Needs assessment of nurse researchers through a research lifecycle framework.

Objective: Health sciences librarian roles are evolving to better meet the needs of faculty. This study explores nursing faculty needs at the University of British Columbia through the research lifecycle framework of planning, conducting, disseminating, and assessing the impact of their research. Methods: A mixed methods survey study with Likert scale, multiple-choice, or ordinal ranking-scale questions and six open-response questions was conducted. The format was a web-based Qualtrics survey; participants had approximately three weeks to respond. Results: Nursing faculty identified the dissemination phase as benefiting most from library support prioritizing reference management and archiving research data as the top needs in that phase. Assessing impact skills such as citation analysis and Altmetrics training was ranked second. The Planning phase was ranked third with systematic review and literature review support most needed. The Conducting phase was identified as the phase where they needed the least support. Conclusion: Understanding the needs of researchers and enhancing scholar productivity is vital to offering responsive library research services. Across the research lifecycle, nursing faculty identified reference management, data management, metrics evaluation, systematic reviews, and literature reviews as the key areas for which they need support.

Tracking changes in adaptation to suspension growth for MDCK cells: cell growth correlates with levels of metabolites, enzymes and proteins.

Adaptations of animal cells to growth in suspension culture concern in particular viral vaccine production, where very specific aspects of virus-host cell interaction need to be taken into account to achieve high cell specific yields and overall process productivity. So far, the complexity of alterations on the metabolism, enzyme, and proteome level required for adaptation is only poorly understood. In this study, for the first time, we combined several complex analytical approaches with the aim to track cellular changes on different levels and to unravel interconnections and correlations. Therefore, a Madin-Darby canine kidney (MDCK) suspension cell line, adapted earlier to growth in suspension, was cultivated in a 1-L bioreactor. Cell concentrations and cell volumes, extracellular metabolite concentrations, and intracellular enzyme activities were determined. The experimental data set was used as the input for a segregated growth model that was already applied to describe the growth dynamics of the parental adherent cell line. In addition, the cellular proteome was analyzed by liquid chromatography coupled to tandem mass spectrometry using a label-free protein quantification method to unravel altered cellular processes for the suspension and the adherent cell line. Four regulatory mechanisms were identified as a response of the adaptation of adherent MDCK cells to growth in suspension. These regulatory mechanisms were linked to the proteins caveolin, cadherin-1, and pirin. Combining cell, metabolite, enzyme, and protein measurements with mathematical modeling generated a more holistic view on cellular processes involved in the adaptation of an adherent cell line to suspension growth. KEY POINTS: • Less and more efficient glucose utilization for suspension cell growth • Concerted alteration of metabolic enzyme activity and protein expression • Protein candidates to interfere glycolytic activity in MDCK cells.

Tactics for Drawing Youth to Vaping: Content Analysis of Electronic Cigarette Advertisements.

BACKGROUND: The use of electronic cigarettes (e-cigarettes), also known as vaping, has risen exponentially among North American youth in recent years and has become a critical public health concern. The marketing strategies used by e-cigarette companies have been associated with the uptick in use among youth, with video advertisements on television and other electronic platforms being the most pervasive strategy. It is unknown how these advertisements may be tapping into youth needs and preferences. OBJECTIVE: The aim of this 2-phase study was to examine the marketing strategies that underpin e-cigarette advertisements, specifically in the context of television. METHODS: In phase 1, a scoping review was conducted to identify various influences on e-cigarette uptake among youth. Results of this scoping review informed the development of a coding framework. In phase 2, this framework was used to analyze the content of e-cigarette advertisements as seen on 2 popular television channels (Discovery and AMC). RESULTS: In phase 1, a total of 20 articles met the inclusion criteria. The resultant framework consisted of 16 key influences on e-cigarette uptake among youth, which were categorized under 4 headings: personal, relational, environmental, and product-related. In phase 2, 38 e-cigarette advertisements were collected from iSpot.tv and represented 11 popular e-cigarette brands. All of the advertisements tapped into the cited influences of youth e-cigarette uptake, with the most commonly cited influences (product and relational) tapping into the most, at 97% (37/38) and 53% (20/38), respectively. CONCLUSIONS: The findings highlight the multidimensional influences on youth uptake of e-cigarettes, which has important implications for developing effective antivaping messages, and assist public health professionals in providing more comprehensive prevention and cessation support as it relates to e-cigarette use. The findings also bring forward tangible strategies employed by e-cigarette companies to recruit youth into vaping. Understanding this is vital to the development of cohesive strategies that combat these provaping messages.

