...Clinical question My clinical question is “how is nursing residency program beneficial to new graduate registered nurses? Nursing residency program is a program designed to increase retention and provide essential tools to promote graduate nurse success and productivity. (Welding, 2011). Nurse Residency program gives the nurse who is a novice the learning base and expertise set required to move to clinical nursing practice competence while giving the skills required to meet the mission and objectives of the organization, the program gives nurses the administration abilities to work cooperatively within a multidisciplinary team. The nurse residency program bridges the gap between...
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...NUR 3303 Nursing Research Introduction Nurse residency programs are important in the desire for nursing recruitment and retention. New graduate hires face many stressful challenges transitioning from student to professional RN in the workforce. Loss of a new graduate nurse leads to a great financial loss and ultimately increase in the shortage that in turn can lead to patient safety issues. The leaders of the nurse residency programs need to be vested and continue to follow and mentor these new professionals well into their second or third year of hire. The purpose if this paper is to critique the research article “Are rural and urban newly licensed nurses different? A longitudinal study of a nurse residency programme” by Marilyn Meyer Bratt, Marianne Baernholdt, and Jessica Pruszynski. My examination focuses on specific aspects of the article in terms of process and validity of research methods and results. According to Burns and Grove (2012) the purpose of reviewing literature provides us with evidence in theory and science about a specific problem, alloying is to decipher information about what is known to us and not. The key concept covered in Bratt, Baernholdt and Pruszynski’s article is to determine if there is a difference among rural and urban nurse residency programs that lead to a higher retention rate? The key points of this review is to assess the two different populations of nurse residency programs using sampling data and dissect the strategies used...
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... & Rankin, 2013, p. e43 The transition from being a nursing student to a novice nurse is a challenge that can be overwhelmingly filled with stress and anxiety. Providing a structured orientation program is helpful in easing this stress and anxiety for a short period of time. After orientation, novice nurses are faced with challenges that require critical thinking and clinical skills beyond what he/she has developed causing a spike in stress and anxiety. Continuing education will help in the progression of a novice nurse to that of an expert nurse, however not exclusively....
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...(Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine [RWJF], 2011, p. 1) Nurses fill a multitude of roles in health care ranging from Licensed Practical Nurse (LPN), Registered Nurse (RN), Advanced Practice Registered Nurse (APRN), master’s of science in nursing (MSN), and doctor of nursing practice (DNP). Nurses are incorporated into every aspect of nursing including communities, colleges, hospitals, doctor’s offices, insurance companies, software development, law making and government. There is no better way to impact health care than to start with the largest sector: nursing. This report covers very important aspects of nursing and provides excellent examples of ways to impact the future of health care by changing the future of nursing. An excellent way to eliminate cost is to empower nurses to function in the roles they were educated and trained for. Two separate studies indicated a savings of over $1,000,000 in a year by utilizing APRNs. (Chenoweth, Martin, Pankowski, & Raymond, 2008)(Chenoweth, Martin, Pankowski, & Raymond, 2005) Currently, physician services that are within the scope of practice of their state laws are covered by Medicare. There should be no difference when it comes to nursing. Nurses should be taught leadership no matter the level of education. Nurses are advocates and require leadership...
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...Wood Johnson Foundation (RWJF) and for two years looked at the impact of the changing environment of health care delivery in the United States, and how nurses factor into the evolving health care system (www.IOM.edu). The joint initiative details 8 recommendations to remove what they determined to be existing barriers “preventing nurses from being able to respond effectively to rapidly changing health care settings” so that nurses, the largest profession in health care, are better equipped and supported in realizing the objectives of the 2010 Affordable Care Act (www.IOM.edu). IOM Recommendations Recommendation 1 Remove scope-of-practice barriers so that advanced practice nurses are able to practice to the full extent of their education and training (www.IOM.edu). This recommendation would empower nurses to be leaders in health care, working side-by-side with physicians, and promoting nursing as more than carrying out tasks ordered by physicians. Recommendation 2 Expand opportunities for nurses to lead and diffuse collaborative improvement efforts (www.IOM.edu). Expanding the role of nurses in the development of policies, standards of care, and the future of health care acknowledges the vital role that nurses play in the success of these efforts for improved patient outcomes. According to Robin Chard, nurses “can practice as full partners with other health care professionals in redesigning systems only if the health care organization...
