Establishing a New Normal for Hospital Care: A Whole of Hospital Approach to Coronavirus Disease 2019 (COVID-19).

Singapore's hospitals had prepared to receive patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), planning various scenarios and levels of surge with a policy of isolating all confirmed cases as inpatients. The National University Hospital adopted a whole of hospital approach to coronavirus disease 2019 (COVID-19) with 3 primary goals: zero hospital-acquired COVID-19, all patients receive timely necessary care, and maintenance of staff morale. These goals to date have been met. A large influx of COVID-19 cases required significant transformation of clinical and operational processes. Isolation room numbers almost tripled and dedicated COVID-19 cohort wards were established, elective care was postponed, and intensive care units were augmented with equipment and manpower. In the wake of the surge, establishing a new normal for hospital care requires maintaining vigilance to detect endemic COVID-19, establishing contingency plans to ramp up in case of another surge, while returning to business as usual.

Graduate nurses' evaluation of mentorship: Development of a new tool.

AIM: Develop and test an instrument to measure graduate-nurses' perceptions of a structured mentorship program. BACKGROUND: New graduate nurses may experience difficulties in the transition from student to practitioner. Mentoring is commonly used to support graduates. However, there is a lack of published tools measuring graduate nurses' perceptions of mentorship. As mentoring is resource intensive, development and testing of a validated tool are important to assist in determining program effectiveness. METHODS: A pretest-posttest interventional design was used. Following a critical review of literature and content experts' input, the 10-item National University Hospital Mentorship Evaluation (NUH ME) instrument was tested with a convenience sample of 83 graduate nurses. Psychometric tests included internal reliability, stability, content validity, and factor analysis. Changed scores were evaluated using paired samples t-test. RESULTS: Seventy-three graduates (88%) out of a possible 83 completed the pre-and post-program survey. Internal reliability was excellent with a Cronbach's alpha of 0.92. Test-retest reliability was stable over time (ICC=0.81). Exploratory factor analysis supported a 1-factor solution explaining 58.2% of variance. Paired samples t-test showed statistical significance between the pre- and post-program scores (p<0.001). CONCLUSIONS: The NUH-ME measure was found to be valid and reliable. Confirmatory Factor Analysis of the tool with different groups of nursing graduates is required. Mentorship programs can be an effective recruitment and retention strategy, but are also resource intensive. Measuring new graduates' perceptions of mentoring contributes to program relevance in addressing their personal, professional and clinical skill development needs. As mentoring engages a diverse range of mentors, feedback through measurement may also positively alter organizational learning culture.