Transitions in Atrial Fibrillation Care: A Systematic Review.

BACKGROUND: Patients with atrial fibrillation (AF) commonly transition between care settings and providers. These transitions are often points in the health care system where errors and clinical deterioration can occur. Anticoagulation interruption or discontinuation and sub-optimal follow-up post-emergency department (ED) discharge are considered major transitional issues. OBJECTIVE: The purpose of this study was to synthesise the evidence examining the impact of transitional care interventions on patient, provider, and health care utilisation outcomes. METHODS: This systematic mixed studies review examined citations from four databases Medline, CINAHL, EMBASE, and Cochrane Central Controlled Register of Trials (CENTRAL) using relevant search terms. Fourteen (14) moderate to high quality articles were selected. RESULTS: The available evidence reporting impacts of transitional interventions on health care utilisation, provider, and patient outcomes in AF patients is mixed and of variable quality. The stronger evidence revealed improvements in patient outcomes including knowledge, quality of life, and medication adherence and increased provider anticoagulant prescriptions resulting from transitional interventions. Hospital admissions and ED visits were not significantly affected by any interventions. CONCLUSIONS: Apps and educational toolkits improved patient knowledge. Pathways increased patient quality of life and provider prescription rates. There is a need for more research to determine the AF transition interventions which maximise patient, provider and health care outcomes.

Nursing and euthanasia: A narrative review of the nursing ethics literature.

BACKGROUND: Medical Assistance in Dying, also known as euthanasia or assisted suicide, is expanding internationally. Canada is the first country to permit Nurse Practitioners to provide euthanasia. These developments highlight the need for nurses to reflect upon the moral and ethical issues that euthanasia presents for nursing practice. PURPOSE: The purpose of this article is to provide a narrative review of the ethical arguments surrounding euthanasia in relationship to nursing practice. METHODS: Systematic search and narrative review. Nine electronic databases were searched using vocabulary developed from a stage 1 search of Medline and CINAHL. Articles that analysed a focused ethical question related to euthanasia in the context of nursing practice were included. Articles were synthesized to provide an overview of the literature of nursing ethics and euthanasia. ETHICAL CONSIDERATIONS: This review was conducted as per established scientific guidelines. We have tried to be fair and respectful to the authors discussed. FINDINGS: Forty-three articles were identified and arranged inductively into four themes: arguments from the nature of nursing; arguments from ethical principles, concepts and theories; arguments for moral consistency; and arguments from the nature of the social good. Key considerations included nursing's moral ontology, the nurse-patient relationship, potential impact on the profession, ethical principles and theories, moral culpability for acts versus omissions, the role of intention and the nature of the society in which euthanasia would be enacted. In many cases, the same assumptions, values, principles and theories were used to argue both for and against euthanasia. DISCUSSION: The review identified a relative paucity of literature in light of the expansion of euthanasia internationally. However, the literature provided a fulsome range of positions for nurses to consider as they reflect on their own participation in euthanasia. Many of the arguments reviewed were not nursing-specific, but rather are relevant across healthcare disciplines. Arguments explicitly grounded within the nature of nursing and nurse-patient relationships warrant further exploration.

Cultural adaptations to augment health and mental health services: a systematic review.

BACKGROUND: Membership in diverse racial, ethnic, and cultural groups is often associated with inequitable health and mental health outcomes for diverse populations. Yet, little is known about how cultural adaptations of standard services affect health and mental health outcomes for service recipients. This systematic review identified extant themes in the research regarding cultural adaptations across a broad range of health and mental health services and synthesized the most rigorous experimental research available to isolate and evaluate potential efficacy gains of cultural adaptations to service delivery. METHODS: MEDLINE, PsycINFO, CINAHL, EMBASE, and grey literature sources were searched for English-language studies published between January 1955 and January 2015. Cultural adaptations to any aspect of a service delivery were considered. Outcomes of interest included changes in service provider behavior or changes in the behavioral, medical, or self-reported experience of recipients. RESULTS: Thirty-one studies met the inclusion criteria. The most frequently tested adaptation occurred in preventive services and consisted of modifying the content of materials or services delivered. None of the included studies focused on making changes in the provider's behavior. Many different populations were studied but most research was concerned with the experiences and outcomes of African Americans. Seventeen of the 31 retained studies observed at least one significant effect in favor of a culturally adapted service. However there were also findings that favored the control group or showed no difference. Researchers did not find consistent evidence supporting implementation of any specific type of adaptation nor increased efficacy with any particular cultural group. CONCLUSIONS: Conceptual frameworks to classify cultural adaptations and their resultant health/mental health outcomes were developed and applied in a variety of ways. This review synthesizes the most rigorous research in the field and identifies implications for policy, practice, and research, including individualization, cost considerations, and patient or client satisfaction, among others.

