Improving Nursing Awareness in Nursing Mentorship at Long Term Care

Posted on November 18, 2022 |

Improving Nursing Awareness in Nursing Mentorship at Long Term Care: As the population of the United States ages, an increasing number of nurses in long-term care (LTC) are needed to care for these complex patients. Nursing mentorship is an opportunity…

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1 Paper details

2 Solution

2.1 Abstract

2.2 Section 1: Nature of the Project

2.2.1 Introduction

2.2.2 Problem Statement

2.2.3 Purpose Statement

2.2.4 Nature of the Doctoral Project

2.2.5 Significance of the Project

2.2.6 Summary

3 Related Key Words

4 Capstone Proposals

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Paper details

Please correct/edit/problem-solve or rewriting the comments from my teacher
An addendum to the previous message with revisions
In both section 1 and 2 you need to discuss using The AMSN education and that this was modified with the experts( per education manual) to reflect a Long Term vs Med Surg unit and this facility’s needs.
Section 1-please see comments
Section 2- please comments
Section 3- please proofread this section or edit it. Make sure that the information that we are saying in Section 1 and 2 are the same in Section 3
I also attached the Staff Education Manual for Preference. I will continue to work with your company, I have a lot of assignments to deal with

Solution

Abstract

As the population of the United States ages, an increasing number of nurses in long-term care (LTC) are needed to care for these complex patients. Nursing mentorship is an opportunity for more experienced professional nurses to take new graduate nurses under their wings and make them feel that they are an important part of the team. Despite an encouraging recent 5.7% increase in enrollments in baccalaureate nursing programs at universities, the nursing shortage is project to continuously be a major issue in long term care facilities, in the United States.

The main focus of the Doctor of Nursing Practice (DNP) project was to provide, develop, deliver, and evaluate a staff education program for senior staff nurses regarding improving nursing awareness and comfort level in effective mentorship to meet the needs of long term care. Using a pre-test and post-test design, the DNP administered a questionnaire to measure the effectiveness nursing mentorship.

Through the project, it was evident that mentorship staff education played a vital role in determining the effectiveness of the development of nursing awareness in mentorship, and its long-term effect. The findings illustrated that nursing mentorship programs are effective in increasing new graduate nurse retention by assisting with role transition, career planning, and providing opportunities for personal and professional growth, hence vital for all the mentees.

Section 1: Nature of the Project

Introduction

Increasing nursing awareness and their comfort level regarding mentorship at LTC is known to help seasoned nurses to improve patient care. As the United States population ages, an increasing number of nurses in long-term care (LTC) needed to care for these complex patients. Low retention rates caused inadequate staffing, decreased patient and nurse satisfaction, and decreased quality of care in the long-term care arena.

However, there is a shortage of nurses in long-term care due to high nursing turnover (Allen, 2017). According to The American Health Care Association (2014), between 2001 and 2012, there was a 50% turnover rate for registered nurses (RN) in skilled nursing care centers in the United States (U.S.).

The need for long-term care is expected to grow substantially over the next three decades, and an increasing number of nurses were needed to care for the Baby Boomer Generation (Barry, 2018). In a profession as complex as nursing, which involves the coordination and delivery of physical, emotional, and existential care in various settings, it is paramount that practitioners adopt evidence-based practice and championed professional development (Sebern et al., 2018).

As the population of the United States ages, an increasing number of nurses in long-term care (LTC) are needed to care for these complex patients. Low retention rates caused inadequate staffing, decreased patient and nurse satisfaction, and decreased quality of care in the long-term care arena. However, there was a shortage of nurses in long-term care due to high rates of nursing turnover (Allen, 2017).

According to The American Health Care Association (2014), between 2001 and 2012 there was a 50% turnover rate for registered nurses in skilled nursing care centers in the U.S. The need for long-term care was expected to grow substantially over the next three decades and an increasing number of nurses was needed to care for the Baby Boomer Generation (Barry, 2018).

In a profession as complex as nursing which involves the coordination and delivery of physical, emotional and existential care in various settings, it was paramount that practitioners adopted the evidence-based practice and championed professional development (Sebern et al. 2018).

