Update on Phase II of - NCSBN · Update on Phase II of NCSBN’s Transition to Practice Study NCSBN...
Transcript of Update on Phase II of - NCSBN · Update on Phase II of NCSBN’s Transition to Practice Study NCSBN...
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Update on Phase II of
NCSBN’s
Transition to Practice Study
NCSBN Long-Term Care Conference
August 24, 2011
Josephine Silvestre, MSN, RN
Nancy Spector, PhD, RN
Associate, Regulatory Innovations
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2009 New Nurse:
“I am frightened for my patients and for
my own license as I soon will be
turned loose with only a resource
person and expected to take a full load
after only 5 days of orientation in my
new assigned unit.”- NC Transition Study
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Background…
NCSBN 2002 & 2004 Employer Studies:
“Yes definitely” to survey question regarding novice graduates being prepared to provide safe and effective care:
45% (2002) & 48.8% (2004)-diploma graduates
40% (2002) & 41.9% (2004)- BSN graduates
35% (2002) & 41.9% (2004)- ADN graduates
30% (2002) & 32.9% (2004)- PN graduates
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Background…
Advisory Board Company (2008)
Surveyed
5,700 frontline nurse leaders
400 nursing deans/directors/chairs
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Background…
90% academic leaders believe their new
students are prepared.
10% of health system nurse leaders believe
new nurses are prepared.
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Advisory Board Study
Biggest Improvement Needed:
Follow up
Initiative
Quality improvement
Time management
Tracking multiple responsibilities
Conflict resolution
Delegation
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Background…
NCSBN hosted the Transition Forum
February 22, 2007
Speakers from other disciplines and countries all
came together.
Various research findings showed need for
transition programs.
Stakeholders agreed to a standardized
regulatory model (AACN, AONE, ANA,
NAPNES, NLN)
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The Perfect Storm Brewing…
Expertise gap (Orsolini-Hain & Malone)
10% staff are new
graduates
50% turnover from
2011-2020 (Dracup & Morrris, 2007)
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Practice Expectations: Hit the Ground
Running!
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Transition to Practice: A
Missing Piece in Nursing
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Lack of Transition Programs Affect
Safety and Quality
Patient safety
Competency
Retention
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Visual Model
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It’s a Collaborative Model
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Modules
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Illinois, North Carolina and
Ohio are the Study States: 113
sites
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Transition to Practice Study
Longitudinal, randomized, multi-
site study comparing patient
outcomes in organizations that
use our transition model versus
those that use their traditional
method.
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Unique Study of Transition
1. Actual patient outcomes
2. Randomization to study or control group
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Research Advisory Panel
Participants
1. Jane Barnsteiner, PhD, RN, FAAN – University
of Pennsylvania
2. Mary Blegen, PhD, RN, FAAN – UCSF
3. Mary Lynn, PhD, RN – University of North
Carolina, Chapel Hill
4. Elizabeth Ulrich, EdD, RN, FACHE, FAAN –
Versant
5. Louis Fogg, PhD – Rush College of Nursing
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Research ObjectivesPrimary:
To determine whether newly licensed nurses’
participation in NCSBN’s TTP model improves
safety and quality outcomes
Secondary:
To determine how well the preceptor module
prepares preceptors for their role
To identify the challenges, and potential solutions,
of implementing the NCSBN transition model
To determine cost/benefit analysis
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Survey Measurement Tools
New Nurse Surveys
Demographics
Competency – NEC & QSEN
Satisfaction – Modified Brayfield & Rothe
Practice issues – NCSBN
Preceptorship experience – National
Institute of Health (NIH) and North
Carolina Foundation for Nursing
Excellence
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Survey Measurement Tools
Preceptor Surveys
Demographics
Competency – NEC & QSEN
Preceptorship experience – NIH and
North Carolina Foundation for Nursing
Excellence
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Phase I Patient Outcomes
Patient falls with and without injury
Postoperative thromboemboli
Hospital acquired pressure ulcers
Patient satisfaction with nursing care
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Phase I Patient Outcomes
Catheter associated UTI
Central line associated blood stream
infections
Failure to rescue
Medication administration errors
LOS
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Data Collection
Web-based data
collection system
Surveys/evaluations
Knowledge
assessments
Hospital outcomes
data
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Confidentiality
Participants will receive individual
password-protected access to the website
Information collected from new nurses,
preceptors, nurse managers
Outcomes data entered by site coordinators
will be kept confidential; data will be
reported in aggregate
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Phase I - Randomization to Model
or Control
Stratified by:
Rural, suburban, urban
Numbers of new nurses
Number of sites
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Phase I – June 2011
Educate institutions regarding TTP study
Obtain informed consent and enroll
preceptors & their nurse managers
Preceptors (intervention group) completed
training module
Complete surveys
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Phase I – July 2011
Obtain informed consent & enroll new
graduate nurses
Complete measurement tools
Demographic & Initial surveys
Knowledge Assessment
Initiate interactive online modules
To be completed within 3 months of start date
Each module will take approximately 6-10 hours
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Phase II
Applications are being accepted for Phase II in
Ohio, Illinois and North Carolina
External validity
RNs and LPNs in settings other than hospitals
Long-term care, community-based facilities,
ambulatory care, etc.
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Long-Term Care Facilities
Assisted living
Nursing homes
Rehab centers
Skilled nursing care centers
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Community-Based Facilities
Home health
Public health
Visiting nurses
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Ambulatory-Care Facilities
Free-standing urgent care
Free-standing surgical centers
Health care provider offices
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Transition to Practice Website
Located at:
www.transitiontopractice.org
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Timeline
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The Future!!
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Questions