Nurses' attitudes towards older people care: An integrative review.

AIMS AND OBJECTIVES: To examine hospital nurses' attitudes towards caring for older adults and delineate associated factors contributing to their attitudes. BACKGROUND: Population ageing is of international significance. A nursing workforce able to care for the ageing population is critical for ensuring quality older adult care. A synthesis of research related to nurses' attitudes towards older adult care is important for informing care quality and the nursing workforce issues. METHODS: A systematic integrative review process guided the review. Cumulative Index of Nursing and Allied Health Literature and Medline databases were searched for primary research published between 2005-2017. A total of 1,690 papers were screened with 67 papers read in-depth and eight selected for this review that met the inclusion/exclusion criteria. RESULTS: Nurses' held coexisting positive and negative attitudes towards generic and specific aspects of older adult care. Negative attitudes, in particular, were directed at the characteristics of older adults, their care demands or reflected in nurses' approaches to care. Across jurisdictions, work environment, education, experience and demographics emerged as influences on nurses' attitudes. CONCLUSION: There is a paucity of research examining nurses' attitudes towards older adult care. The limited evidence indicates that attitudes towards older people care are complex and contradictory. Influences on nurses' attitudes need further study individually and collectively to build a strong evidence base. Interventional studies are needed as are the development of valid and reliable instruments for measuring nurses' attitudes towards older adult care. RELEVANCE TO CLINICAL PRACTICE: Bolstering postgraduate gerontological preparation is critical for promoting nurses' attitudes towards older adult care. Creating age-friendly work environments, including appropriate resource allocation, is important to support older people care and facilitate positive nursing attitudes.

Orientation and transition programme component predictors of new graduate workplace integration.

AIM: To examine the relationships between selected components of new graduate nurse transition programmes and transition experiences. BACKGROUND: Transition support for new graduates is growing increasingly multifaceted; however, an investigation of the effectiveness of the constituent components of the transition process is lacking. METHODS: An online survey was disseminated to new graduates working in acute care settings and included questions related to new graduate transition programmes. The Casey Fink Graduate Nurse Experience Survey was used to quantify the transition experience. RESULTS: New graduate nurses who participated in a formal new graduate (NG) transition programme had significantly higher total transition scores than non-programme nurses. The orientation length and the average number of hours worked in a two week period were significant predictors of transition; the percentage of preceptored shifts was statistically insignificant. CONCLUSIONS: New graduate transition is enhanced with participation in a formal transition programme. Orientation should be at least four weeks in length, and new graduates should work at least 49 hours in a two week period. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers are in key positions to advocate for new graduate nurse transition programmes with adequate resources to support a four week orientation phase and shift scheduling to ensure an adequate number of hours over two week periods to facilitate transition.

A framework for estimating the adverse health effects of contamination events in water distribution systems and its application.

Intentional or accidental releases of contaminants into a water distribution system (WDS) have the potential to cause significant adverse health effects among individuals consuming water from the system. A flexible analysis framework is presented here for estimating the magnitude of such potential effects and is applied using network models for 12 actual WDSs of varying sizes. Upper bounds are developed for the magnitude of adverse effects of contamination events in WDSs and evaluated using results from the 12 systems. These bounds can be applied in cases in which little system-specific information is available. The combination of a detailed, network-specific approach and a bounding approach allows consequence assessments to be performed for systems for which varying amounts of information are available and addresses important needs of individual utilities as well as regional or national assessments. The approach used in the analysis framework allows contaminant injections at any or all network nodes and uses models that (1) account for contaminant transport in the systems, including contaminant decay, and (2) provide estimates of ingested contaminant doses for the exposed population. The approach can be easily modified as better transport or exposure models become available. The methods presented here provide the ability to quantify or bound potential adverse effects of contamination events for a wide variety of possible contaminants and WDSs, including systems without a network model.

