***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Title Turnover intention in new graduate nurses : a multivariate analysis Aim This paper is a report of a study to determine the relationship of new nurse turnover intent with individual characteristics , work environment variables and organizational factors and to compare new nurse turnover  with actual turnover in the 18 months of employment following completion of a residency . Background Because of their influence on patient safety and health outcomes nurse turnover and turnover intent have received considerable attention worldwide . When nurse staffing is inadequate , especially during nursing shortages , unfavourable clinical outcomes have been documented . Method Prospect i ve data collection took place from 1999 to 2006 with 889 new paediatric nurses who completed the same residency .  Scores on study instruments were related to likelihood of turnover intent using logistic regression analysis models . Relationships between turnover intent and actual turnover were compared using Kaplan – Meier survivorship . Results The final model demonstrated that older respondents were more likely to have turnover intent if they did not get their ward choice . Also higher scores on work environment and organizational characteristics contributed to likelihood that the new nurse would not be in the turnover intent group . These factors distinguish a new nurse with turnover intent from one without 79 % of the time . Increased seeking of social support was related to turnover intent and older new graduates were more likely to be in the turnover intent group if they did not get their ward choice . Conclusion When new graduate nurses are satisfied with their jobs and pay and feel committed to the organization , the odds against turnover intent decrease . What is already known about this topic There is concern in many countries about nurse turnover and the result ing effects on patient safety and quality of care . Decreasing ability to recruit experienced nurses has increased the emphasis on recruitment of new graduate nurses , particularly in the United States of America . Historically , new graduate nurses have a high turnover rate within the first year of employment . What this paper adds When new graduate nurses are satisfied with their jobs and pay and feel committed to the organization , the odds of turnover intent decrease . Increased seeking social support to cope with the transition from student to competent Registered Nurse is related to turnover intent . Older graduates ( > 30 ) are 4·5 times more likely to have turnover intent if they do not get their ward of choice Purpose : Although simulation technology in nursing education is becoming increasingly commonplace , a review of the literature reveals a paucity of rigorous , high-level research comparing the effectiveness of simulation with other traditional education methods in the acquisition of clinical knowledge and skills . This research aim ed to investigate the impact of three learning interventions on graduate nurse health  assessment knowledge and skills . It was hypothesized that the patient assessment skills of graduate nurses who completed a simulation learning activity would be superior to those who completed traditional education activities . Methods : Graduate nurses ( n = 74 ) were r and omly allocated to three groups ( 1 : self-directed learning package [ SDLP ] only ; 2 : SDLP plus two scenario-based PowerPoint workshops ; and 3 : SDLP plus two simulation education sessions using a manikin with low-fidelity capabilities . Following the education activities , graduates completed an individual test involving a systematic patient assessment upon a manikin . They were scored using a checklist of relevant responses . Results : Analysis of variance results suggest that the mean test score for nurses in the simulation group ( mean = 135.52 , SD = 26.63 ) was significantly higher ( P < 0.001 ) than those in the learning package group ( mean = 107.42 , SD = 29.82 ) and the PowerPoint group ( mean = 102.77 , SD = 31.68 ) . Conclusions : Simulation appears to be an effective educational tool for teaching patient assessment knowledge and skills to graduate nurses . Incorporation of such technology into graduate nurse education may decrease the time required to become clinical ly proficient , result ing in more confident and work-ready practitioners Rapid turnover of novice nurses eventually results in a shortage of veteran nurses . This study aim ed to clarify the factors affecting rapid turnover of novice nurses in a prospect i ve manner . We carried out an investigation in 20 university hospitals whose directors of nursing service departments accepted our request to cooperate with our research program . These hospitals were selected from all of the 102 university hospitals listed in The Hospital Catalog of Japan . The subjects were 1,203 novice hospital nurses who gave their informed consent for participation in our study . The question naires , which dealt with burnout , assertiveness , stressful life events , reality shock , ward assignment preference , transfer preference , job satisfaction ( workplace , salary , workload , and overtime ) , social support and coping mechanisms were completed by 923 novice nurses in June 2003 . Then , their turnover was investigated in December 2003 . Thirty-seven novice nurses ( 4.0 % ) quit during this period . Multiple logistic regression analysis showed that the factors affecting rapid turnover were 1 ) graduation from vocational nursing schools , 2 ) dissatisfaction with assignment to a ward contrary to their desire , and 3 ) no peers for support . Assignment of novice nurses to wards they choose as far as possible , avoidance of assigning novice nurses to wards alone , and establishment of a support system for nurses who graduate from vocational nursing schools seem to be important for preventing rapid turnover of novice nurses Specialised support for student nurses making the transition to graduate nurse can be crucial to successful and smooth adjustment , and can create a path to positive and stable career experiences . This paper describes an enhanced model of final year nursing student placements  which was trialled in 2006 at the Queensl and University of Technology . The model involved collaboration with two major urban health services and re sources were developed to support effective transition experiences . Ninety-two students , including 29 trial participants and 63 non-trial participants were assessed on preparedness for professional practice , before and after the trial semester . Results indicated an increase in preparedness across the entire sample , but students participating in the trial did not differ significantly in overall preparedness change from those who did not participate . Higher baseline preparedness in the trial group highlighted the possibility that proactive students who choose enrichment experiences tend to be likelier to gain benefit from such options than those who do not . Qualitative findings from focus groups conducted with 12 transition group students highlighted that one of the main beneficial aspects of the experience for students was the sense of belonging to a team that understood their learning needs and could work constructively with them Abstract The transition from student to an accountable health professional is a difficult time for the novice nurse and can result in significant anxiety , stress and poor socialisation into the nursing profession . A strategy applied at a major tertiary teaching hospital to address transitional issues for novice nurses is that of group debriefing sessions . This qualitative study used focus groups to explore the effectiveness of these debriefing sessions for new graduate nurses and trainee enrolled nurses . The results demonstrated that the sessions provided nurses with a supportive environment , access to peer support and a sense of belonging . This provided an opportunity to develop confidence in their nursing competence and improvement in interpersonal communication skills .  