A realist evaluation of a preceptorship pilot project to support and retain newly qualitied nurses during Covid-19

Abstract

Background: Newly Qualified Nurses (NQNs) experience transition shock and are at increased risk of turnover during their first year. Preceptorship support for NQNs can increase retention. The Covid-19 pandemic affected support for NQNs. A pilot preceptorship project was set up in two hospitals in Scotland. The study aimed to evaluate this project and understand the impact on retention.
Methods: A realist evaluation methodology was used. A programme theory was developed. Participants were NQNs, preceptors, managers, charge nurses and Clinical Educators. Data were collected using online surveys, interviews and audio-diaries. Sickness and retention data were collected. Descriptive statistical analysis was brought together with analytic insights from the qualitative data to develop context(c) -mechanism(m) - outcome(o) (CMO) configurations.
Results: The rapid introduction of preceptorship (c) and lack of role clarity (m) and preceptor training (m) led to lack of confidence and ability to provide preceptorship (o). Staff shortages and sickness (c), lack of clear supernumerary status for NQNs (c), and not rostering NQN with preceptor (c) meant that support for NQNs was not safeguarded (m) and this led to NQNs feeling unsafe in their practice (o) and undervalued by the organisation (o). Retention was 85% and 89% in the two hospital pilot sites.
Discussion and conclusion: The Covid-19 context posed challenges in developing and supporting preceptorship for NQNs. Despite this, retention was good. Preceptorship schemes require support and resources to enable preceptors and NQNs to benefit fully.

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https://creativecommons.org/licenses/by-nc-sa/4.0

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DOI

https://doi.org/10.18690/um.fzv.1.2023

Repository URI

https://www.research.ed.ac.uk/en/publications/4310eeb2-7d93-4683-80d8-7c55d3f87a07