NURS FPX 6085 Assessment 2 Problem Statement (PICOT)

NURS FPX 6085 Assessment 2 Problem Statement (PICOT) Student Name Capella University NURS-FPX6085 MSN Practicum and Capstone Professor Name  Submission Date Problem Statement (PICOT) The transition-to-practice phase is a high-stress period for newly graduated nurses, particularly those working in the women’s services unit in busy urban hospitals, due to the presence of high acuity and fast-paced clinical scenarios. Although orientation and preceptorship models exist, there are gaps in training new nurses that increase inconsistencies in practice and put new nurses and patients in jeopardy. This initial project summary will focus on the identified needs, target population, proposed intervention, anticipated outcome, timeframe, and quality improvement methodology. For newly graduated nurses (P) working in a busy urban hospital’s women’s services unit, does the addition of an evidence-based, educational and simulation intervention with orientation (I) lend an improvement to clinical confidence and the ability to manage common and complex scenarios of women’s services (O), when compared to the current orientation models (C) over a 6-12 week period (T)? Population (P): Nurses who have just graduated and are entering practice in a unit of a busy urban hospital that serves women. Intervention (I): Structured, evidence-based educational intervention: Simulation-based learning and orienting activities. Comparison (C): Existing standard orientation process. Outcome (O): More prepared to handle clinically, better-confident, and safer handling of common and high-acuity clinical situations. Time (T): Six to twelve weeks Problem Statement Need Analysis The need for this project focuses on the enhancement of quality, education, and safety in nursing, and the use of evidence-based practice to design a structured and focused educational program for newly graduated nurses utilizing both simulations and targeted orientation activities. Newly graduated nurses often fill vacancies in the high-need and high-stress Women’s and Neonatal Services nursing units in large urban hospitals. They arrive on the job with little (if any) training on how to manage high-risk, complicated, dual-service Obstetric, Gynecologic, and Neonatal cases. These training deficits place both patients and nurses at a high-risk for clinical errors, which affects the quality of care and the nurse’s confidence. The literature notes that inadequate transition-to-practice programs cause high levels of nurse stress, nurse burnout, and nurse practice that is both unsafe and clinically alarming (Reebals et al., 2021). In the context of the available data from the organization, internal quality surveys from the Women’s Services units indicate that newly graduated nurses are prone to: (1) committing near-miss medication errors; (2) delay in the recognition of deteriorating conditions; and (3) failure to escalate care in response to evolving and critical situations within the first three months of practice. Instructor-led workshops have also highlighted problems in the consistency of assessments related to the orientation stage of training (Ibrahim et al., 2024). While there is no documentation to indicate that the completion of simulation exercises is monitored, the current orientation is focused on time management, resulting in limitations to the assessment of the clinical readiness to practice competently and independently. The premise of this project is that the organization possesses the requisite resources for simulation and the capability for teaching to implement the intervention. Possible causes for the lack of clinical simulation for high-acuity cases include the variable structures of orientation and the absence of mentored clinical decision-making during the early stages of clinical transition (Elendu et al., 2024). Many new graduate nurses express that they feel unprepared to manage emergency and high-risk situations within women’s services. This has a detrimental impact on the safety of the patients, as well as the retention of nurses. Creating the conditions for negative outcomes for patients, high employee turnover, and deterioration in the quality of care may be a result of the lack of adequate training. The existing unit-level data within women’s services indicate that the turnover of nurses with under one year of experience is high. This means that a lack of adequate training is also a safety concern and a disruptive turnover in the workforce. Evidence supports that the concern is educational as well as operational and financial, and that the imperative and urgent need for quality improvement in the transition-to-practice is crystallized (Gautam et al., 2023). It is also assumed that the unit nurse educators, preceptors, and leaders will support the integration of simulation-theory-based educational strategies to improve clinical competence and confidence during the transition-to-practice. Population and Setting The target population for this project focuses on newly graduated nurses during their first employment at a busy urban hospital’s women’s services unit. This population can be especially vulnerable during their first transition as it is a complex and busy unit, and they have limited clinical experience. Care for maternal and neonatal patients is also complicated (Mohammed et al., 2025). Women’s services units also demand rapid clinical judgment, a high level of technical skills, and excellent interprofessional communication, which puts a high demand on the education preparation for safe practice. Performance anxiety and lack of self-confidence, fear of making mistakes, and difficulty with prioritizing care in emergency situations are additional challenges this population may face. There is also a lack of self-confidence when it comes to interacting with physicians and senior nurses in emergency situations, and due to the varying levels of education and exposure to obstetric and neonatal emergencies in the nursing education programs, there is a discrepancy when it comes to baseline competencies of graduate nurses who are attending orientation. This ultimately affects their ability to learn and participate in simulations, as well as the overall success of the transition process. The intervention will be housed within an acute care hospital with a nurse residency program that incorporates educational simulations. This type of setting allows orientation to incorporate authentic clinical scenarios with guided practice and intentional feedback. More specifically, the focus is on a high acuity inpatient women’s services unit in a large urban hospital that provides labor, delivery, postpartum, and neonatal services that often experience the rapid deterioration of clinical situations. These women’s services units experience a variety of high acuity obstetrical emergencies, including the need to provide assessment and intervention for postpartum hemorrhage, the need