The academic librarian as co-investigator on an interprofessional primary research team: a case study.

OBJECTIVE: The objective of this study was to explore the role librarians play on research teams. The experiences of a librarian and a faculty member are situated within the wider literature addressing collaborations between health science librarians and research faculty. METHODS: A case study approach is used to outline the involvement of a librarian on a team created to investigate the best practices for integrating nurses into the workplace during their first year of practice. RESULTS: Librarians contribute to research teams including expertise in the entire process of knowledge development and dissemination including the ability to navigate issues related to copyright and open access policies of funding agencies. DISCUSSION: The librarian reviews the various tasks performed as part of the research team ranging from the grant application, to working on the initial literature review as well as the subsequent manuscripts that emerged from the primary research. The motivations for joining the research team, including authorship and relationship building, are also discussed. Recommendations are also made in terms of how librarians could increase their participation on research teams. CONCLUSION: The study shows that librarians can play a key role on interprofessional primary research teams.

New graduate nurse transition programs: Relationships with bullying and access to support.

New graduate nurses are often targets of bullying and horizontal violence. The support offered by new graduate nurse transition programs may moderate the effects of bullying and limit its negative impact on new graduate nurse transition. This study examined the relationships between access to support, workplace bullying and new graduate nurse transition within the context of new graduate transition programs. As part of a mixed methods study, an online survey was administered to new graduates (N = 245) approximately a year from starting employment. Bullied new graduate nurses were less able to access support when needed and had poorer transition experiences than their non-bullied peers. Participation in a formal transition program improved access to support and transition for bullied new graduate nurses. People supports within transition programs positively influenced the new graduate nurse transition experience. Formal transition programs provide support that attenuates the impact of bullying on new graduate nurses and improves transition.

The Landscape of Health Technology for Equity Deserving Groups in Rural Communities: A Systematic Review.

BACKGROUND: Equity-deserving groups face well-known health disparities that are exacerbated by rural residence. Health technologies have shown promise in reducing disparities among these groups, but there has been no comprehensive evidence synthesis of outcomes. PURPOSE: The purpose of this systematic review was to examine the patient, healthcare, and economic outcomes of health technology applications with rural living equity-deserving groups. RESEARCH DESIGN: The databases searched included Medline and Embase. Articles were assessed for bias using the McGill mixed methods appraisal tool. ANALYSIS: Data were synthesized narratively using a convergent integrated approach for qualitative and quantitative findings. RESULTS: This evidence synthesis includes papers (n = 21) that reported on health technologies targeting rural equity-deserving groups. Overall, patient outcomes - knowledge, self-efficacy, weight loss, and clinical indicators - improved. Healthcare access improved with greater convenience, flexibility, time and travel savings, though travel was still occasionally necessary. All studies reported satisfaction with health technologies. Technology challenges reported related to connectivity and infrastructure issues influencing appointment quality and modality options. While some studies reported additional costs, overall, studies indicated cost savings for patients. CONCLUSIONS: There is a paucity of research on health technologies targeting rural equity-deserving groups, and the available research has primarily focused on women. While current evidence was primarily of high quality, research is needed inclusive of equity-deserving groups and interventions co-designed with users that integrate culturally sensitive approaches. Review registered with Prospero ID = CRD42021285994.

Assessing the impact of atrial fibrillation self-care interventions: A systematic review.

This systematic review evaluates the efficacy of self-care interventions for atrial fibrillation (AF), focusing on strategies for maintenance, monitoring, and management applied individually or in combination. Adhering to the 2020 PRISMA guidelines, the search strategy spanned literature from 2005 to 2023, utilizing keywords and subject headings for "atrial fibrillation" and "self-care" combined with the Boolean operator AND. The databases searched included Medline, Embase, and CINAHL. The initial search, conducted on February 17, 2021, and updated on May 16, 2023, identified 5160 articles, from which 2864 unique titles and abstracts were screened. After abstract screening, 163 articles were reviewed in full text, resulting in 27 articles being selected for data extraction; these studies comprised both observational and randomized controlled trial designs. A key finding in our analysis reveals that self-care interventions, whether singular, dual, or integrated across all three components, resulted in significant improvements across patient-reported, clinical, and healthcare utilization outcomes compared to usual care. Educational interventions, often supported by in-person sessions or telephone follow-ups, emerged as a crucial element of effective AF self-care. Additionally, the integration of mobile and web-based technologies alongside personalized education showed promise in enhancing outcomes, although their full potential remains underexplored. This review highlights the importance of incorporating comprehensive, theory-informed self-care interventions into routine clinical practice and underscores the need for ongoing innovation and the implementation of evidence-based strategies. The integration of education and technology in AF self-care aligns with the recommendations of leading health organizations, advocating for patient-centered, technology-enhanced approaches to meet the evolving needs of the AF population.

