Surviving the nursing Shortage:

Week 3: Research Critique Table, Framework and Model
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Purpose
This assignment provides the opportunity to continue the development of the evidence-based practice (EBP) project proposal by adding the research critique table, theoretical framework and change model sections. In addition, the student is required to complete the National Institutes of Health (NIH) certification regarding human subjects. The NIH information focuses on the history of the legal and ethical issues related to research and informed consent.

Course Outcomes
This assignment enables the student to meet the following course outcome:

CO#4 Develop knowledge related to research and evidence-based practice as a basis for designing and critiquing research studies (PO 1, 2, 6, 9)

Directions and Assignment Criteria
Category
Points
%
Description

Research Critique Table
40
25
The required content for this section includes:

· The PICOT question is presented after the title of the table

· Students will select four (4) research-based studies and complete the Research Critique Table following the format noted in the sample.

· All selected research-based articles must be consistent the selected PICOT question.

· Complete citation of selected research study is required in the column labeled: Citation

· Permalink for each research article is required and located in the column labeled: Citation

· The required column headings are:

o Citation

o Purpose of the research

o Research Design and sample

o Data collection methods

o Results

o Strengths and limitations (both must be identified for each research study)
Theoretical Framework
10
12
The required content for this section includes:

· Explain the theoretical framework that will be used in this project

· Cite a reference for the selected framework

· Describe how the theoretical framework is useful to the selected PICOT question
Change

Model
10
12
The required content for this section includes:

· Explain the change model that will be used in this project

· Describe the steps within selected

· Cite a reference for the selected change model

· Describe how the change model is useful to the selected PICOT question
Paper Specifications
5
6
NIH certificate was submitted

Research Critique Table was submitted

Complete citation of research article and permalink included in the column labeled as Citation in the Research Critique Table

Reference list is required

A dictionary, required textbook for this course and lesson information, are NOT to be used as scholarly references for this assignment.

References are current – within a 5-year time frame (prefer 2014 – 2017).
APA Format (6th edition)
5
6
APA guidelines as found in the 6th edition of the manual are to be used to identify the research study used on the Research Critique Table.

One deduction for each type of APA style error
Writing Mechanics
5
6
Rules of grammar, spelling, word usage, and punctuation are followed and consistent with formal written work as found in the 6th edition of the APA manual.
Total
85
100 %

Research Critique Table (sample)

(Writer NOTE: Below is my original PICO Question)

State the PICOT Question: PICO question: In healthcare providers, does instructional exercise program and wellness initiative as compared to non-instructional exercise program ensure healthy work environment?

P – Healthcare providers
I – Instructional exercise program
C – Non-instructional exercise program
O – Healthy work environment

Citation
Purpose of the research
Research Design and Sample
Data Collection Methods
Results
Strengths (S)

Limitations (L)
Cavanaugh & Huse. (2014). Surviving the nursing Shortage: Developing a nursing orientation program to prepare and retain intensive care unit nurses. Journal of Nurse Executives, 16(2), 34-56.

Permalink
To create an orientation program that would produce competent nurses to work in the NICU who had no previous NICU experience. The orientation program would also be streamlined to ensure all new hired nurses were provided the same information and patient types
Quantitative Study

N=27 nurse orientees over a two-year period
Formal preceptor program developed for identified preceptors

Orientation program developed to foster critical thinking, interpersonal relationships, and technical skills in new orientees

Caffarella’s program model used to create a program due to fluidness of the teaching model
Final orientation evaluation revealed 100% of orientees felt the program prepared them to competently work independently

The clinical educator identified key components of a successful program: well-prepared preceptors and biweekly conferences with the preceptor, orientee, and clinical educator

Retention rate after two years was 93%
S-program design/concepts transferrable to other nursing departments

L-small sample size
Hardy, J. & Smith, J. (2016)

Enhancing staff development with a structured preceptor program. Journal of Nursing Education, 54(1), 101-110.

Permalink
To redesign an orientation program on an ICU unit due to high staff turn-over, low staff satisfaction rates, and a 14-bed expansion.

Orientation model based off Connelly and Hoffart and including the Myers-Biggs cognitive personality style assessment
Qualitative Study: Phenomenological

Examination of previous orientation program with new design based on structure, identifying qualified preceptors, developing a preceptor course, and orientation packets for the new nurse

Current program lacked structure
Identification of staff nurses who would make effective preceptors, development of a preceptor educational course, management commitment, development of an orientation manual
Greater satisfaction with preceptor role N=5 total staff who had gone through the preceptor class

New staff members feel orientation process is designed to meet learning needs

Increased overall staff satisfaction

Many employment applications due to referrals from current staff
S-study can be transferred to other types of nursing departments

L- no exact measurements regarding number of participants, possible bias of researcher
Loft, W. (2015). Moving forward: Creating a new nursing services orientation program. Journal of Nurse Executives, 76(2), 56-61.

