RESUMO
The purpose of this article is to describe the process from inception to accreditation of a post-baccalaureate nurse residency program between a VA Healthcare center and a university school of nursing so that other nurse educators can benefit from its development. Establishing a nurse residency program bridges the gap between education and practice and provides support to graduate nurses entering the workforce.
Assuntos
Acreditação/normas , Comportamento Cooperativo , Internato não Médico/normas , Enfermeiras e Enfermeiros/normas , Desenvolvimento de Programas/normas , Competência Clínica , Currículo/normas , Bacharelado em Enfermagem , Humanos , Internato não Médico/organização & administração , Objetivos Organizacionais , Desenvolvimento de Programas/métodos , Escolas de Enfermagem , Desenvolvimento de Pessoal/organização & administração , Estados Unidos , United States Department of Veterans AffairsAssuntos
Competência Clínica/normas , Educação Continuada em Enfermagem/organização & administração , Recursos Humanos de Enfermagem/educação , Preceptoria/organização & administração , Desenvolvimento de Pessoal/organização & administração , Atitude do Pessoal de Saúde , Mobilidade Ocupacional , Tomada de Decisões Gerenciais , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Capacitação em Serviço/organização & administração , Relações Interprofissionais , Masculino , Mentores/psicologia , Pesquisa em Educação em Enfermagem , Casas de Saúde/organização & administração , Recursos Humanos de Enfermagem/psicologia , Projetos Piloto , Poder Psicológico , Avaliação de Programas e Projetos de Saúde , Apoio Social , Inquéritos e Questionários , Local de Trabalho/organização & administração , Local de Trabalho/psicologiaRESUMO
OBJECTIVES: We used stress process theory to identify family caregiving variables that are salient to the experience of managing older adults' home enteral nutrition. In this article, we describe the specific tasks family caregivers performed and their unique training needs in the context of caregiver preparedness, competence, effectiveness, and health care use. DESIGN: Hospital billing lists from two university-affiliated institutions in Miami, FL, were used to identify older adults who had enteral tubes placed over a 6-month period. Consent was obtained from those older adults discharged for the first time on home enteral nutrition and their family caregivers at the first scheduled outpatient visit. SUBJECTS/SETTING: In-home interviews were conducted with a diverse sample of 30 family caregivers (14 white, 8 Hispanic, 7 African-American, 1 Asian) during their first 3 months (mean=1.83+/-0.69 months) of home enteral nutrition caregiving. STATISTICAL ANALYSES PERFORMED: Descriptive statistics were used to summarize data for all variables; chi(2) analysis was conducted to analyze differences in categorical variables. One-way analysis of variance was used to analyze mean differences among caregivers grouped by ethnicity for total number of hours and tasks performed. Post hoc comparisons were conducted using the Tukey HSD test. The Spearman rho correlations were calculated to assess bivariate associations between quantitative variables. RESULTS: Caregivers reported providing from 6 to 168 hours of care weekly (mean=61.87+/-49.67 hours), in which they performed an average of 19.73+/-8.09 caregiving tasks daily. Training needs identified were greatest for technical and nutrition-related tasks. Preparedness for caregiving scores were low (mean=1.72, maximum=4.0) and positively correlated with caregiver competence (P<.001) and self-rated caregiver effectiveness (P=.004). Preparedness negatively correlated with health care use (P=.03). CONCLUSIONS: Caregivers of older adults on home enteral nutrition need training for multiple nutrition-related and caregiving tasks. Multidisciplinary interventions, involving dietitian expertise, are needed to better prepare caregivers to improve both caregiver effectiveness and enteral nutrition outcomes.