisition, orientation, and rotations [ 3 ].…”