Abstract
Background: Effective recruitment, retention, and nurse recognition are important for building and maintaining the Registered Nursing workforce. During the first year of practice newly licensed registered nurses (NLRNs) report the most difficult aspect of transition to practice is developing competence and confidence in new patient care situations and the turnover rate is high. QSEN competencies were integrated into nursing curriculum and transition to practice (TPP) programs created to better prepare NLRNs for practice. Knowledge of NLRNs self-assessment of confidence in the QSEN knowledge, skills, and attitudes (KSA), and knowledge and safety competencies prior to transition will inform nurse educators and clinical leaders of the needs of NLRNs for successful TTP. Understanding attributes of employment important for recruitment and retention can help decrease turnover and address the nursing shortage. Method: A secondary data analysis was completed to explore pre-licensure nursing students and NLRN’s self-assessment of confidence and competence in the QSEN KSA and knowledge and safety competencies. Data collected with the National Quality and Safety Self-Inventory (NQSSI) instrument from NLRNs was analyzed to compare confidence and competence in the evidence-based nursing competency domains pre and post participation in aTTP program. NQSSI scores were also analyzed to explore differences in confidence and competence in nursing competency domains and knowledge, skills, and attitudes between samples of NLRNs who graduated pre-COVID, and pre-licensure nurses and NLRNs who completed their nursing program during COVID. Job Factor Survey data was analyzed to identify attributes of employment important to NLRNs upon entry to professional practice. Results: NLRNs who participated in a TTP program had higher NQSSI scores post participation. NLRNs who participated in virtual clinical practicum and pre-licensure nurses who completed their education during COVID had significantly higher NQSSI scores than NLRNs who completed their education prior to the COVID-19 pandemic. NQSSI scores were highest for pre-licensure nurses who had a structured virtual online clinical experience. The most important attributes of employment identified by NLRNs and pre-licensure nurses were structured programs, career advancement, encouragement, and salary. Conclusions: TTP programs are beneficial for increasing NLRNs perceptions of confidence and competence in the QSEN evidence-based practice competency domains. NQSSI scores of NLRNs and pre-licensure nurses support increased QSEN curriculum content and virtual clinical practicum as effective for obtaining confidence in the QSEN KSAs and knowledge and safety competencies. Structured learning experiences may provide opportunities for nurse educators to role model and emphasize best practices resulting in increased self-perceptions of confidence and competence by NLRNs. Understanding and developing structured programs that offer encouragement and opportunities for advancement are important considerations for the recruitment, retention, and recognition of the nursing workforce.