Registered nurses' cultural orientation competence for culturally and linguistically diverse nurses in the hospital setting: A cross-sectional study.

AIMS: To explore registered nurses' cultural orientation competence profiles for providing culturally and linguistically diverse (CALD) nurses with orientation in the hospital setting, and to identify which factors are associated with cultural orientation competence profiles. DESIGN: A descriptive, explorative cross-sectional study. METHODS: Data were collected from December 2020 to January 2021 using the Preceptors' Orientation Competence Instrument (POCI) and Preceptors' Cultural Orientation Competence Instrument (POCCI). A total of 844 registered nurses from one university hospital district in Finland participated, reflecting a response rate of 10%. A K-means cluster algorithm was employed to identify different cultural orientation competence profiles. RESULTS: The cluster analysis identified three cultural orientation competence profiles (A, B and C). Nurses in Profile A evaluated their cultural orientation competence the highest, with members of profiles B and C demonstrating the second highest and lowest, respectively, cultural orientation competence scores. Several factors were associated with cultural orientation competence profiles, namely, orientation education and student mentoring education, support from managers and colleagues, motivation, willingness to act as a preceptor, time to provide orientation, sufficient clinical and theoretical nursing skills and current work title. CONCLUSION: Cultural diversity and acceptance of it can be enhanced by building accepting culture towards new incomers and offering continuing education to improve the cultural competence of staff, which can further benefit patient care of CALD patients. Orientation practices can be improved by rewarding staff and building collaborative teamwork culture. IMPLICATIONS FOR PROFESSION AND/OR PATIENT CARE: Organizations can strengthen nurses' cultural orientation competence; for example, by providing adequate orientation education and allocating more time to the orientation process. REPORTING METHOD: The STROBE criteria were used to report the results of the observations critically. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Development and psychometric testing of the preceptors' orientation competence instrument (POCI).

AIM: To develop and psychometrically test a Preceptors' Orientation Competence Instrument measuring orientation competence of nurses working as new employee preceptors. BACKGROUND: Competence of nurse preceptor is essential for a successful preceptorship and thus nursing staff´s commitment to the organization. DESIGN: Instrument development according to the COSMIN guidelines. METHODS AND PARTICIPANTS: Four phases were implemented: 1) establishment of the theoretical framework, modification of the validated Mentor Competence Instrument and generation of new items; 2) content validity testing; 3) structural validity testing; and 4) internal consistency testing. Content validity was evaluated by 14 experts using content validity index methods. Structural validity was evaluated using exploratory factor analysis with a convenience sample of 844 Finnish nurses. Internal consistency was evaluated by measuring Cronbach's alpha. RESULTS: The content validity index of subdimensions of the instrument ranged from 0.80 to 0.94 for relevance and 0.80-0.94 for clarity. Exploratory factor analysis resulted in a seven-factor model with 53 items (61.62% of total variance): preceptor characteristics, goal-oriented orientation, guidance in reflective discussion, knowledge of work unit orientation practices, creation of a supportive learning atmosphere, preceptor motivation and giving of developmental feedback. Cronbach's alpha values varied from 0.79 to 0.93. CONCLUSION: Preceptors' Orientation Competence Instrument demonstrated adequate psychometric properties based on content and construct validity as well as internal consistency. Therefore, it is useful for self-evaluation of orientation competence of nurses working as new employee preceptors.

Nurse preceptors' orientation competence and associated factors-A cross-sectional study.

AIMS: To identify distinct orientation competence profiles amongst nurse preceptors and explain the associated factors. DESIGN: A cross-sectional study design. METHODS: The data were collected during the winter of 2020-2021 from registered nurses (N = 8279, n = 844) at one university hospital in Finland through an online questionnaire that included a self-administered electronic version of the Preceptors' Orientation Competence Instrument. K-means clustering was then used to identify nurse preceptor profiles. Chi-square, Fisher's exact test, Kruskal-Wallis and Mann-Whitney tests were used to analyse factors associated with competence profiles. The results were reported as frequencies, percentages, mean and standard deviation. RESULTS: A total of three distinct orientation competence profiles (A, B, C) were identified. Profile A nurses evaluated their orientation competence at the highest level, whereas profile C nurses evaluated their competence at the lowest level. Sufficient clinical and theoretical experience, a motivation to work, willingness to orient new employees and participation in orientation and/or mentoring education were found to be associated with competence profiles. CONCLUSION: The findings expand the current knowledge base of nurse preceptors' orientation competence. Health care organizations should recognize different orientation competence profiles amongst the nursing staff since the selection of a preceptor should always be based on possessing the necessary orientation competence rather than availability. The results indicate that preceptors (who reported taking on various tasks and covering multiple roles) need support from co-workers to sufficiently concentrate on employee orientation tasks. The results also indicate that preceptors need further orientation education, which should-for example-outline the learning goals for new employees and how preceptors can assess employee performance. IMPACT: What problem did the study address? Prior research has not applied a robust theoretical framework covering all aspects relevant to a preceptor's competence. What were the main findings? A nurse's clinical and theoretical experience, motivation to work, willingness to orient new employees, and prior participation in orientation and/or student mentoring education were found to influence their level of orientation competence. Where and on whom will the research have an impact? Healthcare organizations can use the results of this study to make the selection of preceptors competency-based rather than their availability. Nurse leaders can use the results of this study to pinpoint which areas of nurses' orientation competence and associated factors need to be improved. Increased orientation competence will enable clinical nurses to provide high-quality orientation to new employees, which is crucial to the retention of nursing staff and the quality of patient care.