Mentoring was voluntary, based on mutual respect with agreed expectations, and valuable to both the mentor and the mentee. The benefits of successful mentoring relationships are appreciated in increased job satisfaction, improved teaching skills, promotion of collegiality, team building, and improved academic and clinical performances (Breit, 2015).

Problem Statement

Mentoring new nurses and increasing their awareness gave a more experienced professional nurse a chance to take a new graduate nurse under their wings and make them feel that they were an essential part of the team (Anbro et al., 2020). Despite an encouraging recent 5.7% increase in enrollments in baccalaureate nursing programs at universities (American Association for Colleges of Nursing (AACN), 2014, the nursing shortage was to continuously be a significant issue in long term care facilities in the United States (Snavely, 2016).

According to the AACN (2014), several factors influenced the nursing shortage, including insufficient numbers of nursing faculty, an aging nursing workforce, increasing the healthcare needs of an elderly patient population, and nursing job burnout and dissatisfaction that were driving nurses away from the profession.

Recent economic challenges in the nursing profession such as nursing facilities, quality of care, and staffing were intricately related to nursing home economics that temporarily affected the nursing shortage and the need for nurses in some regions. This resulted in low nursing retention, especially in LTC facilities. The impact of the nursing shortage in the U.S. was and continues to be a national concern that was compounded by a rise in patient acuity and a shrinking labor pool (Squires et al., 2017).

The AACN (2014) reported that approximately 69,000 nursing candidates were not admitted into a nursing program due to a lack of nursing faculty who possessed a required doctorate. The U.S. Department of Labor stated a need to increase the number of available nurses by 19.4% by the year 2020 to fill vacancies related to industry growth and replacement (Juraschek et al., 2012). However, with the combination of older nurses retiring from practice, academia, and administration and dissatisfaction, the nursing profession had to identify strategies to help increase recruitment and retention to address this nursing shortage, especially in long-term care facilities (Snavely, 2016).

Presently, this author’s long-term care practicum site in Chicago is also having trouble retaining skilled and dedicated nurses (Kasmierczak & Personal Correspondence, September 15, 2017) and lack of nursing awareness in terms on mentorship. Lack of nursing awareness in mentorship was the reason for poor retention at LTC. Evidenced based education mentorship program was initiated for the ineffective mentoring and the experienced staff’s lack of awareness and comfort.

Additionally, there were no education programs on mentorship at this project site to educate senior nurses on effective mentorship to improve their nursing awareness and comfort level. This staff educational program was planned to address how to build trust with the mentee nurse; develop leadership skills among the senior nurses to improve their effective communication techniques, and promote their comfort level in the mentorship process.

Through attrition of experienced nurses retiring or seeking fewer demanding positions, professional nurses’ vacancy rate increased faster than the rate at which novice nurses can be hired and gain comparable experience (MCHC, 2014). Reports from the MCHC illustrated that nursing’s first-year turnover rate was 27% in the Chicago area. Experienced nurses leaving the inpatient setting were experts that took with them the skills of mentorship and awareness of issues that new graduate nurses lacked.

Professional nurses working 12-hour shifts in a short-staffed department paired with inexperienced nurses contributed to the dissatisfaction and departure of experienced nurses (Lavoie-Tremblay, Trepanned, Fernet, & Bonneville Roussy, 2014). Compounding the concern was that although the number of nurse graduates increased, these new nurses were less likely to remain within the same organization beyond five years, which continued the cycle of an inexperienced workforce (Spetz, 2015). This imbalance of experience led to safety concerns of an inappropriate skill mix of nurses to care for patients with higher acuity (Schuelke et al., 2014).

In the United States, the annual nursing turnover rate in long term care facilities (LTCF) is estimated to be as high as 56% for registered nurses (RNs), 51% for licensed practical nurses (LPNs), and 75% for certified nursing assistants (CNAs) (Antwi & Bowblis, 2016). These alarming figures underline the need for effective frameworks that mitigate the root causes of the high turnover rates.

The most common reasons nurses and CNAs in LTC leave their organization include insufficient development and career opportunities, high-stress levels, lack of nursing awareness about mentorship and a hostile work environment. Inadequate staffing reduced autonomy, intense workload, anxiety or nervousness, low compensation, and interpersonal conflict (Castaneda & Scanlan, 2014; Currie & CarrHil, 2012; Kwon et al., 2014; McGilton et al., 2013).

