Beruflich Dokumente
Kultur Dokumente
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Celeste R. Romp, MSN, ARNP, CCNS, RN-BC, is Critical Care Educator,
Jewish Hospital and St. Marys Healthcare, Louisville, Kentucky.
Ermalynn Kiehl, PhD, ARNP, CNS, is Associate Dean, School of Nursing,
University of Louisville, Louisville, Kentucky.
The authors have disclosed that they have no significant relationships
with, or financial interest in, any commercial companies pertaining to
this educational activity.
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BACKGROUND
The nurse educator at a 442-bed metropolitan community medical center, which employs approximately
760 registered nurses and hires approximately 150 new
registered nurses a year, determined that there was a
need to evaluate the preceptor program for newly
hired nurses. An orientation evaluation survey of
nurses was instituted that included five Likert-style
questions and five open-ended questions about their
experience with their preceptors. Some of the questions orientees were asked included the following: (a)
rate their overall satisfaction with their preceptors in
general, (b) provide specific examples of something a
preceptor said or did that stood out to them as helpful
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TABLE 1
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Steps of the Stetler model
Phase I: preparation
Application
Defining the purpose of the review to aid the reviewer in
identifying measurable outcomes; searching for applicable
articles; and identifying barriers, both internal and external,
that could influence the decision-making process
Critiquing the chosen literature with utilization in mind; each article
is validated regarding its relative level of support for the topic
searched and whether there is sufficient evidence in the
literature to continue
Synthesizing and evaluating the findings to determine desirability
and feasibility of applying the findings to practice
Translating findings into a plan then implementing the plan
into practice
Evaluating the change in practice
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279
Copyright @ 2009 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Copyright @ 2009 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
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Determining graduate
nurses experiences
during orientation in
their own words
Delaney (2003)
Roche, Lamoureux,
and Teehan (2004)
Level of evidencea
Level VI
Level VI
Level VII
Level VI
(qualitative
sections)
Level III
General findings/Conclusions
Design/Method
Based on the rating system for the hierarchy of evidence of Melnyk and Fineout-Overholt (2005).
Winter-Collins and
McDaniel (2000)
Purpose
Reference
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TABLE 2
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DISCUSSION
All five phases of the Stetler model were used which
resulted in a well-planned execution of the project.
Additional interesting points for discussion include the
issue of rewards and recognition, continuing professional development of the preceptors, and addressing
the education needs of preceptors who were unable to
attend the formal classes.
During the review of the literature, another theme
emerged. Research also indicated that providing
rewards and recognition to preceptors increases
their commitment to the preceptor role (Dilbert &
Goldenberg, 1995; Henderson, Fox, & Malko-Nyhan,
2006; Marincic & Francfort, 2002; Usher, Nolan, Reser,
Owens, & Tollefson, 1999). When the preceptors in
this project were surveyed, a question related to
recognition was included. Food was ranked Number
1, and a written thank-you note was also in the Top 5.
Some ways that rewards and recognition were addressed in this program were by providing refreshments at preceptor classes and by providing thank-you
notes from the nurse manager that included a free
meal ticket. In addition, when orientees praised
individual preceptors on the orientation evaluations,
individual letters were sent to the preceptors homes
thanking them and letting them know why an orientee
had recognized them. When funds were not immediately available to purchase other requested reward
items, such as coffee mugs and canvas bags, promotional item donations from vendors were accepted.
During the preceptor update classes, an additional
survey related to professional development was
distributed to all in attendance. It asked where they
were currently in their own professional development
and what opportunities they would like for additional
professional development. Information provided in
response to those questions included mentor and
clinical ladder programs, professional nursing member-
CONCLUSION
The literature supports the educational development of
preceptors to increase new nurses job satisfaction and
ultimately nurse retention. The Stetler Model of
Research Utilization provided an excellent framework
for program development and was used to effectively
apply EBP. The outcome was improvement of new
orientees satisfaction with their preceptors. At this
same time, a 3.9% drop in turnover rate was experienced. Research indicates that the changes made to
the preceptor program were a contributing factor;
however, additional research would be needed to
determine the degree to which preceptor education
programs contribute to decreasing nurse turnover rates.
With the emphasis on EBP, staff development
educators must be able to effectively apply research
to practice. Using the Stetler Model of Research
Utilization as a guide, staff development questions
can be answered by using the steps of preparation,
validation, comparative evaluation/decision making,
translation/application, and evaluation. By ensuring
that all steps are addressed, major pitfalls can be
avoided and research can accurately be translated into
a staff development educators practice.
RE FER ENCE S
American Association of Critical Care Nurses. (2008). AACN practice alerts. Retrieved June 16, 2008, from http://www.aacn.org/
WD/Practice/Content/practicealerts.pcms?menu=Practice
American Heart Association. (2005). American Heart Association 2005 guidelines for cardiopulmonary resuscitation and
emergency cardiovascular care. Retrieved June 16, 2008,
from http://www.americanheart.org/presenter.jhtml?identifier=
3035517
Aucoin, J. (Ed.). (2005). Nursing professional development certification preparation-self-learning program [CD-Rom]. Pensacola, FL: National Nursing Staff Development Organization.
Avillion, A. (2001). Core curriculum for nursing staff development
(2nd ed.). Pensacola, FL: National Nursing Staff Development
Organization.
Casey, K., Fink, R., Krugman, M., & Propst, J. (2004). The
graduate nurse experience. Journal of Nursing Administration, 34(6), 303311.
Delaney, C. (2003). Walking a fine line: Graduate nurses
transition experiences during orientation. Journal of Nursing
Education, 42(10), 437443.
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For more than 40 additional continuing education articles related to research, go to NursingCenter.com\CE.
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November/December 2009
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