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Network Work Ready

Justice Health Forensic Mental Health Network; Organisational Development Unit.
Project Added:
15 December 2020
Last updated:
16 December 2020

The Big Wee Problem at Sydney Children’s Hospital Network.

Summary

Contribute to a skilled workforce by developing capable and confident graduate nurses.

Aim

  • To increase graduate nurses that will have their clinical practice assessed using the registered nurse standards of practice from 0%-100% by March 2021.
  • To increase the number of facilities that satisfy the site readiness self-assessment guide from 0%-100% by March 2020.
  • To increase the graduate nurses self-reported positive experience from 44% - 95% by March 2021.

Network work ready poster

Benefits

This project will ensure that there is:

  • A standardised approach in supporting, monitoring and assessing graduate nurses during their graduate year
  • Targeted, development and career pathways to support development investment decisions.

Program status

Program dates

  • March 2019 - December 2020.

Status

  • Sustained - Solution 1: The project has been implemented and is sustained in standard business.
  • Implementation - Solution 2: The project is ready for implementation or is currently being implemented, piloted or tested.

Background

Feedback from the graduate nurses in their first year of practice is that there is a clear structure and direction. However, following completion of their graduate program they report they are left to their own devices, with no clear guidance regarding pathways for career development.

They also tell us that their experiences vary depending on the facility. Our clinical support staff have differing views and expectations of graduate progression through programs. In Justice Health Forensic Mental Health Network (the Network) there is the added dimension of providing health care in a high secure environment to a vulnerable client group with complex health needs and a disadvantaged socioeconomic background.

The graduate nurses’ program is resource intensive; our networks’ graduate nurse program has significantly increased by 82% in the last decade. In the last decade the number of graduates has increased from 8 to 54, and facilities providing involved in the program have increased from 10 to 32. The biggest expansion has been in regional and rural sites.

As the program has expanded the implementation of program structure and adherence to operational procedures across the sites has been inconsistent. The project aim is to strengthen the graduate nurse program to promote consistency across sites, enhancing program governance, to ensure capable and confident nurses that can meet the needs of our patients.

Following completion of the transition year the retention of graduate nurses remains high at 85%, then significantly decreases after three years, due to a lack of career and developmental pathways. We aim to developing nursing career and development pathways for the Network.

Implementation

Solution1 – Strengthen the graduate nurse program which builds the foundation for nursing career and development pathways in the network

This solution will address various facets of the program which include design governance, structure of education days, content delivery, monitoring, orientation, evaluation, support structure, assessments, communication and documentation.  As part of the solution 1 this project will implement:

Striving for success: is your unit graduate nurse ready? (site readiness self -assessment guide) - to prepare sites to support graduate nurses.

Program passport - reflects learning needs and signed off by their supervisors and program coordinators.

Communication platforms - (CNE teleconference, Intranet, rotation handover, Local Drive, Update Program Business Rules) – disseminate and reinforce program expectations.

Adopt Kirkpatrick Evaluation methodology - to enhance program evaluation.

Standardised adoption Registered Nurse Standards of Practice - to assess the clinical progression of graduate nurses.

Solution 2- Develop nursing career and development pathways for the network

The nursing pathways will be developed for the network in consultation with nurses from all levels and experts in the education, talent development and leadership. The pathway will build on the graduate nurse program as the foundation of the nursing stream. The pathways will include a structured career development in the form of leadership and management, education, clinical leadership and research.

Promote the Public Sector Capability (PSC) Framework as a means for measuring and developing capabilities for the Network

Establish the Network nursing career pathways

Design targeted nursing development programs mapped to the PSC Framework and the nursing career pathway

Publish nursing career and development  guides for the Network

Implementation sites

  • Justice Health and Forensic Mental Health Network

Partnerships

  • Agency for Clinical Innovation (ACI)

Results

  • Plan, do, study and act cycles were implemented to evaluate the outcomes.
  • Kirkpatrick Evaluation Model was implemented to collect data.

Lessons learnt

  • Adapting to technology for flexible program delivery during COVID 19.
  • My priority is not always the priority of others.
  • Trust the process our initial planning and vision of the project shifted considerably as we started to explore the root causes.

References

  • Aggar C, Gordon CJ, Thomas THT, et al. Evaluation of a community transition to professional practice program for graduate registered nurses in Australia. Nurse Educ Pract. 2018 Sep;32:101-107.
  • Baldwin KM, Black DL, Normand LK, et al. Integrating Retired Registered Nurses Into a New Graduate Orientation Program. Clin Nurse Spec. 2016;30(5):277-83.
  • Doughty L, McKillop A, Dixon R, Sinnema C. Educating new graduate nurses in their first year of practice: The perspective and experiences of the new graduate nurses and the director of nursing. Nurse Educ Pract. 2018 May;30:101-105.
  • Lyman B, Gunn MM, Mendon CR. New graduate registered nurses' experiences with psychological safety. J Nurs Manag. 2020 May;28(4):831-839.
  • Mellor PD,Gregoric C. New Graduate Registered Nurses and the Spectrum of Comfort in Clinical Practice. J Contin Educ Nurs. 2019 Dec;50(12):563-571.

Further Reading

Journals

  • Educating new graduate nurses in their first year of practice: The perspective and experiences of the new graduate nurses and the director of nursing.
  • Doughty L.[3],  McKillop A.[2],  Dixon R.[2], et al  Nurse education in practice  volume 30 pages 101-105 May 2018.
  • Strategies new graduate registered nurses require to care and advocate for themselves: A literature review.Mellor P.[1],  Gregoric C.[1] and  Gillham D.[1] Contemporary nurse  volume 53 issue 3 pages 390-405 June 2017.

Contacts

Sindiso Dube
Nurse Manager Leadership Programs
Justice Health and Forensic Mental Health Network
Sindiso.Dube@health.nsw.gov.au

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