The nursing shortage compounded by experienced clinical nurse turnover and lack of nursing awareness in mentorship for senior nurses creates a challenge for LTC facilities to staff their nursing units appropriately. This Doctor of Nursing Practice (DNP) project developed staff education to meet the needs of long-term care and served as a contributing factor that will help senior nurses in this LTC facility develop and improving nursing awareness on mentorship.

Evidence-based literature was used to establish a mentorship program to be adopted at the project site. This educational project focused on staff education to meet the needs of long-term care for experienced nurses’ potential to enhance their nursing awareness and measuring the comfort level in mentoring new and novice nurses employed at this project site. This EBP targeted professional nurses already employed within the organization and utilized the mentorship skills they acquired as mentors.

Purpose Statement

The gap in practice that was the focus of this evidence-based project was the lack of nursing awareness in mentorship in long term. Presently, there are no education programs on mentorship at this project site. The purpose of this EBP was to develop, deliver, implement and evaluate a staff education program to meet the needs of long-term care geared towards senior staff nurses to increase their awareness and their comfort level in effective mentorship. The practice-focused question guiding for this project asked whether the staff educational program would increase the senior nurse awareness in mentorship in a long-term care facility.

A staff education design program was used to address on how to increase senior nurse awareness and their comfort level regarding mentorship at LTC. This project aligned with the type’s scholarly projects conducted by Doctor of Nursing students through the development and planning for staff education and quality improvement to meet the needs of LTC.

An educational program was implemented to meet the needs of LTC by the help of content people who help designing and evaluated the staff educational program such as Director of Nursing, Supervisors, RN’s and other management people. According to Walden University (2015), the DNP project should be based on evidence-based practice and address the needs of the practice setting.

The EBP developed mentorship program that helped to improve the nursing awareness and comfort with mentorship of long-term care senior nurse mentors. A large emphasis was placed on experienced nurses as expert resources within a structured program. However, it was clear that the retention of nurses is a multifaceted issue that requires an innovative program to address a diverse and multigenerational workforce that capitalized on experienced nurses’ awareness and comfort level in mentoring new nurses (Aiken et al., 2012).

Identifying ineffective mentorship as the problem, and lack of awareness and comfort with mentoring as the gap in practice, aligns with a project to deliver education to experienced nurses regarding mentoring focusing on increasing their awareness and comfort with mentoring.

A mentorship is an invaluable tool in the professional development of new and seasoned nurses in several different nursing areas that included clinical, education, research, and administration (Frost and Nickolai, 2013). This supported mission and vision by applying the learning acquired in a real-world environment to build the mentorship skills and expertise to strengthen advanced nursing practice, augment healthcare delivery, and improve patient outcomes. Patients reported a better quality of care when they were treated in a facility with high nurse satisfaction rates and were more likely to recommend these healthcare facilities, which would result in a positive social change for both nurses and patients (Aiken et al., 2012).

The setting for this evidence-based project was an LTC facility located in Chicago, Illinois. This project facility had low nursing retention rates for nurses working in LTC. Therefore, it was an appropriate facility to design and implement an education program on mentorship to improve nursing awareness and comfort level. Senior nurses at this project facility invited to participate in this EBP. This mentorship program used Patricia Benner’s Novice to Expert model that theorized “that individuals while acquiring and developing skills, pass through five levels of proficiency: novice/beginner, advanced beginner, competent, proficient and expert (Dracup & Bryan-Brown, 2004).”

Nature of the Doctoral Project

A pre and post survey methodology was used for this staff education DNP project to meet the needs of LTC and to evaluate if senior nurses awareness improved in mentorship after the implementation of staff educational program by the help of content experts people from DNP site such as Director of Nursing, Supervisors, RN and other management staff who reviewed and help designing staff educational program. The program was designed for senior staff nurses to improve their awareness and comfort level of mentorship at this practicum site. For this project’s purposes, the mentor was a nurse who was considered experienced, competent, or expert in long-term care.

