Nurses' perception of individual and organizational changes caused by a novel clinical training system for new graduate nurses: A qualitative research using photovoice.

BACKGROUND: Clinical training for new graduate nurses has a positive impact on their clinical competence; however, there is limited evidence on the impact of this training at the organizational level and on the processes that mediate these impacts. OBJECTIVES: To identify the individual and organizational impacts of a clinical training system and the mechanism that produces them by exploring nurses' perceptions of the changes in health facilities after the introduction of a standardized clinical training system in Vietnam. DESIGN: Qualitative research using an ethnographic approach; photovoice was used to obtain insights into nurses' perceptions. SETTING: Health facilities of four provinces and one city in Vietnam participated in the Project for Strengthening of the Clinical Training System for New Graduate Nurses. PARTICIPANTS: New graduate nurses, preceptors, and managers who engaged in the clinical training program. METHODS: Qualitative data, including photographs, were collected through photovoice sessions and inductively analyzed using thematic analysis. RESULTS: Sixteen photovoice sessions were conducted with 94 nurses from 22 hospitals. Three themes emerged: "acquiring competency" as an individual change, "fostering mutual learning culture" as an organizational change, and "improved quality of care and nurse empowerment" as the impact. The clinical training system was found to enhance diverse competencies of new graduate nurses, preceptors, and nurse managers, while facilitating collaboration among different professions, departments, and organizations and cultivating a better learning environment. Organizational changes were initiated with the hospital director's support. These changes were interactively related and produced the impact. CONCLUSIONS: The novel clinical training system for new graduate nurses could strengthen nurses' competencies and facilitate organizational changes to actualize a positive impact on nursing care and nurses' status. These findings could facilitate the design of an effective training program to stimulate organizational learning to produce better health outcome.

Helping patients with chronic conditions overcome barriers to self-care.

This article provides an overview of barriers to self-care, patients' perceptions and understanding of their chronic illness, interviewing techniques, and approaches nurse practitioners can use to reduce or eliminate barriers to self-care in adults with chronic conditions.