Abstract
The Maricopa County Student Nurse Practice Readiness Program was designed to address the shortage of qualified nurses to fill vacancies in the county and improve the readiness of new graduate nurses (NGNs). The program's intended outcomes were to enhance partnerships between education and practice, increase the confidence of senior nurses, assist healthcare facilities in hiring well-trained nurses, and plan for future sustainability based on pilot success. However, high nurse vacancy rates, which can directly impact patient safety, are reported due to the aging and retiring nursing staff, an aging population requiring a higher level of nursing care, and the COVID-19 pandemic. The program also aimed to improve diversity, equity, and inclusion (DEI) but did not apply to students. The overall program cost was $738,000, and the program was successfully piloted with 53 students enrolled in 2022. Monthly performance measures showed increasing participation, supervised hours, and patients served, and the program aims to expand to 1,800 student nurses by December 2026.
Problem or Need Addressed By the Program
The nursing industry is facing a crisis due to a shortage of trained nurses to fill vacancies across the country. This problem was exacerbated during the COVID-19 pandemic, making it even more challenging to hire and retain qualified nurses. Additionally, the "Education-Practice Gap" is a significant concern in the nursing field, leading to deficiencies in clinical judgment due to the complexity of the clinical environment, and inadequate skills in critical areas of nursing practice, such as communication, organization, and clinical decision-making. This program aims to address these issues by providing comprehensive training and support to new graduate nurses to bridge the gap between education and practice, ultimately improving the quality of patient care.
Program Description
The Maricopa County Student Nurse Practice Readiness Program was designed with the primary objective of addressing the nursing gap and increasing the practice readiness of new graduate nurses in Maricopa County, Arizona. The program aims to achieve this goal by providing senior nursing students with better preparation to enter and remain in the healthcare workforce. The program was initiated with the recognition of the nursing crisis, which has resulted in a shortage of trained nurses to fill vacancies across the county and country. The difficulty in hiring and retaining qualified nurses has been exacerbated during the COVID-19 pandemic, which has further highlighted the need for such programs.
The program was developed with a focus on enhancing partnerships between education and practice, using nursing facilities and specially trained nurse preceptors. It was established with the support of Robin Schaeffer Consulting, LLC, which oversees the implementation and management of the program. The county has played a significant role in implementing the program by providing funding for costs associated with employers hiring preceptors, nursing education faculties, and stipends for nursing students.
The program aims to assist multiple healthcare-related facilities, including potential employers such as Psychiatric Crisis Center and Maricopa County Correctional Health Services, to hire well-trained nursing staff more quickly. The program's primary outcomes include helping senior nurses increase their confidence in their skills and practice readiness, assisting nurses in transitioning into the workplace more efficiently, and planning for future sustainability based on pilot success.
The Maricopa County Student Nurse Practice Readiness Program has been designed as a comprehensive and sustainable initiative that offers various benefits to different stakeholders. The program's main beneficiaries are senior nursing students who receive better preparation for entering and remaining in the healthcare workforce. The nursing facilities benefit from the enhanced partnership with nursing education faculties and specially trained nurse preceptors, which helps in addressing the nursing gap and hiring well-trained nursing staff more quickly.
The county benefits from the program as it assists in addressing the nursing crisis, which has been a significant issue for Maricopa County and contributes to the overall development of the healthcare sector. Moreover, the program's success has the potential to attract more funding and resources from other partners interested in similar initiatives. This will help in expanding the program to other areas and benefit a more extensive clientele.
The program's time frame for development and implementation is not explicitly stated in the information provided. However, the program's focus on planning for future sustainability based on pilot success indicates that it is a long-term initiative that aims to achieve lasting impact. Therefore, it can be inferred that the program's development and implementation are ongoing, and the success of the program is being measured continuously.
The Maricopa County Student Nurse Practice Readiness Program is a well-designed initiative that addresses the nursing gap and aims to increase the practice readiness of new graduate nurses. The program's objectives, process, intended outcomes and contributions of various partners have been clearly defined, indicating a comprehensive and sustainable initiative. The program's success has the potential to benefit various stakeholders, including senior nursing students, nursing facilities, the county, and potential employers. Overall, the Maricopa County Student Nurse Practice Readiness Program is a much-needed initiative that aims to make a significant contribution to the healthcare sector in Maricopa County.
