Transitioning from acute to primary health care nursing: an integrative review of the literature

Abstract

Aims and objectives This paper seeks to explore the transition experiences of acute care nurses entering employment in primary health care settings. Background Internationally the provision of care in primary health care settings is increasing. Nurses are moving from acute care settings to meet the growing demand for a primary health care workforce. While there is significant research relating to new graduate transition experiences, little is known about the transition experience from acute care into primary health care employment. Design An integrative review, guided by Whittemore and Knafl's (2005) approach, was undertaken. Following a systematic literature search eight studies met the inclusion criteria. Methods Papers which met the study criteria were identified and assessed against the inclusion and exclusion criteria. Papers were then subjected to methodological quality appraisal. Thematic analysis was undertaken to identify key themes within the data. Results Eight papers met the selection criteria. All described nurses transitioning to either community or home nursing settings. Three themes were identified: (1) a conceptual understanding of transition, (2) role losses and gains and (3) barriers and enablers. Conclusion There is a lack of research specifically exploring the transitioning of acute care nurses to primary health care settings. To better understand this process, and to support the growth of the primary health care workforce there is an urgent need for further well-designed research. Relevance to clinical practice There is an increasing demand for the employment of nurses in primary health care settings. To recruit experienced nurses it is logical that many nurses will transition into primary health care from employment in the acute sector. To optimise retention and enhance the transition experience of these nurses it is important to understand the transition experience. Conflict of Interest Nil conflicts FundingCA is a fulltime PhD candidate supported by an Australian Postgraduate Award scholarship. ABSTRACTAims and objectives. This paper seeks to explore the transition experiences of acute care nurses entering employment in primary health care settings.Background. Internationally the provision of care in primary health care settings is

Transitioning into new clinical areas of practice: An integrative review of the literature

“…As reported by Ashley et al. () in their review of transition to primary health care employment, the limited research is in stark contrast to the large body of literature published around the transition of new graduates into nursing practice (Cowin & Hengstberger‐Sims, ; Rush, Adamack, Gordon, Lilly, & Janke, ; Scott, Keehner Engelke, & Swanson, ). While common themes emerged from this review, the limited available literature highlights the need for further research to better understand the transition process and support workforce planning across the spectrum of health care areas.…”

“…While current theories of transition for newly qualified nurses outline specific process and its outcomes from such experiences (Duchscher, ), it is unclear whether such theories can be applied to experienced registered nurses. Furthermore, a recent literature review regarding registered nurse transition to primary health care (Ashley et al., ) found that successful transitions was associated with individual expectations, personal characteristics and organisational support and that understanding such experience during transition could optimise retention and enhance the nurses experiences. This integrative review will build on existing knowledge by critically synthesising what is currently known about the experiences of registered nurses transitioning into new clinical areas and identify considerations for research, policy and practice.…”

Work satisfaction and future career intentions of experienced nurses transitioning to primary health care employment

“…The experience of transition has been described in the literature as being personally and professionally challenging (Ashley, Halcomb, & Brown, ) (Banner & Johnston, ; Currie, Flinn, & Martin, ). This study has provided new data to explore the work satisfaction of experienced nurses new to PHC and their future career intentions.…”

Experiences of registered nurses transitioning from employment in acute care to primary health care—quantitative findings from a mixed‐methods study

“…The process of transitioning has been reported as stressful, and associated with a lack of confidence, role ambiguity and role conflict as the requirements of the new role become clear (Kramer, McGuire, Halfer, Brewer, & Schmalenberg, ; Parker, Giles, Lantry, & McMillan, ). These phases may be followed by periods of readjustment as workers “unfreeze” from the old role and acquire the skills and confidence needed to fulfil their new role (Ashley et al, , Ashforth, ; Holt, ). The association between these phases of transition and the impact they may have on job satisfaction, patient/client safety and retention in the workforce have not been widely researched in the PHC sector (Ashley et al, ).…”

“…These phases may be followed by periods of readjustment as workers “unfreeze” from the old role and acquire the skills and confidence needed to fulfil their new role (Ashley et al, , Ashforth, ; Holt, ). The association between these phases of transition and the impact they may have on job satisfaction, patient/client safety and retention in the workforce have not been widely researched in the PHC sector (Ashley et al, ). However, evidence from other sources, in particular new graduate nurses entering the workforce, suggests that negative transitioning experiences have been associated with increased staff turnover (Parker et al., ; Yeh & Yu, ) and patient safety concerns (Gaynor, Gallasch, Yorkston, Stewart, & Turner, ; Murray‐Parahi, DiGiacomo, Jackson, & Davidson, ; Rush, Adamack, Gordon, Lilly, & Janke, ).…”