Authors (including presenting author) :
Yan YPK (1), Hui T S (1), Cheung MY Daisy (1), CHAN W K (1)
Affiliation :
(1) Central Nursing Division, Kwong Wah Hospital
Introduction :
Nursing shortage and high turnover are great challenge to global health care top management. Recent year of social climate and events induce immigration tide and shifting to another career further exacerbate nursing attrition and affect our healthcare system. Although input of new graduates’ nurses could spontaneously relieve nursing shortage, it still failed to compensate the loss. Contrary, COVID pandemic in recent few years decrease opportunity of nursing student’s clinical practicum. Simulation training and clinical practicum arranged in non-acute healthcare setting could not replace down-to-earth clinical experience gained in acute hospital. Most literatures stated that comprehensive residency program for new graduates is worth to produce higher retention of junior nurses. As such, “Basic Skill Enhancement (BSE) Program” was designed for pre-RN TUNS before registration; Staff Partnership Program Orientation and Induction Program (SPP O&I) was arranged after registration; in addition of clinical preceptor and ward-based clinical mentor, with aim to tackle new graduates’ inadequate clinical experience under COVID pandemic, and assist them to have a smooth role transition from nursing student to professional nurses under acute hospital setting.
Objectives :
(1) To enhance basic nursing knowledge and clinical skill of new graduates, improve caring attitude and strengthen risk management in clinical area; (2) To establish supportive culture and assist new graduates quickly adapt clinical environment and facilitate role transition; (3) To assist new graduates develop effective communication skill with colleagues, patients, and multi-disciplines.
Methodology :
Department were invited to nominate experience nurses to design and being speaker to conduct BSE program. Training contents were based on HA 15 basics procedure of the proficiency of Junior Nurses Program.
Getting department supervisor supported on duty arrangement, Pre-RN TUNS were invited to join BSE program upon first reporting duty day. Departmental representatives shared local clinical practices and common incident. Demonstration and return demonstration were arranged in practical room afterward to strengthen Pre-RN TUNS clinical skills and fill up theoretical-practice gap. Daily “Take home Message” was conducted to recap knowledge at the end of the workshop and establish learning culture among peer-group. Quiz and evaluation conducted at last day to evaluate the effectiveness of BSE program.
After registration, five-day SPP O&I program was arranged to new graduates to provide advanced critical clinical skill and risk management. Patient safety is ultimately vital in clinical practise. Thus, Quality and Safety (Q&S) team introduced Nursing Quality Indicator (NQI), nursing standard and incident sharing, to increase new graduates’ clinical alertness and develop clinical judgement. Limited clinical exposure makes new graduates experienced more stress in caring critically ill patients. As such, critically patient simulation transportation training workshop was priority introduced to them. High-risk medication management, team communication skill, hands-on practice on portable ventilator and infusion machine were also included. New generation prefer convenience and advanced technology in learning. Therefore, video shooting of equipment demonstration uploaded on website and online learning could facilitate their self-learning. Followed with high fidelity simulation and immediate debriefing further strengthen their critical care knowledge and confidence in critical care. Lastly, Nursing Practice Workshop at the end of SPP O&I program to evaluate new graduates’ performance after completing both programs. Better Patient Communication (BPC) and Crew Resources Management (CRM) workshop delivered effective communication skill and teamwork with colleagues and other multi-disciplines. Other supportive measures like duty arrangement with accompany by clinical preceptor and clinical mentor in daily work could provide instance feedback to new graduates and increase their confidence which further help them develop self-esteem and autonomy
Result & Outcome :
101 Pre-RN TUNS completed five identical classes of three-day BSE Program from July to September 2022 respectively. Measured self-confident level of Pre-RN TUNS weighting from 1 to 10, weighted above 5 from 56% increase to 92% after program completion.
94 new graduates completed three identical classes of five-day SPP O&I Program from September to Nov 2022 respectively. 95% new graduates agreed “Basic Skill Enhancement program” should be recommended for “Pre-RN TUNS” next year. Reflecting that both programs enhance new graduates’ clinical competency and support their daily work.