Permalink

To redesign a hospital orientation which would create a more meaningful experience for new employees.
Quantitative: Descriptive Study: Predictive

N=74 surveys returned/reviewed from May to December 2004

May to June results were from the current orientation process

New orientation process began July 12
Redesign orientation based on Scope and Standards of Practice for Nursing Professional Development

Orientation checklist replaced self-study tests

Modular orientation classes set up to allow employees who did not need to specific classes the opportunity to spend time on assigned units
May and June results reflected what administrators already knew to be issues with current system

July through December results showed an overall improvement in satisfaction rates of the new orientation program
S- sample size of 74; able to critique results from the two programs; survey comprehensive using Likert-scale as well as open-ended questions

L-Unknown number of total orientation participants versus number of surveys returned;

a 3 month follow-up survey resulted in poor response, so no significant data was able to be reported
Meyer, G. & Meyer, S. (2017). Utilization-focused evaluation: Evaluating the effectiveness of a hospital orientation program. Nursing Leadership in Healthcare, 78(9), 90-98.

Permalink
To evaluate the effectiveness of current orientation practices and which aspects of the program were viewed as positive and which were viewed as negative
Quantitative:

Descriptive study: Survey

N=59; total number of surveys distributed = 90
Improve areas of orientation program based on survey results
Top three survey questions noted to be:

The need to provide quality time and opportunity to practice new clinical skills

Having a designated preceptor was important

Offering preceptor classes to potential preceptors was vital to successful orientation programs
S- The survey was pilot tested before distribution.

Surveys were distributed to all shifts in multiple departments

L-Small sample size (rate of return was 60%)
Modic, C. & Harris, Y.T. (2015). Masterful precepting: Using the BECOME method to enhance clinical teaching, Journal of Nursing Education, 67(12), 134-145.

Permalink

To provide staff unit educators a tool for educating and mentoring preceptors
Descriptive Study: Survey

To examine commonly experienced orientee behavior

N= 342 from 13 states in the U.S. and Ontario, Canada
The classification and recognition of common orientee behaviors allows preceptor programs to include effective teaching strategies for preparing the preceptor when these behaviors are encountered
The most frequently encountered orientee behavior was slowness and disorganization

Most strategies used by preceptors to deal with different orientee behavior fell into one of 6 categories: Behavioral, Emotive, Cognitive, Organizational, Modeling, and Elicit help
S-large sample size

L-fixed questions regarding preceptor education, results were unclear as to whether strategies provided by the preceptor in dealing with a difficult orientee was successful or not
Morris, C., Pfeifer, K., Catalano, R, Fortney, G., Nelson, L., Rabito, B., & Harap, H. (2013). Outcome evaluation of a new model of critical care orientation. Critical Care Clinics of North America, 64(4), 573-582.

Permalink
To determine if a new orientation program had an effect on satisfaction, retention, turnover, staff vacancy, staff preparedness, and cost effectiveness
Quasi-Experimental

N=173

A total of 197 nurses had participated in the new program, with only 173 giving consent to answer questions

Questionnaires were handed out to educators, managers, preceptors, and orientees.

Questionnaires were given at set intervals throughout the program and after the program for direct feedback.
Key components recognized by participants allowed the program develops to improve the current orientation program
Two successful teaching strategies identified: pocket guides and time spent in the simulation lab (p=0.023)

The created Critical Care Institute program, which helped prepare new hire nurses for patient care was rated high among the different groups.

One year after the program was instituted:

-Retention rates increased by 2%

-Turnover rates decreased by 1.5%

-ICU vacancy rates decreased by 10%

Cost for the new program increased by $24,810

Length of orientation remained the same
S-Large sample size

L-No clear conclusions drawn regarding why certain values are so far below the national level (ICU vacancy rates and turnover rates)
Prouix, R. & Bourcier, C. (2017). Graduate nurses in the intensive care unit: An orientation model. Journal for Nursing Leadership, 33(10), 194-201.
To find a more efficient way to develop skills during a new graduate nurse’s orientation and improve the orientation program
Qualitative Study

Phenomenolog-ical

Examination of previous orientation program with new design based on themes found in recent literature regarding challenges and stresses of a new graduate nurse
Unit preceptor team

Program redesign based on the stages of skill acquisition of a new graduate nurse
Year 1: original goals of the program were met

Informal interviews at the conclusion of orientation yielded positive feedback

Preceptors found the redesign rewarding

New design saved the unit money
S-study can be transferred to other departments based on themes tested

L-No exact number of orientees mentioned; unsure of level of ICU patients; subjects were new graduate nurses only
Thomason, T.J. (2014). ICU nursing orientation and post orientation practices: A national survey. Nursing Leadership, 22(2), 67-75.

Permalink
To determine the national practices regarding current instruction methods, preceptor training, and post-orientation programs for ICUs.
Descriptive study: Survey

A geographic map of the U.S. was divided into 7 regions. Inclusion criteria for hospitals included JC accredited and have one or more ICUs, not including pediatric ICU or progressive care units

N=24 hospitals participated; results obtained from either a telephone survey or electronic survey

Survey tool included 35 questions
Information gathered regarding national practices for ICU orientation programs including instruction methods and post-orientation support
Orientation times based on previous experience and RN level

87% of hospitals used didactic, classroom education with average 73 hours spent

All hospitals surveyed reported the same three key elements to measure success of an orientation program
S-a beginning attempt to gather information regarding national orientation programs

L-small sample size

Electronic surveys sent to CNSs who had affiliation with organizations
Ward, G. H. (2013). Enhancing orientation and retention: One unit’s success story. Applied Nursing Leadership, 4(1), 22-29.

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