Nursing Shortage
The Maricopa County Student Nurse Practice Readiness Program aimed to address the impact of COVID-19 on the nursing shortage crisis. The pandemic has exacerbated the issue, with healthcare facilities struggling to retain qualified nurses due to increased workloads and the emotional toll of the pandemic. The program sought to provide nursing students with the necessary skills and support to transition into the workforce more effectively and become better prepared to provide quality care to patients during these difficult times. By partnering with nursing facilities and specially trained nurse preceptors, the program aimed to enhance the partnerships between education and practice, thereby increasing the confidence of senior nursing students and helping to fill the high nurse vacancy rates in Maricopa County.
Program Cost
- Overall program costs: Allocations for Contractor not to exceed $738,000 and agreements not to exceed $312,000
- Contractor administrative costs: $328,000 (November 2021-December 2022)
- Capstone experience oversight of nurses within six weeks of graduation: $20,000 maximum
- Nursing student one-time stipends: $27,500 maximum ($500 per student upon program completion)
- Work Experience Agreements (partnership with local medical facilities): $129,000 maximum to transition and place senior nurses in the workplace; $135,000 per employer to pay Preceptors to provide oversight of the nurses
- Funding is to offset compensation for patient load reductions
- Work Experience Agreement with Maricopa County Correctional Health: $27,000 to hire new graduate nurses, and $33,000 maximum to train Preceptors to provide oversight of the nurses
Results/Success of the Program
The Maricopa County Student Nurse Practice Readiness Program has implemented a pilot assessment to measure the increase in self-efficacy and resilience of preceptors after receiving six hours of training, and then after their preceptor experience. Upon completion of the Enhanced Preceptor Course, Preceptors qualify for six hours of nursing CEUs. In addition, the program measures any increase in knowledge, skills, and attitudes necessary for nursing students to manage a full patient assignment. The Readiness to Practice platform includes a list of competencies necessary for a nurse to safely care for patients, and once completed, students will have a transcript of mastered skills to share with potential employers to demonstrate readiness to practice. Some practice partners have verbally committed to hiring the students that are part of this pilot, and the program will also track employment at 6 and 12 months after graduation.
- Preceptors: A pilot assessment was conducted to measure any increase in self-efficacy and resilience with each preceptor. A survey was done before and after 6 hours of training, and then after their preceptor experience.
- Upon completion of the Enhanced Preceptor Course, Preceptors qualify for 6 hours of nursing CEUs
- Student Nurses: Measure any increase in the student’s Knowledge, Skills, and Attitudes (KSAs) necessary to manage a full patient assignment. KSAs were measured using the Readiness to Practice Indicators (RPIs) in Engage Platform tool at baseline, after four shifts, and after 11 shifts.
- September – December 2022: 53 students enrolled; 62 preceptors trained with Enhanced Preceptor Course
- 2 nursing students dropped out, and 51 remained (total). 12 students completed their rotations in September 2022. 35 students completed their rotation in November. 4 students completed their rotation in December.
- The Readiness to Practice platform includes a list of competencies necessary for a nurse to safely care for patients once they are hired. This platform has not been used with students before.
- Once completed, students will have a transcript of mastered skills to share with potential employers to demonstrate readiness to practice.
- Some practice partners have verbally committed to hiring the students that are part of this pilot.
- This pilot will also track employment at 6 and 12 months after graduation.
- Monthly Performance Measures:
- September 2022: 7 nursing student participants; 768 supervised hours; 344 patients served; 0 students completed their required hours
- October 2022: 17 nursing student participants; 672 supervised hours; 176 patients served; 10 students completed their required hours
- November 2022: 44 nursing student participants; 1,349 supervised hours; 474 patients served; 47 students completed their required hours
- December 2022: 4 nursing student participants; 72 supervised hours; 30 patients served; all 51 students completed their required hours
The Maricopa County Student Nurse Practice Readiness Program has shown impressive success in addressing the nursing gap and increasing the practice readiness of new graduate nurses. The program has helped senior nursing students increase their confidence in their skills and practice readiness. The program has also assisted multiple healthcare-related facilities in hiring well-trained nursing staff more quickly.
Furthermore, the program has responded effectively to budget constraints and addressed the county's new economic reality, as the high nurse vacancy rates in the county can directly impact patient safety. By successfully implementing the pilot program and extending contracts through December 2026 to expand the program to engage even more nursing students and additional schools, with a goal of 1,800 student nurses having the opportunity to transition to the workplace more efficiently, the Maricopa County Student Nurse Practice Readiness Program has demonstrated its potential for long-term success and positive impact on the healthcare industry.
Supplemental Materials