Associations Between the COVID-19 Pandemic and New Nurses' Transition to Practice Outcomes: A Multi-site, Longitudinal Study

Maja Djukic; Nikhil Padhye; Zhichun Ke; Erica Yu; Caitlin McVey; Warisara Manuel; Yashamika Short; Rosemary Pine; Shamail Caligone

doi:10.1016/S2155-8256(23)00067-4

Associations Between the COVID-19 Pandemic and New Nurses' Transition to Practice Outcomes: A Multi-site, Longitudinal Study

J Nurs Regul. 2023 Apr;14(1):42-49. doi: 10.1016/S2155-8256(23)00067-4. Epub 2023 Apr 5.

Authors

Maja Djukic¹, Nikhil Padhye², Zhichun Ke³, Erica Yu⁴, Caitlin McVey⁵, Warisara Manuel⁶, Yashamika Short⁷, Rosemary Pine⁸, Shamail Caligone⁹

Affiliations

¹ John P. McGovern Distinguished Professor in Nursing Associate Professor, Jane and Robert Cizik School of Nursing, The University of Texas Health Science Center at Houston.
² Professor, Jane and Robert Cizik School of Nursing, The University of Texas Health Science Center at Houston.
³ Graduate Research Assistant, The University of Texas Health Science Center at Houston.
⁴ Margaret A. Barnett/Partners Professor in Nursing, and Associate Dean & Department Chair, Undergraduate Studies, Jane and Robert Cizik School of Nursing, The University of Texas Health Science Center at Houston.
⁵ Associate Vice President, Nursing Institute, Memorial Hermann Health System, Houston, Texas.
⁶ PhD Student, Jane and Robert Cizik School of Nursing, The University of Texas Health Science Center at Houston.
⁷ Nurse Residency Program Coordinator, Memorial Hermann Texas Medical Center, Houston.
⁸ Director of Hospital Education and Professional Development, Memorial Hermann Texas Medical Center.
⁹ Nurse Residency Program Assistant, Memorial Hermann Texas Medical Center.

Abstract

Background: The transition between nursing school and nursing practice has been well studied and recognized as a turbulent time for new nurses. Existing literature suggests that transition to practice (TTP) programs can successfully support new nurses through this challenging period. However, TTP program outcomes have not been studied related to the COVID-19 pandemic, which altered TTP experiences for many new nurses by limiting their access to clinical sites for hands-on patient care experience and shifting delivery of nursing education and TTP programs from in-person to virtual environments.

Purpose: The purpose of this study was to analyze the associations between TTP outcomes and the COVID-19 pandemic.

Methods: This was a retrospective correlational, longitudinal study using secondary analysis of Vizient /AACN Nurse Residency Program survey data from the Casey-Fink Graduate Nurse Experience Survey and the Nurse Resident Progression Survey. Self-reported data from new nurses in Southeast Texas who participated in a standardized TTP program before the COVID-19 pandemic (2017-2019) were compared with self-reported data from nurses who participated in the TTP program during the pandemic (2020 and 2021).

Results: A total of 2,673 nurses participated in this study. When adjusting for demographic composition of the cohorts, statistically significant differences (p < .05) were identified in the advocacy, patient safety, and commitment outcomes with a decline in change scores from baseline to 12 months in the COVID-19 pandemic cohort compared to the pre-COVID-19 pandemic cohort.

Conclusion: Our findings provide new information on the impact of the COVID-19 pandemic on new nurses' participating in a standardized TTP program. The results indicate that patient safety and commitment to staying employed in the organization and the nursing profession should be priority improvement areas for employers and TTP program staff as they work to support new nurses' TTP in a pandemic.

Keywords: COVID-19; Transition to practice; education; new graduate nurses; nurse residency program.