Pediatric Nurses\u27 Perspectives on Medication Teaching in a Children\u27s Hospital

Purpose To explore inpatient pediatric nurses\u27 current experiences and perspectives on medication teaching. Design and Methods A descriptive qualitative study was conducted at a Midwest pediatric hospital. Using convenience sampling, 26 nurses participated in six focus groups. Data were analyzed in an iterative group coding process. Results Three themes emerged. 1) Medication teaching is an opportunity. 2) Medication teaching is challenging. Nurses experienced structural and process challenges to deliver medication teaching. Structural challenges included the physical hospital environment, electronic health record, and institutional discharge workflow while process challenges included knowledge, relationships and interactions with caregivers, and available resources. 3) Medication teaching is amenable to improvement. Conclusion Effective medication teaching with caregivers is critical to ensure safe, quality care for children after discharge. Nursing teaching practices have not changed, despite advances in technology and major changes in hospital care. Nurses face many challenges to conduct effective medication teaching. Improving current teaching practices is imperative in order to provide the best and safest care. Practice Implications This study generated knowledge regarding pediatric nurses\u27 teaching practices, values and beliefs that influence teaching, barriers, and ideas for how to improve medication teaching. Results will guide the development of targeted interventions to promote successful medication teaching practices

Transition of Experienced and New Graduate Nurses to a Pediatric Hospital

This study reports on the 3-, 6-, 12-, and 18-month outcomes of 118 newly hired registered nurses (RNs) who completed a 12-month transition-to-practice program at a pediatric hospital. Experienced RNs (n = 42) and new graduate RNs (n = 76) showed improved organization, prioritization, communication, and leadership skills over time. The experienced RNs reported better communication and leadership skills than the new graduate nurses. Results inform transition program development for both new and experienced nurses. The American Association of Colleges of Nursing (2012) predicts that, without a multifaceted approach, a national nursing shortage will occur by 2020. Many nurses leave their first position and sometimes the profession within the first year of employment (Baxter, 2010; Welding, 2011). Retaining nurses is a vital component of any approach to averting a nursing shortage. In an attempt to retain nurses, healthcare institutions often provide a transition-to-practice (TTP) or nurse residency program for new graduate nurses (NGN) entering the profession. The Institute of Medicine (2011) in its Future of Nursing report also recommends a transition program for nurses moving to a new specialty or to advanced practice roles. Completing a NGN transition program is associated with a decrease in nurse attrition by as much as 80% (Halfer, Graf, & Sullivan, 2008; Rush, Adamack, Gordon, Lilly, & Janke, 2013; Spector et al., 2015). This reported decrease has led to organizational interest in transition programs to improve retention. The goals of residency programs for the NGN have ranged from increasing new nurse confidence and competence, to increasing satisfaction and retention (Fink, Krugman, Casey, & Goode, 2008; Goode, Lynn, McElroy, Bednash, & Murray, 2013; Institute of Medicine, 2011; Spector et al., 2015). Although literature supports the effectiveness of transition programs for the NGN (Fink et al., 2008; Goode et al., 2013; Spector et al., 2015), there is little evidence on the experienced nurse’s transition to a new specialty practice. Furthermore, most transition programs do not report outcomes beyond the first 12 months of employment. Thus, the purpose of this study is to evaluate nurse stressors and supports during and after a 12-month transition-to-employment program for both new and experienced nurses transitioning to a pediatric practice

Lessons Learned: Newly Hired Nurses\u27 Perspectives on Transition into Practice

This descriptive qualitative study explored data from debriefs of all newly hired nurses at 3, 6, and 12 months posthire during a newly designed transition-to-practice program at a pediatric hospital. Four major themes emerged: preceptors, education process, adaptation to the organization, and role transition. Supportive factors included staged orientation, limited preceptors, mentors, regular communication with leaders, and a culture of teamwork. Stressors included too many preceptors, mentorship needs, floating, communication challenges, and organizational changes