“In from the Beginning” – Evaluation of a framework to improve the experience of nurses commencing in the emergency department

Australia has a nursing shortage. Emergency Departments (EDs) are particularly affected, necessitating interventions to support and retain new emergency nurses. This study evaluates "In from the Beginning," a framework designed to improve the experience of new emergency nurses. A 12-month longitudinal study was conducted in 2023-2024 at three Australian EDs with 72 nurses. Surveys administered at baseline, six and 12 months were used to assess ascent to competence and belonging. Differences between groups were assessed using nonparametric tests, changes over time with linear mixed-effects models and content analysis for free text. All 72 nurses participated, 15 received the intervention, 50 (70 %) completed 12 m follow-up. Participants reported high levels of feeling welcomed (median 26.5/30). The intervention group reported lower baseline self-confidence, but greater rate of improvement compared to control group (β=8.95, SE=3.75, p = 0.019). There were no differences in belonging, learning and competency. Qualitative data emphasised importance of mentorship. Retention at 12 months was 87 % in the intervention group and 65 % in control group (Χ2(1) = 1.72. p = 0.19). The "In from the Beginning" framework provided support to new emergency nurses and resulted in improved self-confidence. Future research will explore long-term impacts on retention.