Nursing ResearchPresentation by:

Susan A. Bethel, MSN, RN, NE-BCManager of Nursing Scholarship & ResearchGreenville Health System Employee Service Center Building 701 Grove Rd/ Greenville, S.C. 29605 Office: 864-455-7007 sbethel@ghs.org I www.ghs.org

Trudy Ackard, MSN, RN Education Consultant (RN) I Nurse Residency Program Coordinator Learning and Development I Greenville Health System701 Grove Road I Greenville, SC 29605Office: 864-455-6198 I Department: 864-455-6100 Fax: 455-6101tackard@ghs.org I www.ghs.org

Current Research Involving New RN Graduates and Faculty Participation In Delphi Study

ObjectivesDescribe current research involving new graduates in our

nurse residency programReview ongoing Delphi study involving faculty and GHS

nursesDiscuss proposed future study involving new RNs in their

second year of practice

Impact of Redesigned Competency Based Graduate Nurse Residency Program on Critical Thinking and

Experience of New Graduate RNs during their First Year of Transition into Practice

Research Questions

• What is the difference in level of critical thinking of new graduates who participate in the nurse residency program as measured throughout the one year program?

• What is the level of readiness as perceived by the nurse managers related to the new graduates’ clinical and non clinical skills ?

• Is there a relationship with characteristics of new RNs ( education, age, clinical track) related to the perceptions of their clinical competence?

• How are characteristics of new RNs related to their performance in terms of critical thinking and clinical competence as measured by assessors

Participants

• Three cohorts enrolled • Hired September – February 2015 • N= 59 • Academic Degrees

– Associate Degree = 6– BSN = 53

Measurement

• Partnered with Healthcare Advisory Board/ Nurse Executive Center – Critical Thinking Diagnostic Tool

• Self assessment by new grad at one year• Assessors evaluate new grad @ 3mo,6mo & 1 yr. • Problem Recognition, Clinical Decision Making, Prioritization, Clinical

Implementation & Reflection • Completed inter rater reliability for the assessors

– Nurse Readiness for Practice Tool • Nurse Manager completes at one year

• Casey Fink Graduate Nurse Experience Survey© – Self assessment by new graduate at start of program, 6 months and one year – Frequently used tool – validity established and reliability of .71-.90

Casey Fink Survey

Preliminary- Casey FinkCheck the top three skills/procedures you are uncomfortable performing independently at this time.

Critical Thinking Diagnostic

Creating a Nursing Research Agenda : Clinical and Academia Collaborative Delphi Study

GHS: Susan Bethel MSN RN; Cathie Osika Landreth MSN RN;

Anita DeWeese MSN RN; Stephanie Pulis MSN RN

Greenville Technical College :

Debbie Lyles PhD RN; Alissa Samoya DNP RN

Clemson University: John Whitcomb PhD RN

USC Upstate : Lynette Gibson PhD RN

Bob Jones University: Ai Kato MSN RN

Lander University: Liz McDowell PhD RN

What are the priorities for development of research studies that closely align with improving patient care, nursing practice & nursing education ?

Explore priorities for building nursing research over next 3 years

Input from both clinical nurses in health system and affiliated nursing faculty

Delphi technique method utilization

Future collaboration on mutual research studies

Round One SurveyOPEN ENDED QUESTIONS

What clinical / research question(s) do you have about patient/caregiver/ family or community involvement that interests you?

What clinical/research question(s) do you have about communication in your practice?

What clinical /research question(s) do you have about the continuum of care in your specialty?

What clinical/research question(s) do you have about the use of technology in patient care, nursing practice

or nursing education?

What clinical /research question(s) do you have about the quality of care and/or patient safety in your specialty?

What clinical / research question(s) do you have involving healthcare professional accountability?

What clinical/research question(s) do you have involving workforce structure, process or environment?

What clinical /research question(s) do you have about education?

Please indicate any other research question(s) or clinical question(s) should be studied.

Impact of Reflective Practice as Learning Process for New Graduate RNs Early in their Career

Research Team

Susan Bethel MSN RN NE-BC

Trudy Ackard MSN RN

Bobbie Rhodes MSN RN

Rev. John Hartman D.Min

Lynette Gibson PhD RN

Purpose

• Guide new nurses through the use of reflective practice

• Facilitate the new nurse at the descriptive level of reflection– Three levels of reflection: descriptive, dialogic and

critical

• Use multi media approaches for reflection

Aims

• Qualitative Study– Questions

• What is the learning associated with the application of reflective practice for the new graduate RN during their second year of employment in professional nursing practice in a clinical setting?

• Do new RNs perceive that the use of reflective practice as value-added in their nursing practice?

• Do new RNs perceive that the use of reflective practice impacts quality and safety at the bedside?

Theoretical Framework

• Transformative Learning (Mezirow)– Able to transform your frame of reference– Occurs when one critically reflects on the assumptions upon which

their interpretations, beliefs and habits of mind are based

• Reflective practice is a process, deliberative and continuously evolving

• Enables the growth of one’s self and knowledge– increasing ability to integrate into the deepening and expanded clinical practice

Design/ Method

• Qualitative design • Conducted over one year • Sample

– Recruited from 2 cohorts of new RNs from this year’s nurse residency program

– Will be conducted during their second year of employment at GHS on a patient care unit

• Educational session on reflective practice• Tools for reflection

– Journaling– Focus groups– Online Survey

Questions?