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...(IOM) 2010 report defines for future nurses and health care workers its vision and goals in transforming current practice into something remarkable. The IOM, a non-profit organization, conducts research in a systematic approach to guide the nation in improving health. (Edelman, Kudzman, & Mandle, 2014). As we all know, the health care delivery system is changing significantly due to health care reforms such as the Affordable Care Act of 2010 (ACA). As we delve into this matter we will discover what the future of nursing can expect. We will investigate the effect the IOM report has on education, leadership, and future nursing practice. Potter & Perry (2011) describe the health care system of the future as high quality patient-centered care, accessible to all populations. The IOM (2010) reports that nursing practice is being shifted away from acute and specialty care, and directed towards primary care. The emphasis for health care is now centered on preventing illness, promoting wellness, and maintaining chronic conditions. (IOM, 2010). In order to meet the current goals set forth by the IOM, higher education is in order. The IOM has set a series of goals that they would like to see in place in the future. One of these goals is 80% of nurses to hold a baccalaureate degree by 2020. With the increased demands of health care, nurses must be prepared to meet the needs of the ever-changing health profession. According to IOM (2010) nurses must be properly equipped to meet diverse...
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...The recommendations in the report are directed towards state and local governments, policy makers licensing bodies, colleges, nurses, health care researchers, and many other groups and organizations ("IOM," 2010, p. 16). The Institute of Medicine advised eight recommendations, however; in this report three of the recommendations are going to be discussed: Education, Nursing Practice, and Leaders in Nursing along with the impact they shall have on each recommendation. Nursing Education The Institute of Medicine recommends that nurses should achieve higher levels of education to provide a foundation for the new model of care for the Healthcare reform. The Institute of Medicine gives reason why a higher level of Education is necessary. A few of the reasons are as follows: * Nursing competencies have greatly increased over the years. Nurses need knowledge of evidence-based practice, health policy, public health, geriatrics, leadership skills, and system improvements. * Nurses must make critical decisions related to sicker patient populations. * Nurses now work with more sophisticated lifesaving technology. * Nurses must now work together with multi-disciplinary care teams which include Pharmacists, Physicians, social workers, and physical therapists. The impacts of the recommendations are as follows: * By the year 2020 80% of nurses hold a Bachelor Degree of Nursing * Workplaces offer tuition reimbursement * Increase...
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...Challenges of New Graduate Nurses: Transition to Practice Job retention rates amongst newly graduate nurses tend to fluctuate widely. These fluctuations have many possible and combined explanations including orientation quality, level of confidence, residency programs, pay rates, mentoring programs, management support, and countless views of job satisfaction. My concept will focus on transition to practice success of new graduate nurses in relationship to their organization’s orientation process, job satisfaction, and the effects of job retention rates. Identifying these challenges are significant noting that low retention rates are costly for health care facilities as well as for the economy. According to Gemberling, Tretter-Long, Reiner, Potylycki, and Davidson in their article Clinical Support for the Off-Shift Nurse and the Graduate Nurse: The Clinical Rock Stars, “Depending on the specialty, estimated replacement costs for an RN were $42,000-$64,000 [in 2005]” Gemberling et al. (2011). This topic is especially important for new graduate nurses when considering a first place of employment. Nursing educators and health care managers have been analyzing and designing new ways to combat low retention rates specifically for newly graduated nurses. Review of Literature Several factors influence job satisfaction, which is a key characteristic that effects job retention rates. Gemberling et al. (2011) found that most new nurses leave their first job because of stress related...