Objectives for the educational program was developed from a review of the literature, the evidence in the literature, meeting the needs of LTC and by the help of content experts such as Director of Nursing, Supervisors, RN’s and other management staff who helped to designed and formulate the staff educational program. The educational program was tailored based on DNP site needs. The DNP student obtained approval for project implementation at the LTC. Information was presented in categories such as length of employment, years of service, and ranks of the top reasons for separation from the organization.

The DNP project leader, the primary investigator, introduced the nurse mentorship program during the orientation and explained the mentor’s role. The primary investigator explained the nurse mentor’s participation with consent where applicable involvement in the capstone project (completion of the data collection instruments) was voluntary and obtained approval from Walden University Institutional Review Board before project implementation.

Data were gathered to answer the project question using data gathered from pre and post survey questions developed in line with the needs of LTC. De-identified demographic data such as role, sex, age range, and race, nationality, educational level, nursing years of experience and ethnicity were also collected.

Data from pre and post surveys were utilized to assess the participant’s perception of readiness and the effectiveness of the project. The pretests survey given during program development, and the results used to guide education development. Staff Education program regarding mentorship was designed based on needs of long-term care. It is also revised, reviewed by DNP site content experts (Director of Nursing, Supervisors, RN’s and other management staff) by using education module derived from Academy of Medical-Surgical Nurses (AMSN) tool (2012) tailored to meet the DNP site needs.

The AMSN tool was designed in 2012 and provides guidelines and insights on mentorship and on the development of a successful mentorship relationship. The tool provides guidelines for the mentee, mentor and site coordinator. In particular, the AMSN tools helps build supportive and encouraging mentoring relationships, guides on professional, personal, and interpersonal growth, and facilitates effective communication on expectations, learning opportunities, and stressors.

The AMSN manual elaborates that the tool can be applied as a core mentoring program or different appropriate guidelines selected from the program based on mentoring needs. The adaptation of the AMSN into a long term care was guided by the mentoring needs of long-term care that significantly vary from the medical surgical nurses’ mentorship needs. One of the main differences is on the patient ratio, where LTC has ratio of 1:25, while medical surgery units have a patient ratio of 1:5 (Harris-Kojetin et al., 2019).

Hence, in adapting the AMSN to LTCX, DNP site content experts using available existing data from site, literature and theoretical support, analyzed the mentoring needs of the facility and determined the site specific objectives of the staff education module, as guided by Walden Manual for Staff education. The staff education module was verified and revised through a formative approach based on the LTC nurses’ mentoring needs. The demographic data, pre surveys and posttests survey, were used as a source of evidence for evaluation of learning after the staff education program regarding mentorship was implemented.

The Walden University Library was used to access databases for this literature review. CINNAHL, PubMed, and Medline Advancements and developments in technology, educational standards, and clinical practice included the databases used. The AMSN (2014) discussed the benefits of nursing mentorship programs and provides directions for implementing a nursing facility’s successful nurse mentorship program.

According to Eller et al. (2013), mentorship education programs help to create conversations between senior nurses and mentees so that both can assess and alter their behaviors as needed. Eller et al. (2013) and Frost and Nickolai (2014) explained how job stress, issues with other nurses, and monetary troubles often cause new nurses to leave their nursing positions.

Similarly, Barbera (2014) noted factors associated with staff retention that included professional development opportunities, teamwork, communication, and interaction with colleagues. This mentorship program was cost-efficient, shown to benefit the nurses and the mentor, and the facility (Walker-Reed, 2015).

In a nursing mentorship program, a more experienced nurse acted as a guide, expert, and role model for a new or less-experienced nurse (Walker-Reed, 2015). Expert nurses would benefit from an educational program on mentoring that improved self-confidence, understanding of moral and ethical issues, and develop real-world skills to improve retention.

According to the AMSN (2016), mentoring guided nurses in their professional, personal, and interpersonal growth. Experienced site nurses recognized as long term care mentors who contributed to a changing culture that benefited the organization and nurses by elevating the performance of the whole healthcare team employed in the LTC, which would be evidence for this EBP project. The information gained from the posttest evaluation of learning from the participants of the staff education project. Post Survey questionnaires served as the second source of evidence as that information provided the participant perception of the experience.

