Improving Retention of Home Health Nurses: Fostering Outcome Sustainability Through an Innovative Orientation and Mentorship Program.

Home healthcare plays an increasingly vital role in contemporary postacute healthcare. Staffing instability and lack of perceived organizational support is a stimulus for nursing attrition from the organization with far-reaching impact on staff morale, patient care, agency budgets, and relationships with other healthcare settings. The purpose of this article is to describe a redesign of an agency's nursing orientation and the development of a mentorship program for newly hired home healthcare nurses within a large Midwestern integrated health system. During this time frame, 154 nurses completed the newly designed orientation program and, of those, 91 participated in the mentorship program. In this article, we evaluate 1-year new-hire nursing retention rates over a 4-year period, examine new-hire job satisfaction and perceptions of preceptors and mentors during their first year, and discuss issues of outcome sustainability. Agency-wide turnover rates for all home healthcare nurses decreased from 15.4% in 2016 to 10.1% in 2018, demonstrating the associated impact of these initiatives on staffing stabilization.

[Midwives and Nurses in Early Childhood Intervention: The Benefit of Additional Qualification]. / Gesundheitsfachkräfte in den Frühen Hilfen: Wie nützlich ist die Zusatzqualifikation? Eine quantitative Studie.

Midwives and Nurses in Early Childhood Intervention: The Benefit of Additional Qualification Abstract. BACKGROUND: Early childhood interventions are locally and regionally organized support services for families from pregnancy until the end of the third year of life. The interventions promote diverse measures to enhance parental skills in order to improve developmental and living circumstances. Midwives and nurses with additional qualification support burdened families in early childhood intervention. METHOD: Within a retrospective survey (standardized interviews, CAPI) mothers' (N = 298) perspective of the benefit of the home visiting support is assessed. Data from two groups were compared: (1) mothers in the care of a midwife or nurse with additional qualification (GruppeGFK + Quali) and (2) mothers cared for by a midwife or nurse without additional qualification (GruppeGFK). RESULTS: (1) Families with weighted levels of psychosocial burdens reported an enhanced need for help. (2) Midwives and nurses with additional qualification support more frequently families with high levels of psychosocial burdens. (3) Mothers with care of midwives and nurses with additional qualification reported this support as more useful in relation to every day demands than mothers with regular care after birth (questionnaire for evaluation of the received support: GruppeGFK + Quali: mean = 2.57; GruppeGFK : mean = 1.97; t (121) = 2.799, p = .003). CONCLUSION: The study complements results of national and international studies showing that families with high levels of psychosocial burdens accept home visiting support. Furthermore, this support seems to be useful. An increase of the offer and the additional qualification is recommended for improving the developmental and living conditions of families with psychosocial burdens.

Nursing simulation: a community experience.

The education sector faces major challenges in providing learning experiences so that newly qualified nurses feel adequately prepared to work in a community setting. With this in mind, higher education institutions need to develop more innovative ways to deliver the community-nurse experience to student nurses. This paper presents and explores how simulation provides an opportunity for educators to support and evaluate student performance in an environment that models a complete patient encounter in the community. Following the simulation, evaluative data were collated and the answers analysed to identify key recommendations.

Educating Home Healthcare Nurses About Heart Failure Self-Care.

The ability of home healthcare nurses to effectively educate patients with heart failure (HF) on appropriate self-care is key to lowering the hospital readmission rates and other adverse outcomes. Evidence indicates, however, that nurses often lack current knowledge about HF self-care. Furthermore, patient education often fails to produce health literacy. Thus, this educational intervention for home healthcare nurses included content about key aspects of managing HF (e.g., diet, medications), as well as how to use the teach-back method during patient education. Pre- and posttesting (using the Nurses' Knowledge of HF Education Principles Questionnaire) and role-playing were used to evaluate the intervention delivered to 33 home care nurses. Findings exposed knowledge deficits regarding high-sodium foods, symptoms indicating deterioration, problematic weight gain, fluid management, as well as other topics related to HF. The education was partially effective in addressing these nurses' knowledge gaps. The evidence-based education for home healthcare nurses suggests that not only may nurses lack knowledge essential to teaching HF self-care; they may also lack effective patient education skills such as using the teach-back method.

An innovative strategy to increase a professional workforce: the fast track initiative for health visitors in England.

OBJECTIVES: Fast tracking is one strategy that organizations use to ameliorate workforce shortfalls by attracting new recruits, and accelerating their skills development and experience. In response to the Government's target of rapidly expanding the number of health visitors in England's National Health Service, the fast track initiative was launched to recruit newly qualified (fast track) as well as experienced (standard entry) nurses and midwives onto health visiting programmes. This paper evaluates the fast track initiative, from the perspective of fast track and standard entry students, practice teachers and health visitor managers. METHODS: A mixed methods design was used comprising a questionnaire survey (n = 71 students), semi-structured interviews (n = 37 students), telephone interviews (n = 13 managers) and six focus groups (n = 24 practice teachers). Data were collected between April 2012 and July 2013. Descriptive statistics, t-tests and the Pearson Chi-square test were used to analyse the quantitative data. The qualitative data were analysed thematically. RESULTS: Motivations for health visiting as a career choice were similar for fast track and standard entry students, with career progression and interest in health promotion being key motivators. There was consensus that personal qualities and characteristics were more important than experience or qualifications. However, fast track students were significantly less confident about their public health competencies in leadership and management (p < 0.05) and communication (p < 0.02). Practice teachers and managers also reported that fast track students required more intensive supervision particularly at the beginning of the programme. Programme completion including pass rates and academic achievement showed no significant difference by route of entry (p > 0.5). CONCLUSION: Fast tracking offers a useful recruitment strategy in order to expand the health visitor workforce, but longitudinal research is needed to confirm benefits such as retention and career trajectories.

Students' and tutors perceptions of the use of reflection in post-registration nurse education.

The aim of this study was to explore post-registration nurse students' and tutors perceptions of the use of reflection in education. The benefits of reflection have been highlighted in a number of studies; however, there is a paucity of literature on students' perceptions of the use of reflection in post-registration nurse education. A qualitative approach was used to explore the six post-registration nurse students' and three tutors perceptions of the use of reflection in education. Semi-structured interviews were used to access perceptions and the data was analysed. The findings of this study are discussed under the themes; benefits of reflection, barriers to reflection and suggestions for improvement of the use of reflection. Conclusions include recommendations for future research and practice. Recommendations include tutors providing sufficient time and regular support for reflective practice without the constraints of using set reflective models. These findings have implications for those involved in curriculum development for post-registration nurses' education and those seeking to develop reflective abilities in students.