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...healthcare organization operating in states that mandate minimum nurse to patient staffing ratio (xxx). 6.2. Decreased quality of patient care * Staff shortages caused by nursing turnover are associated with significant decreases in the general quality of patient care, increases in the length of patients stays within hospital and greater number of hospital acquired infection (xxx). 6.3. Increased contingent staff costs * Many healthcare organizations are forced to rely on contract nurses to overcome staff shortages caused by high level of nurse turnover. Such contract nurses can cost twice as much to employ as nurses employed directly by the company (xxx). 6.4. Increase nurse turnover * Nurse turnover creates staffing shortages that increase the work demands placed on the organizations remaining nurses. This heightens the risk of the remaining nurses quitting due to excess workload and constantly increasing nurse turnover within organization (xxx). 6.5. Increased turnover of medical support staff * High level of nurse turnover creates disruptive, unstable work environments that negatively impact the retention of other medical service providers that work with the nurses (xxx). 6.6. Increased staff costs * Considerable resources are required to recruit, hire and train nurses to replace nurses who quit. Healthcare organizations that suffer from high level of nurse turnover may find difficulty to recruit new nursing candidates...
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...Nurse Practitioner Post Graduation Fellowships University of Maryland, Baltimore Ariel Gibson Introduction Traditionally nurse practitioners (NPs) have entered directly into practice after completing an advanced nursing degree. In 2010 the Institute of Medicine released a report on the future of nursing which recommended that “state boards of nursing, accrediting bodies, the federal government, and health care organizations should support nurses’ completion of a transition-to-practice program after they have completed a prelicensure or advanced practice degree program or when they are transitioning into new clinical practice areas” (Institute of Medicine, p.7, 2010). Background Many novice NPs feel unprepared, uncertain, and isolated during their first years of practice. According to a study by Hart and Macnee (2007), only ten percent of NPs felt they were well prepared for practice after completing their NP program while fifty one percent felt that they were only somewhat or minimally prepared. Study participants felt least prepared in the areas of “coding and billing, casting, complementary and alternative medicine, electrocardiogram interpretation, microscopy, simple office procedures, splinting, suturing, X-ray interpretation, and clinical management of mental health diseases”. In the study it was felt that basic NP education lacked clinical rigor and could benefit from more clinical hours. Eighty seven percent of the NPs studied stated they would...
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...The Impact of the 2010 IOM Report on The Future of Nursing Robert Loperfido Felician Health Policy and Politics NURS 385 Helena Correia RNC, MSN August 18, 2014 The Impact of the 2010 IOM Report on The Future of Nursing The United States is at a significant junction. Health care reforms are being carried out and the system is beginning to change. The largest component of the health care workforce is nurses and the needs to strengthen this group will only improve the delivery of care and the health care system. The IOM and the Robert Wood Johnson Foundation established that accessible, high quality care cannot be achieved without extraordinary nursing care and leadership (American Nurses Association, 2014, p. 1). The report calls on nurses individually and as a profession to embrace changes needed to promote health, prevent illness and care for people across the lifespan. The report also calls for support from interprofessional collaborations from physicians, dieticians, physical therapist and other multisector professions to work with nurses to make the changes necessary for a more accessible, cost efficient and high quality health care system. This report expands on the theme that high quality, safe, evidence based patient centered care is a critical role of nursing and that to have a successful health care system rests on the future of nursing (Institute of Medicine, 2010). In 2010 the President signed into law and Congress approved health care legislation...
