THE CAREER PATH OF BACCALAUREATE NURSING GRADUATES WHO HAVE TAKEN UP ADVANCED PRACTICE ROLES AND THEIR PERCEIVED IMPACT ON HEALTHCARE OUTCOMES

Background:
Baccalaureate nursing (BN) education is a crucial means to cultivate and maintain a high-quality nursing workforce to meet the increasing demand of the society. In Hong Kong, a four-year BN program has been introduced since the mid-1990s to provide students with a solid foundation in theory and practice. Many of these graduates have now achieved a higher level of education and assumed roles of advanced practice. In Hong Kong, no studies have been conducted that examine the elements deemed critical to successful transition to advanced practice roles in BN graduates’ career path. In addition, there is limited evidence to suggest BN program in Hong Kong contributes to optimal healthcare outcomes.

Aims:
This study aims to identify the critical elements in the career path of graduates from a BN program who have taken up advanced practice roles, the challenges of the transition from registered nurse to novice practitioner, the perception of attributes of nurses practicing advanced practice roles, and the graduates perception of their impact on healthcare outcomes. A clear understanding of strategies to help nurses advance within ranks and their impact on healthcare outcomes is needed to inform the curriculum development and better prepare graduates to meet the needs of the population.

Methods and results:
A qualitative design was used. In-depth interviews were undertaken with a purposive sample of ten BN graduates who had taken up advanced practice roles in Hospital Authority hospitals. The participants had between 10 to 13 years of post-registration experience. All participants had obtained a Master’s degree and received ongoing professional education. Their perceived attributes of nurses practicing advanced practice roles include dedication to providing the best possible patient care, being assertive and accountable, and being a good team member. The major challenge of the transition from registered nurse to novice practitioner includes working effectively within the nursing and multidisciplinary team to accomplish shared goals. The participants commented that the BN program developed and sharpened their writing, critical thinking, analytical and research skills and these were helpful in preparing them for a broader scope of practice. The participants perceived themselves as more able to communicate effectively with patients, and to prevent conflicts between patients, families and healthcare providers. The active participation in the development of institutional clinical guidelines also helps to improve the quality of care and reduce variability in practice.

Conclusion:
This study suggested the importance of BN education in preparing graduates for assuming advanced practice roles. Effective interpersonal skills and being a strong team player are critical elements that enable successful transition to novice practitioners. Further exploration of the employers’ perception on critical elements in the career path of graduates who have taken up advanced practice roles, and quantitative evaluation of the BN program’s impact on healthcare outcomes would be warranted.