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A Competency-Based Checklist to Facilitate Transition for Novice Cardiology Nurse Practitioners Public Deposited

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The first year of practice represents a vulnerable period of transition for any nurse practitioner (NP), particularly those entering specialty practice. A search of the literature revealed a gap in the evidence regarding the development of onboarding programs for NPs in outpatient cardiology practice. For a hospital-owned, outpatient cardiology practice in a medium-sized Midwestern city, a quality improvement (QI) study of a competency-based cardiology onboarding program was deemed crucial in ensuring a healthy transition as well as retention. The study framework was based on Meleis’ Transition Theory and the Plan-Do-Study-Act (PDSA) Model for QI. A competency checklist based on the American College of Cardiology (ACC) competency statements for advanced practice providers served as the role supplementation intervention (independent variable). A pretest, posttest design using a convenience sample of one novice NP and a validated instrument, the Nurse Practitioner Role transition Scale (NPRTS), would measure NP role transition as a proxy for role insufficiency (dependent variable). The NPRTS was measured at baseline and six week intervals over the first six months of practice following the PDSA format. The study found support for the checklist in enhancing the turnover experience as evidenced by an 18 point, or 18.85%, increase in the total NPRTS score during this interval. Assessment of balancing measures did not demonstrate a decrease in the preceptor productivity during implementations. Additional study with a larger population is needed to further validate these findings. The project not only demonstrates support for the onboarding checklist to improve transition, but also to more clearly define the role and expectations for NPs as part of a patient-centered, interprofessional cardiovascular team.

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