The providers of early graduate programs should give graduates access to policies and procedures that refer to and include evidence and references

Providers of early graduate programs should provide experienced staff and preceptors for graduates to access. It has been proven that out of hours coverage and access to more experienced nurses for supervision is critical to graduate nurses.

Programs should educate on clinical governance and risk management in orientation and then integrated throughout the year.

Early graduates need to be encouraged to participate in quality initiatives and understand their role in improving patient care.

Early graduate programs should include the recent research and major quality improvement issues within the providing health service.

Evidencedbased practice is a reflection on excellence and promotes skill development and job satisfaction.

Policies and procedures should refer to and include evidence and references.

Provision of a good learning and safe environment assists with lowering the likelihood of graduates making mistakes.

Clinical risk management (CRM) is a systems approach to patient safety. In order for graduate nurses to become integrated into safe and relevant clinical governance, they need to acquire CRM information and practice in the context of their employment. This information should be delivered at the beginning of employment and thereafter developed and translated into routine practice.

Research suggests that graduates not only need the information, but also need support from ward or unit staff to integrate CRM information.

Research indicated many experienced nurses might not possess CRM information. Preceptor and supervisors may need CRM information and updates to enable them to assist early graduates.

Early graduates need information on the quality process within the providing health service. Included in the information are the quality issues most commonly addressed such as falls prevention and medication safety. Research suggests that interruptions to the medication rounds are a high risk for all registered nurses.
 

Johnstone, M. and Kanitsaki O, Building graduate nurse competency in risk management and harm minimisation: third and final report. Volume 2 (Appendices). 2004, Department of Nursing and Midwifery, RMIT University/Western District Health Service.

Johnstone M, Kanitsaki.O., Patient Safety and the Integration of Graduate Nurses Into Effective Organizational Clinical Risk Management Systems and Processes: An Australian Study. Quality Management in Health Care, 2008. 17(2): p. 162-173.

Wolters Kluwer Health, Quality Management in Health Care, Patient safety and the integration of graduate nurses into effective organizational clinical risk management systems and processes: An Australian study, viewed 15 December 2008, http://ovidsp.tx.ovid.com/spb/ovidweb.cgi?&S=DGOGFPCCGADDKLKLNCGLICJ.htm

Hauswald, M and Joslyn, S  Qualitative approaches to the study of adverse events and near misses, Society for Academic Emergency Medicine, 2008 vol.15, no.12, pp. 1312-1314

Biron A D et al., Characteristics of work interruptions during medication administration 2009 Journal of Nursing Scholarship, Vol41 Issue 4 p. 330-336.