The Influence of Nurses’ Confidence on Practice Breakdown

Abstract

Background: New graduate nurses are tasked to provide complex clinical care in hospitals. As they transition into professional practice, they may lack confidence leading to practice breakdown. Objective: Determine the relationship between nurses’ confidence level and practice breakdown in a community hospital. Methods: An electronic cross-sectional survey was conducted among nurses at Mountainside Medical Center. Data were collected from 100 registered nurses using the Casey-Fink Graduate Nurse Experience Survey, the Nurse Practice Breakdown Checklist, and a demographic questionnaire. Descriptive statistics were utilized to summarize the characteristics of the respondents, including mean scores for role confidence and practice breakdown. The chi-square test for equal proportions was used to examine the distribution of responses across nurse characteristics. Mean scores were compared using an independent t-test. One-way ANOVA was conducted to examine the relationship between the demographic variables, confidence, and practice breakdown. Statistical analyses were conducted using SAS 9.4. Approvals to conduct the study were obtained from the Western Copernicus Group Institutional Review Board and William Paterson University’ s Institutional Review Board. Results: A total of 100 nurses responded to the survey, yielding a response rate of 20.4%. Respondents were likely to have five years or more of experience (60, 60%) or have a history of being a charge nurse (n=69, 69%). Overall mean scores for role confidence and practice breakdown were 3.42, (SD=0.67), and 0.95(SD=1.37), respectively. Older nurses had higher role confidence, p<0.05. Those with a specialty certification demonstrated higher role confidence (mean = 3.63, SD = 0.60) and lower levels of practice breakdown (mean = 2.96, SD = 1.30). There was no relationship between confidence level and practice breakdown. Implications for nursing practice: Practice breakdown is most likely a multifactorial phenomenon, and additional research is recommended.