Debriefing sessions are an effective psychosocial support mechanism that can ameliorate the ‘ reality shock ’ experienced by nurses in their first year of practice . Group debriefing is an important component in the transitional support process and should be used to complement other strategies to enhance the psychosocial experiences of novice nurses Objective In an effort to better underst and turnover rates in hospitals and the effect of new nurses on them , this study sought to describe the characteristics and attitudes toward work of newly licensed RNs , a population important to both the nursing profession and the health care system . Methods A survey was mailed to a r and om sample of new RNs in 35 states and the District of Columbia . A total of 3,266 returned surveys met the inclusion criteria , for a response rate of 56 % . RNs who qualified had completed the licensing examination and obtained a first license between August 1 , 2004 , and July 31 , 2005 . Data pertaining to four areas were collected : respondent characteristics , work- setting characteristics , respondents ' attitudes toward work , and job opportunities . Respondents who were not working were asked to specify why . Results Of the eligible newly licensed RNs , 58.1 % had an associate 's degree , 37.6 % had a bachelor 's degree , and 4.3 % had a diploma or a master 's or higher degree as their first professional degree . They were generally pleased with their work groups but felt they had only moderate support from supervisors . About 13 % had changed principal jobs after one year , and 37 % reported that they felt ready to change jobs . More than half of the respondents ( 51 % ) worked voluntary overtime , and almost 13 % worked m and atory overtime . Also , 25 % reported at least one on-the-job needlestick in a year ; 39 % , at least one strain or sprain ; 21 % , a cut or laceration ; and 46 % , a bruise or contusion ; 62 % reported experiencing verbal abuse . A quarter of them found it “ difficult or impossible ” to do their jobs at least once per week because of inadequate supplies . Conclusions This study provides descriptive evidence that a majority of newly licensed RNs are reasonably satisfied and have no plans to change jobs , but the group is not homogeneous . The negative attitudes expressed in response to some survey questions suggest that newly licensed RNs may not remain in the acute care setting s where they start out . Investing in better orientation and management may be the key to retaining them in hospitals . The authors will be following these RNs for two years and will develop predictive models of turnover rates ProblemNew nurse graduates experience a stressful role transition into healthcare organizations , with 30 % leaving their first job within 1 year and 57 % leaving by 2 years of employment . Aim This study tests whether an internship program , Social and Professional Reality Integration for Nurse Graduates ( SPRING ) , improves new nurse graduate retention , sense of belonging , organizational commitment , and anticipated turnover . Design Quasi-experimental , posttest only , control group design . Method New nurse graduates hired by an academic institution that completed SPRING  were compared with  baseline nurse graduates who did not complete SPRING  , using the  Organizational Commitment Question naire , Modified Hagerty-Patusky Sense of Belonging Instrument  , and Anticipated Turnover Scale . Retention was also examined . Results Anticipated Turnover was higher for baseline nurses than for 6-month SPRING nurses . Six-month SPRING nurses have lower antecedent sense of belonging than baseline or 12-month SPRING nurses . One-year retention is higher for SPRING new graduates than for non-SPRING new graduates . Conclusion Internship programs for nurse graduates must support the socialization of nurses and their transition into the professional role as well as teach the skills and knowledge needed for competence . This study supports the value of a comprehensive program for new nurse graduates in improving nurse retention and decreasing new nurse graduate intent to leave the organization at 6 months This is the third and final part of a series of articles that report the findings of a study that investigated the effects of a summer externship program on the transition into a professional role among nurses who participated in a summer nurse externship program at an acute care pediatric hospital . Specifically , this article reports the retention and recruitment benefits of a  summer nurse externship program for the institution from 1998 through 2003 . A total of 153 externs out of the 193 ( 79.0 % ) assumed a registered nurse position at the institution , and 77 % remained in that role for 12 months . Overall , the nurse extern program for this institution appeared to be an effective recruitment and retention strategy that is on par with the institution and national data for retention and turnover data BACKGROUND Research regarding the relationship between preceptorship and development of critical thinking in new graduate nurses is sparse . No studies could be found that examined the relationship of preceptor education to critical thinking scores of new graduate nurses . METHODS A quasi-experimental , mixed- methods design measured critical thinking ability of new graduate nurses .  Focus group interviews were conducted with preceptors who attended an author-developed educational program . RESULTS Preceptors ' participation in the educational session contributed to the evaluation subscale of critical thinking skills of the experimental group on the California Critical Thinking Skills Test ( F = 4.709 , p = .039 ) . Preceptors had positive qualitative responses . CONCLUSIONS Critical thinking skills of new graduate nurses can be improved and learning relationships developed through preceptor education . Further study is suggested 
    Output:
    
The evidence suggests that transition interventions /strategies do lead to improvements in confidence and competence , job satisfaction , critical thinking and reductions in stress and anxiety for the newly qualified nurse .
CONCLUSIONS This systematic review demonstrates the beneficial effects of transitional support strategies for newly qualified nurses from the perspective of the new nurse and their employer .
The overall impact of support strategies appears positive , irrespective of the type of support provided .
This may suggest that it is the organisations ' focus on new graduate nurses that is important , rather than simply leaving them to acclimatise to their new role themselves .