HealthSeptember 27, 2022

How nursing transition programs can improve new nurse competency

You've done the work of hiring skilled nurses and ensuring nursing core competencies are being met. But there's a looming problem in the nursing world: shortage.

According to the American Nurses Association, nearly 500,000 registered nurses are expected to retire by 2022. To make up for a potential nursing shortage, the United States Bureau of Labor Statistics anticipates the need for 1.1 million new nurses to replace retirees and expand care. With so many new nurses to train — more than 2.2 million new nurses are expected to enter the nursing workforce through 2030 — how can you ensure competency of those transitioning to practice? To meet this need, many hospital systems have implemented new nurse transition programs to help develop those entering practice to build competencies quickly and confidently.

Transition programs prepare new nurses by developing skills and confidence

The nursing shortage and lingering coronavirus pandemic are having a distressing impact on the competency of new nurses entering the workforce. New graduate nurses are typically not proficient in multiple skill areas, even after receiving an education designed to help them acclimate them to the nuances of nursing practice. So even though all nurses who practice are expected to be competent, new nurses, in particular, often need help developing their nursing skills to improve patient safety and efficiency. Transition programs can help improve new nurse performance and skill level, bringing them up to the facility's standards.

Key nurse competencies and abilities

Nurse competency, as defined by the American Nurses Association (ANA), is an expected level of performance that integrates knowledge, skills, abilities, and judgments. Competency can be a nurse's ability to be:

  • Confident
  • Knowledgeable
  • Safe
  • Timely

Eight nursing skill areas

In 2016, an Australian study identified eight skill areas in which a new nurse is expected to be practice-ready by their colleagues. These areas included:

  1. Behavior conducive to learning
  2. Communication and documentation
  3. Efficient and effective communication
  4. Personal care (assessment, planning, and evaluation of care using comprehensive nursing models)
  5. Preventing risk and promoting patient safety
  6. Privacy and dignity
  7. Professional nursing behaviors
  8. Therapeutic nursing behaviors and respect for personal space

While many of these skill areas are critically important to a new nurse, these were just a few of the 30 total skill areas identified by seasoned nurses as contributing to competency. Other skill areas in which experienced nurses identified a lack of new nurse competency included multidisciplinary team working, promoting self-care, medications and IV products, cultural competence, and critical analysis and reflective thinking.

How can transition programs help improve new nurse competency?

RN transition programs are becoming increasingly popular as nursing educators recognize the need for competency improvement processes. Transition programs generally include nurse orientation and onboarding, nurse residency training, and nurse internship programs. The quality of the relationship between the nurse clinical preceptor and the new nurse is also critical for competency development.

Developing key skills, competence, and confidence

An integrative review published in the journal Advances in Nursing Science suggests that transition programs help new nurses develop their skill set in several key areas, such as clinical decision-making, critical thinking, organizational skills, communication, prioritization of patient care, and leadership. In some cases, competence in these skill areas was measured by testing critical thinking skills and observing new nurse behaviors during patient-simulated assessments. Compared with limited transition programs, structured transition programs appear to improve new nurse competence more. Also, longer transition programs appear to increase competency based on new nurse self-reporting. New nurses were more likely to self-report feeling more competent and confident with year-long transition programs, compared with more traditional, three-month nurse orientation programs.

Improved patient safety

Improved competency among new nurses has another benefit — improving patient safety. New nurses with higher competency scores are less likely to report practice errors. Additionally, in hospitals offering established transition programs, new nurses are less likely to engage in negative safety practices, such as violating safety precautions. This, in turn, leads to fewer patient errors, such as medication errors.

Getting started with nursing transition programs

There's no one right way to develop or improve a transition program within your hospital. But making your program as effective as possible starts with identifying primary areas for new nurse competency improvement and then planning strategies to improve performance. You can help develop transition programs to better prepare and support new graduate nurses as they transition to practice and grow in their own nursing practice. Because so many new nurses are expected to enter the workforce, taking these steps is crucial to improving nurse competency — and patient care — in the long run.

Learn how Lippincott Solutions can support new nurse transitions and improve competency.

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