ToUCH Program on competence, occupational stress and self-efficacy of newly graduated registered nurses in United Christian Hospital: A mixed method research study

Abstract

Introduction: Despite the structural concept and framework of the preceptorship program developed by Hospital Authority could facilitate the transitional period amongst preceptees, during implementation, the content of the program solely emphasizes on the skill and knowledge and the aspect of psycho-social support is being neglected.

Objectives: The aims of this study were to facilitate smooth psycho-social and professional reality integration for first-year preceptees during the transition to Registered Nurses in UCH, to foster a caring culture for newly graduated RN and to promote a sense of belonging and commitment to ToUCH.

Method: The ToUCH program entails 3-domain of integrations and 6-stage of themes. A mixed method research study was conducted between 11^th August 2014 and 16^th July 2015. Three validated questionnaires were adapted to assess preceptees' competencies, stress level, and coping ability respectively along their employment of first year.

Result: All newly graduated registered nurses in August 2014 (n=98) with majority of female (71.4%) were invited to participate in the study. Using a ANOVA test to compare the difference of measuring outcomes at baseline and other 4 measuring points after program commencement, there was a significant increase in overall mean clinical competence [F (4, 473) = 13.53, p < .0001). The overall mean OSSNN was significant improvement [F (4, 471) = 8.5, p < .0001]. It was found that new graduates had a significant improvement in goal-setting, effort investment, persistence when encountering barriers and recovery from setbacks [F (3, 371) = 7.77, p < .0001]. When comparing the 2013 preceptee’s resignation rate, the 2014 preceptee’s resignation rate has prominently proved the ToUCH program more effective to increase retention. It was found that the rate of resignation due to work stress was sharply decreasing from 5 to 1 out of 85 and 101 preceptees 2013 and 2014 respectively.

Conclusion: This one-year ToUCH program can increase preceptees’ confidence in providing patient care, cope with stress more effectively as well as return quickly to state of mind after suffering stress. Based on the findings, increased skill competencies and improved stress level suggest that the ToUCH program enriches bonding, promotes sense of belonging and maintains a high retention rate of new graduates.