Induction and Rapid Orientation of Agency Nursing Staff in the Hospital Setting: A Systematic Synthesis of Qualitative Studies

Abstract

Aim: To aggregate the experiences of temporary nursing staff in the hospital setting related to their induction and rapid orientation to new wards, describe the methods used, and identify facilitating and hindering factors.

Design: Qualitative meta-synthesis.

Methods: A meta-aggregation of qualitative literature was conducted, including studies on temporary nursing staff in hospitals.

Data sources: A database search (MEDLINE, CINAHL) was conducted in July 2021, and updated in April 2024.

Results: Eight studies fulfilled the inclusion criteria and were selected. 10 syntheses from 29 categories based on 115 findings could be formed and divided into two overarching themes: 'orientation in a new or unfamiliar environment' and 'working as agency nursing staff'. The results highlight the importance of rapid orientation for nurses unfamiliar with a ward, and the challenges of collaboration between agency and permanent nurses. Twelve methods of induction were identified, for example showing around the ward, equipment introduction or use of protocols and folders. Different facilitators were described, like the initiative of the agency nursing staff, a positive attitude of management personnel and a designated contact person. All included studies named a lack of formal feedback mechanisms and time constraints of the permanent staff as barriers to rapid orientation.

Conclusion: This meta-synthesis emphasises the necessity of induction and rapid orientation for agency nursing staff, demonstrating varied practices. Future concepts should consider both permanent and agency staff perspectives and involve all stakeholders in development, implementation and evaluation.

Impact: A lack of induction of temporary nurses to new wards is discussed as potentially compromising quality of care. The often time-consuming induction of temporary nurses also poses a challenge for permanent staff. The results of this meta-synthesis provide an in-depth insight into the importance of induction and rapid orientation for temporary nursing staff, as well as the factors that facilitate and hinder this.

Reporting method: The eMERGe reporting guidance.

Patient or public contribution: No patient or public contribution.

Keywords: agency nursing; employment; hospitals; induction; inservice training; nursing staff; orientation; qualitative research; staff attitude; temporary staff.

FIGURE 1

Flowchart of article selection process.