A programme theory for a transition programme for novice nurses in emergency departments : a realist review

Abstract

AIMS : To develop a programme theory for a transition programme for novice nurses working in emergency departments. DESIGN : A realist review was conducted, guided by the Realist and Meta-narrative Evidence Synthesis–Evolving Standards publication standards. DATA SOURCES : PubMed, CINAHL, Web of Science, Scopus, and the Wiley Online Library. REVIEW METHODS : A realist review methodology was used to consider the contexts, mechanisms, and outcomes of transition programmes implemented in emergency departments. The Population, Concept, Context framework was used to develop a search strategy. Four reviewers independently screened the records using Rayyan. Conflicting decisions were evaluated against the inclusion and exclusion criteria to reach a consensus. The data were extracted literatim to a Google form and exported in an Excel spreadsheet. The frequencies for categorical data were calculated, and the textual data were thematically analysed. The theories supporting the programme theory were identified using a Behaviour of Interest, Health context, Exclusions and Models or Theories (BeHeMoth) search. RESULTS : Eleven reports of the 1275 records met the inclusion criteria. Three contextual factors influencing the transition programme, namely, the characteristics of the novice nurse, interpersonal relationships, and the emergency department, were identified. Mechanisms were classified as resources, including programme champions, learning and teaching activities, and responses to the programme. The primary outcomes included novice nurses and emergency departments. Secondary outcomes included the establishment of educational support structures. The final programme theory was developed based on the review results and supporting theories. CONCLUSION : Novice nurses with specific characteristics will most likely become proficient in a well-equipped and well-maintained emergency department when sufficient support is offered while maintaining healthy interpersonal relationships. A transition programme that is provided by experts and codesigned is one way of supporting novice nurses.