2.50
Hdl Handle:
http://hdl.handle.net/10755/211734
Type:
Research Study
Title:
COMPARISON OF EXPERT AND NOVICE RURAL NURSE DAILY PRACTICE ACTIVITIES
Abstract:
Purpose/Aims: The purpose was to compare rural novice and expert work activities and medication errors in order to better understand the workplace. Rationale: The literature is mixed about the rural nursing quality and safety. Some studies report novice nurses commit more medication errors than experts while others do not. Some authors state novices perform the same duties as expert nurses and without transition support. As turnover of new rural nurses ranges from 35-65% during the first year of practice, responsibilities and pressures of practice need to be understood. Understanding novice rural nurses practice is foundational to program improvement. Methods: Participants of a national residency program participated in tracking and reporting daily work activities and medication errors. Novice and expert nurses reported one week’s shifts three times during a year. The Medication Error Survey was also completed three times. During the first reporting period 217 novices’ (163) and experts’ (64) reports were averaged and compared using  Spearman’s Correlations, Kruskal-Wallis and Mann-Whitney tests. Results: Novices cared for significantly more patients per shift (f 1.690, .06) than experts. Experts did not report workload reductions while teaching new employees. Expert nurses supervised more people during a shift (f 17.460, .001). Novices found more patient errors (f 5.563, .019). Expert nurses also spent more time on more committees than did novice nurses (f 3.764, .054). Using the Medication Error Survey, there was not significant differences between novice and experts other than in reporting/documenting errors found. Experts made significantly more reports. Experts reported making fewer errors than novices but this was due to a lack of rating the questions about making errors rather than a difference in error commission.  Although responses could have been-no errors, nearly one third of expert participants refused to answer the question at all. Implications: Medication error Safety issues need further examination, systems organization, and nurse education. Future research questions include: Why do expert nurses avoid answering medication error questions when they could affirm or deny commission of an error anonymously?  Was personal safety an issue? Which organizational systems produce professional safety concerns? What occurs and when for socializing novices to report errors? How do nurses define professional advancement? If advancement means more supervision and committee work in addition to patient care, is this satisfying? Were experts given workload accommodations for committee work and supervision? How often are expert nurses pulled from patient care? Comparison among groups over time needs reporting.  Since novices reported finding more patient errors than experts, an understanding of who commits errors is needed. Do experts and novices perceive errors differently? Are there socialization issues involved in not reporting errors?  Differences in practice impact job expectations of novices and experts. More information is needed in order to develop effective transition to practice programs.
Keywords:
Novice nurse; Expert nurse; Workplace; Rural nurse culture
Repository Posting Date:
20-Feb-2012
Date of Publication:
20-Feb-2012
Other Identifiers:
5055
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typeResearch Studyen_GB
dc.titleCOMPARISON OF EXPERT AND NOVICE RURAL NURSE DAILY PRACTICE ACTIVITIESen_GB
dc.identifier.urihttp://hdl.handle.net/10755/211734-
dc.description.abstractPurpose/Aims: The purpose was to compare rural novice and expert work activities and medication errors in order to better understand the workplace. Rationale: The literature is mixed about the rural nursing quality and safety. Some studies report novice nurses commit more medication errors than experts while others do not. Some authors state novices perform the same duties as expert nurses and without transition support. As turnover of new rural nurses ranges from 35-65% during the first year of practice, responsibilities and pressures of practice need to be understood. Understanding novice rural nurses practice is foundational to program improvement. Methods: Participants of a national residency program participated in tracking and reporting daily work activities and medication errors. Novice and expert nurses reported one week’s shifts three times during a year. The Medication Error Survey was also completed three times. During the first reporting period 217 novices’ (163) and experts’ (64) reports were averaged and compared using  Spearman’s Correlations, Kruskal-Wallis and Mann-Whitney tests. Results: Novices cared for significantly more patients per shift (f 1.690, .06) than experts. Experts did not report workload reductions while teaching new employees. Expert nurses supervised more people during a shift (f 17.460, .001). Novices found more patient errors (f 5.563, .019). Expert nurses also spent more time on more committees than did novice nurses (f 3.764, .054). Using the Medication Error Survey, there was not significant differences between novice and experts other than in reporting/documenting errors found. Experts made significantly more reports. Experts reported making fewer errors than novices but this was due to a lack of rating the questions about making errors rather than a difference in error commission.  Although responses could have been-no errors, nearly one third of expert participants refused to answer the question at all. Implications: Medication error Safety issues need further examination, systems organization, and nurse education. Future research questions include: Why do expert nurses avoid answering medication error questions when they could affirm or deny commission of an error anonymously?  Was personal safety an issue? Which organizational systems produce professional safety concerns? What occurs and when for socializing novices to report errors? How do nurses define professional advancement? If advancement means more supervision and committee work in addition to patient care, is this satisfying? Were experts given workload accommodations for committee work and supervision? How often are expert nurses pulled from patient care? Comparison among groups over time needs reporting.  Since novices reported finding more patient errors than experts, an understanding of who commits errors is needed. Do experts and novices perceive errors differently? Are there socialization issues involved in not reporting errors?  Differences in practice impact job expectations of novices and experts. More information is needed in order to develop effective transition to practice programs.en_GB
dc.subjectNovice nurseen_GB
dc.subjectExpert nurseen_GB
dc.subjectWorkplaceen_GB
dc.subjectRural nurse cultureen_GB
dc.date.available2012-02-20T12:11:11Z-
dc.date.issued2012-02-20T12:11:11Z-
dc.date.accessioned2012-02-20T12:11:11Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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