Patient safety and the integration of graduate nurses into effective organizational clinical risk management systems and processes: An Australian study

Objectives: This article explores and describes key processes facilitating the integration of neophyte graduate nurses into safe and effective organizational systems and processes as part of a hospital's overall local clinical governance and clinical risk management (CRM) program. Methods: This study was undertaken using an exploratory descriptive case study method. Four sample units of analysis were used, notably, 2 cohorts of graduate nurses (n = 11) undertaking a 12-month graduate nurse transition program; key stakeholders (n = 34), that is, nurse unit managers, clinical teachers, preceptors, a quality manager, a librarian, and senior nurse administrators employed by the participating health service; and pertinent literature sources. Results: Data revealed that the cohort of graduate nurses under study became substantively integrated into the hospital's organizational and patient safety system processes within the first 3 to 4 months of their employment. Processes most contributing to this integration included the graduates receiving pertinent information about CRM at the very beginning of their employment (at induction) and thereafter throughout their graduate nurse year. In addition, the graduates needed focused support to assist their efforts to integrate the CRM systems and processes of their employer organization into their normal working practices. Conclusions: In order for new graduate nurses to become integrated into safe and effective organizational systems and processes as part of a hospital's overall local clinical governance and CRM program, they needed pertinent information on CRM at the beginning of their employment and thereafter be supported throughout their graduate nurse year to develop and translate that information into their routine (everyday) practice. Further comparative research involving larger cohorts of graduate nurses is required.