Significance of the Project

The primary stakeholders who have the privilege to stand and benefit from this project about improving nursing awareness and comfort level in mentorship of experienced nurses are the patients. The nursing mentorship’s primary purpose is to help reduce the turnover of the trained nurses, which in return, will create a state of balance in the nursing facilities to provide excellent service care to the patients. It will as well reduce safety issues within the nursing facilities. The skills that nurses have been used to measure patient outcomes in sections of patient falls, the rate of infections and errors done during medications and which directly relates between medication errors and the years of experience that nurses have.

In their literature review, Schuelke et al. (2014) found a direct correlation between medication errors and nurse experience years. Nurses in practice with less than one year of experience had higher chances of having medication errors than nurses with additional or many years of experience. This project opens the door for future studies and may improve nursing awareness in mentorship. This project may have a positive impact on social change as improving nursing awareness and measure comfort level in mentorship.

The DNP staff education project for the improving nursing awareness in mentorship at LTC was tailored, reviewed, designed based on DNP site needs. It is also evaluated by LTC content experts such as Director of Nursing, Supervisors, RN’s and other management staff based on project site needs that promotes an interdisciplinary approach.

This project promoted a staff educational improvement approach that improve nursing awareness in mentorship. When an experienced nurse leaves or retires from a health organization, the workforce of it is affected negatively due to the loss of the seasoned nurse’s expertise experience, which may have an impact on quality and patient care (Hill, 2010).

Education aims to help maintain nurses in their active role and be able to be seen and recognized as the shareholders of the organization and be given tasks to play within the organization as informal leaders. Downey, Parslow, and Smart (2011) described informal nurse leaders as the front-line staff that consistently transcend the challenges in practice and the work environment. They will help other nurses to have a clear mind and picture of their responsibilities as nurses.

They will help improve the quality of the services they provide within the healthcare settings by having positive patient outcomes away from medical errors, infection rates, and patient falls, both seasoned and experienced nurses when they become mentors. They’ll help incorporate competence, confidence, clinical expertise and, excellent professional relationships within the healthcare settings. Their leadership roles and guidance will help support colleagues’ nurses by influencing the right mix of skills and changing nurses’ retention by addressing the forecast in nurses’ shortage.

Nurse turnover places a financial burden on organizations by diverting significant amounts of financial resources from the organization’s priorities, such as new equipment for patient care and technology to support changes in healthcare. A mentorship program that prevents one nurse from exiting the organization can make a significant impact on the organization’s financial outcomes (Downey et al., 2011).

Thus, this project could promote a culture of continuous improvement so that the mentoring program would remain a relevant strategy in addressing the nursing shortage. Continuous improvement in the nursing shortage prevented the waste of limited resources while propelling the LTC facility towards its long-term goals.

Summary

As the aging population continued to rise, so did the need for qualified and credible nurses. Researchers linked a strong association between decreased nursing awareness in mentorship in LTC and adverse patient outcomes (Snavely, 2016). The local project site had an identified gap in nursing awareness regarding mentorship in LTC. An LTCF in Chicago had been struggling with nursing satisfaction and retention.

Establishing staff educational program regarding mentorship emerged as a viable strategy for improving their awareness, recruitment and retention of new nurses because of its effect on the processes of socialization and transition from the academic setting to the clinical environment. The DNP student structured a mentorship program to increase awareness, comfort level in mentorship, and attract more nursing staff members at the LTC facility.

This EBP project purpose was to develop, deliver, and evaluate education for experienced nurses to increase awareness and comfort level regarding mentoring tailored the needs of LTC. It was reviewed, designed and evaluated by content experts such as Director of Nursing, Supervisors, RN’s and other management staff.

The motivation for developing this education project was related to improving recruitment, but mentorship would increase the growth of the nurse’s awareness and comfort level in mentorship. This project’s results will contribute to the evidence base of mentorship and nursing practice in long term care, evidence as being needed for long term care (Billings & Leichsenring, 2014) .

Section 2 will include analyzing relevant theories and frameworks as the potential foundation for the mentorship program to be implemented in an LTC facility. The literature review expanded on the reasons for enhancing and improving nursing mentorship and evidence for supporting experienced nurses as mentors. Section two outlined and discussed the concepts, models and theories; relevance to nursing practice, role of DNP and project leader.

Related Key Words

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Mentorship in nursing journal articles
Development of a nurse mentorship program
Effective mentoring in nursing
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