Nurses in a SNAP: Increasing Self-Confidence for Competent Nursing Practice through a Student Nurse Employment Model

Brittany Burke
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Abstract

Although self-confidence is strongly correlated with safe patient care, there is limited research about self-confidence perceptions among new graduate nurses upon entry into licensed practice. This study evaluated the effect of the Student Nurse Apprenticeship Program’s (SNAP) three-tiered employment model on new graduate registered nurse (RN) self-confidence and the organization’s subsequent return on investment. Evaluate the effect of a pre-licensure, student nurse employment model on licensed nurses in three areas: perceived self-confidence related to patient safety, new graduate nurse orientation length, and organizational RN retention. A quasi-experimental, nonequivalent control group posttest study was conducted at Norton Healthcare (NHC) with SNAP Cohort One. Graduate RNs who completed SNAP and a control group of non-SNAP new graduate RNs took the Health Professional Education in Patient Safety Survey tool prior to starting NHC new graduate nurse orientation. During SNAP application, applicants completed the Human Systems Integration tool which aids in assessment of the relationship between the individual and the role’s responsibilities. In SNAP Cohort One, statistically significant (p < 0.05) increases in perceived self-confidence related to patient safety were found in SNAP graduates. Organizational retention was captured at 90% from SNAP to NHC RN, a 94% one-year RN retention, and a 96% two-year RN retention. The mean new graduate RN orientation length for SNAP graduates decreased three weeks. Total organizational cost avoidance of $8.5 million was shown in decreased orientation time and first year RN retention. This study shows that the new graduate RNs completing SNAP had higher perceived self-confidence related to patient safety compared to new graduate RNs who did not complete SNAP. With the success of SNAP Cohort One, in conjunction with the strong return on NHC’s financial investment and creation of a workforce pipeline, NHC continued the program. After five successful cohorts and 696 student nurses, SNAP graduates avoided the organization over $33 million in first year RN turnover costs. SNAP graduate to NHC RN retention remained at 90%, with first year RN retention at 92%, and second year RN retention at 84%. The mean decrease in orientation time for all five cohorts remained between two and three weeks.
护士在一个SNAP:通过学生护士就业模式提高自信胜任护理实践
虽然自信与病人的安全护理密切相关,但关于新毕业护士进入执业许可后的自信认知的研究有限。本研究评估了学生护士学徒计划(SNAP)三层就业模式对新毕业注册护士(RN)自信心和组织后续投资回报的影响。评估预许可、学生护士就业模式在三个方面对持牌护士的影响:与患者安全相关的感知自信、新毕业护士入职时间和组织注册护士保留。在诺顿医疗保健(NHC)进行了一项准实验,非等效对照组后测研究,其中包括SNAP队列1。完成SNAP的毕业生注册护士和未完成SNAP的新毕业注册护士的对照组在开始NHC新毕业护士培训之前接受了患者安全调查工具中的卫生专业教育。在申请SNAP期间,申请人完成了人力系统集成工具,该工具有助于评估个人与角色职责之间的关系。在SNAP队列1中,SNAP毕业生与患者安全相关的感知自信增加有统计学意义(p < 0.05)。从SNAP到NHC注册护士的组织保留率为90%,一年注册护士保留率为94%,两年注册护士保留率为96%。SNAP毕业生的平均新毕业生注册护士培训时间缩短了三周。总组织成本避免为850万美元,体现在培训时间和第一年注册护士保留率的减少上。本研究表明,与未完成SNAP的新毕业生注册护士相比,完成SNAP的新毕业生注册护士对患者安全的感知自信更高。随着SNAP第一批项目的成功,加上国家健康中心财政投资的强劲回报和劳动力渠道的建立,国家健康中心继续实施了该项目。在五个成功的队列和696名学生护士之后,SNAP的毕业生避免了该组织第一年超过3300万美元的注册护士流动成本。SNAP毕业生到NHC的注册护士保留率保持在90%,第一年注册护士保留率为92%,第二年注册护士保留率为84%。所有五个队列的平均适应时间减少保持在两到三周之间。
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