Rural and urban older adults' perspectives of strength in their daily lives.

AIM: The purpose of this study was to understand older adults' perspectives of strength in their daily lives. BACKGROUND: Maintaining strength is important as the population ages and many older adults live into their 80s and 90s. Few studies have explored older adults' views of strength and its management as they age. METHODS: A qualitative descriptive design was used. The sample consisted of 5 focus groups (n = 41) that participated in semistructured interviews. Transcribed data were analyzed using the constant comparative method. RESULTS: Three themes emerged-the capacity to meet variable demands, changes in strength, and strategies to stay strong. CONCLUSIONS: Older adults regard strength as an integration of physical and internal capacities for meeting a range of demands and use physical, mental, and social activities for staying strong. Nurses have an important role in helping older adults focus on strength and their abilities rather than inabilities to enhance healthy aging.

Canadian academic nursing librarians: impacts of the COVID-19 pandemic on librarianship practice.

Objective: This study explored changes in the practice of academic nursing librarianship at large Canadian universities during the COVID-19 pandemic with a particular focus on academic nursing librarians' work with nursing graduate students and nursing faculty. Methods: Semi-structured interviews were conducted with eleven academic nursing librarians about changes to their librarianship practice during the COVID-19 global pandemic. Interviews were conducted between 20 April and 14 May 2021, discussing experiences during the study period March 2020 to May 2021. Results: Canadian academic nursing librarians experienced (i) the adoption of the completely virtual library ; (ii) changes to the type and prevalence of online instruction ; (iii) the discovery that online consultations work well ; (iv) the discovery of the extent to which relationships are valued and intentional ; (v) an increase in requests for instruction and co-authorship of knowledge syntheses; and (vi) the benefits and challenges of remote work. Discussion: Experiences were divergent, shaped in part by the institutions' pre-pandemic practices. Additionally, some participants reported no impact of the pandemic on their research, instruction, and collaborations with nursing graduate students and nursing faculty. In particular, institutions already offering online masters programs in nursing reported less significant disruption. The temporary transition to the completely virtual library revealed benefits of online consultations, opportunities for reaching more students through asynchronous learning, the importance of relationships to nursing liaison work, and value of the flexibility to work remotely . Conclusion: The COVID-19 global pandemic continues to evolve. With a return to in-person classes at Canadian universities, there is much to learn from the experiences during the first 18 months of the pandemic.

Telehealth Use for Enhancing the Health of Rural Older Adults: A Systematic Mixed Studies Review.

BACKGROUND AND OBJECTIVES: Telehealth holds potential for inclusive and cost-saving health care; however, a better understanding of the use and acceptance of telehealth for health promotion among rural older adults is needed. This systematic review aimed to synthesize evidence for telehealth use among rural-living older adults and to explore cost-effectiveness for health systems and patients. RESEARCH DESIGN AND METHODS: This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study designs reporting health promotion telehealth interventions with rural-living adults aged 55 and older were eligible for review. Following screening and inclusion, articles were quality-rated and ranked by level of evidence. Data extraction was guided by the Technology Acceptance Model and organized into outcomes related to ease of use, usefulness, intention to use, and usage behavior along with cost-effectiveness. RESULTS: Of 2,247 articles screened, 42 were included. Positive findings for the usefulness of telehealth for promoting rural older adults' health were reported in 37 studies. Evidence for ease of use and usage behavior was mixed. Five studies examined intention to continue to use telehealth and in 4 of these, patients preferred telehealth. Telehealth was cost-effective for health care delivery (as a process) compared to face to face. However, findings were mixed for cost-effectiveness with both reports of savings (e.g., reduced travel) and increased costs (e.g., insurance). DISCUSSION AND IMPLICATIONS: Telehealth was useful for promoting health among rural-living older adults. Technological supports are needed to improve telehealth ease of use and adherence. Cost-effectiveness of telehealth needs more study, particularly targeting older adults.