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...face of an ever-changing health care system, as nurses, we have no choice but to change as well. The Institute of Medicine (IOM), an independent organization with a mission to, “Serve as advisor to the nation to improve health,” created a report outlining major categories of change necessary so that nurses can meet the changing health care needs of the United States (Institute of Medicine, 2010). This report, titled, “The Future of Nursing: Leading Change, Advancing Health”, will be the focus of this paper. This paper will look at the impact of the Institute of Medicine’s report on nursing education, nursing practice in primary care, the impact of the report on the nurses as leaders, and how the author of this paper will change her practice to meet the goals of the report. One of the key points in the report states, “Nurses should practice to the full extent of their education and training” (Goeshchel, 2011). This report fully encourages nurses to never stop learning, and to prepare themselves to maintain a high level of knowledge in their field. The IOM report also follows this key message on education with recommendations for moving forward. One of the recommendations is that as a profession, nurses “increase the proportion of nurses with baccalaureate degrees to 80% by 2020” (Goeshchel, 2011). The next two recommendations are that nurses “double the number of nurses with a doctorate degree by 2020, and ensure that nurses engage in lifelong learning” (Goeshchel, 2011)....
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...American Nurses Association (ANA) “Nursing is the protection, promotion, and optimization of health and abilities and prevention of illness and injuries, alleviation of suffering through the diagnosis and treatment of human response, advocacy of care of an individual, families, communities and population”. Nurses are providing care in all different heath care settings like hospitals, nursing homes, schools, medical offices, natural disasters, immunization clinic, research centers, pharmaceutical research and or any health related emergency like Ebola outbreak. Impact Of IOM Report On Health Care Practice The Institute Of Medicine (IOM) IOM (The Institute Of Medicine) is started in 1970. IOM is nonprofit, independent organization. It governs independent of government and give wise, reliable, and legal advice by providing reliable evidence. “The IOM is health arm national academy of science which was charted under president Abraham Lincoln in 1863.Nearly 150 years after national academies of science has expanded in to what is collectively known as national Academies which comprises the national Academy of science, national academy of engineering, the national research council and the IOM”. The IOM gives answer the nation’s most critical questions about health care. The nursing profession and medical field growing fast, nurses playing vital role with patient care. In 2008 The Robert Wood Johnson Foundation and The Institute of Medication (IOM) started a two year program to the transform...
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...valid points for the need to reform nursing. Registered Nurses (RN) do not practice at the level that are trained. According to the IOM’s report that need to change. For example some states do not allow nurse practitioners to perform at their educational there practice is governed by state laws (Institute of Medicine of the National Academies [IOM], October 2010)). With escalating health care costs advance practice nurses (APRN) need to be playing a larger role in the health care system, both delivering and decision making about health care. APRN’s need to be working from health promotion to disease prevention. States may need to streamline scope of practice regulations that reflect the full extent of the APRN educational level. The Federal government is well suited to reform changes at the states level and offer incentives for adopting best care practices. The IOM’s Report also recommendations changes need to occur within the Centers for Medicare and Medicaid, Congress needs to ensure that nurses practice at their educational level (IOM, October 2010) The Need to Transform Education As health care advances so should nurses. Nurses need to be encouraged at the educational to be lifelong learners. As patients present with more complex problems nurses need to have the most up to date education and training available. Nursing education needs to be updated and adaptive enough to change with patients changing needs. Nurses need to have the most up to date technology and science...
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...actions of the nursing staff. The health care delivery system and nursing profession consider this report as a framework for transformation. The changes in health care system and nursing workforce are directed to health care researchers, payers, national, state and local government leaders, professionals and executives comprised of nurses and others, and individual policy makers. These changes are also directed to educational organizations, licensing departments, and charitable and legal institutions who advocate for customers ("Institute of Medicine," 2010). Committee of IOM created key messages that constitute its suggestion for this change, which focus on education, leadership, and practice in nursing. The need to transform practice is addressed in first key message of Institute of Medicine, “Nurses should practice to the full extent of their education and training”. United States is proud to have more than three million nurses today. Nurses in each state have scope of nursing practice developed by the state board of nursing. The scope of nursing practice in each state has variations and it affects all registered nurses especially Advance Practice Nurses. According to Institute of Medicine report scope of nursing practice should be uniform and customized in all the states to permit them to practice to the full extent of their clinical preparation and education. Similarly after graduation before obtaining a clinical staff position,...
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