New graduate registered nurse practice readiness for Australian healthcare contexts: a collective instrumental case study

Harrison, Helena Clare (2018) New graduate registered nurse practice readiness for Australian healthcare contexts: a collective instrumental case study. PhD thesis, James Cook University.

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For new graduate registered nurses (NGRNs) practice readiness, or the ability to enter the healthcare setting and practice competently as a registered nurse (RN) is essential for safe patient care and meeting the needs of healthcare providers (individuals and institutions) (HCPs). A NGRN's level of practice readiness can affect transition to the RN role, retention rates and patient safety. Studies aimed at exploring the preparation and transition of NGRNs from student to RN suggest that NGRNs are not 'practice ready'. Researchers that have investigated the concept of practice readiness describe it as a multidimensional concept that is poorly defined and shaped by context. Researchers examining the practice readiness of Australian NGRNs have focussed on specific geographic areas and healthcare contexts; undergraduate nurses (UGNs); or involved graduates from other professions. Minimal research has been undertaken to explore the perspectives of healthcare professionals working with NGRNs in Australian healthcare settings across diverse geographic locations.

While growing evidence implies that NGRNs are not practice ready, a common understanding of NGRN practice readiness and how practice readiness is achieved, measured and determined remains unclear and variable. As a result, inconsistencies in expectations exist between HCPs, NGRNs and education providers. Such inconsistencies can lead to NGRNs having difficulty meeting HCPs' expectations, adjusting to their new role and providing a safe standard of care.

Using a multiple case study approach, the concept of NGRN practice readiness from the perspective of healthcare professionals in Queensland, Australia is explored. Four case studies of healthcare institutions in four different geographic locations were completed. Constructivism and symbolic interactionism were used as the theoretical framework to help explain how individual HCP's perception, context and practice intersect to conceptualise descriptions and meanings of NGRN practice readiness. Methods employed for data generation and collection included individual and focus group interviews; document review; field notes; and memos. Individual and cross-case analyses were conducted using selected grounded theory methods of coding and categorising of data; concurrent data collection and analysis; constant comparative analysis; and memo writing. Data from each case were integrated and interpreted against the research questions to provide an in-depth understanding of NGRN practice readiness.

The cross-case analysis identified four major categories: Dominance of context; Determining practice readiness; Defining practice readiness; and Developing practice readiness. The findings highlight how decisions about practice readiness are informed by HCP's personal and professional context. Practice readiness is defined as a multidimensional concept encompassing personal, clinical, industry and professional capabilities. Findings indicate that acquiring the required level of practice readiness relies on factors present in a NGRN's pre- and post-registration education and clinical experiences and occurs across a 4-year continuum of learning that includes a NGRN's first year of practice, where the NGRN makes the final transition from student to professional RN. Recommendations from this study will inform policies and practices that aim to improve NGRN practice readiness and consequently their transition, integration and retention in the healthcare workforce.

Item ID: 56555
Item Type: Thesis (PhD)
Keywords: case study, nursing, practice readiness, healthcare, new graduates, registered nurses
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Copyright Information: Copyright © 2018 Helena Clare Harrison
Additional Information:

For this thesis, Helena Harrison received the Dean's Award for Excellence 2019.

Some references, including access links, have been altered to protect anonymity: locations are referred to by Case number.

Publications arising from this thesis are available from the Related URLs field. The publications are:

Chapter 3: Harrison, Helena, Birks, Melanie, Franklin, Richard, and Mills, Jane (2017) Case study research: foundations and methodological orientations. Forum Qualitative Sozialforschung, 18 (1). pp. 1-17.

Date Deposited: 10 Dec 2018 02:29
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1110 Nursing > 111099 Nursing not elsewhere classified @ 100%
SEO Codes: 92 HEALTH > 9202 Health and Support Services > 920210 Nursing @ 100%
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