News Article Portrayal of Virtual Care for Health Care Delivery in the First 7 Months of the COVID-19 Pandemic.

Objectives: The onset of the 2020 coronavirus pandemic resulted in rapid implementation of virtual care solutions at an unprecedented pace. The news media, as a trusted source for many Canadians, plays a vital role during emergencies by reporting on changes in health care protocols, policies, and technologies. This article presents the results of a qualitative analysis of Canadian news articles between February and August of 2020 to identify critical themes with respect to virtual care. Methods: A full-text search of the database Canadian Newsstream resulted in 1542 articles (708 duplicates), of which 294 articles were included in the final analysis. Inductive analysis was used to generate themes and identify voices, contradictions, and tensions in the articles. Results: Analysis generated four themes: coronavirus disease (COVID-19) as a catalyst for virtual care, safety and protection, economic impacts, and telehealth as a model of care. Media portrayals represented some voices (e.g., physicians) while limiting others (e.g., patients), reflected some contradictory messaging with respect to safety and protection, and raised key issues and concerns about virtual health care delivery during the first 7 months of COVID-19. Conclusions: Our findings of successful and rapid uptake, uses and concerns around funding, and privacy and virtual care adoption reported in the news media can be used to inform longer term implementation and sustainability. Policy makers could benefit from crafting messages that balance information and reassurance. Public/patient perspectives, which were largely missing from news media, are needed to gauge receptivity and sustainability.

Ethical, Policy, and Practice Implications of Nurses' Experiences With Assisted Death: A Synthesis.

The conceptualization of assisted death as an act performed by physicians has resulted in a lack of attention to nurses' roles and experiences with the processes that surround an assisted death. In this article, we synthesize evidence from 6 articles focusing on the experiences of 55 nurses from Canada, Belgium, and the Netherlands, with relevant ethical and policy implications derived from the literature. Nurses have a central role in negotiating inquiries about assisted death and in providing wraparound care for patients, families, and other health care providers. This role is impactful for nurses and requires significant personal and professional moral work.

Best practices of formal new graduate transition programs: An integrative review.

OBJECTIVES: The aim was to identify the best practices of formal new graduate nurse transition programs. This information would be useful for organizations in their support and development of formal transition programs for newly hired nurses. DESIGN: An integrative review of the nursing research literature (2000-2018). DATA SOURCES: The literature search included PubMed (MEDLINE), CINAHL (Cumulative Index to Nursing and Allied Health Literature), and EMBASE (Excerpt Medica dataBASE). Studies that dealt with programs geared towards pre-registration nursing students were removed. At least two researchers evaluated the literature to determine if the article met the inclusion and exclusion criteria. The final number of articles included in this review is 76. REVIEW METHODS: Cooper's (1989) five-stage approach to integrative review guided the process: problem formulation, data collection, evaluation of data points, data analysis and interpretation, presentation of results. This approach was supplemented by the PRISMA guidelines for reporting systematic searches. RESULTS: Selected studies (n=76) included a range of new graduate nurse program types. The literature was examined according to four major themes: education (pre-registration and practice), support/satisfaction, competency and critical thinking, and workplace environment. Common elements of programs were a specified resource person(s) for new graduates, mentorship, and peer support opportunities. Gaps were observed between pre-registration and new graduate nurse practice realities. A range of educational strategies were used but few were evaluated. Most programs staggered education over time but the limited evidence showed no difference in new graduate nurse transition or satisfaction. New graduate nurse support was an important emphasis of all programs with preceptors the most common form of support and with beginning evidence showing quality vs quantity in preceptor support. Strengthening the quality of preceptor support was evident across studies with the bundling of concurrent strategies found to be helpful. Competency and confidence were found to increase over time for new graduate nurses in transition programs. Workplace environments influenced new graduate nurse transition and organizational commitment. CONCLUSIONS: The variable quality of evidence limits the conclusions that can be drawn. The strongest evidence consistently showed new graduate nurse programs enhanced critical thinking, competency and retention and there were advantages with use of bundled preceptor strategies to support new graduates.