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Date Available
4-15-2026
Year of Publication
2026
Document Type
DNP Project
Degree Name
Doctor of Nursing Practice
College
Nursing
Department/School/Program
Nursing
Faculty
Dr. Debra Hampton
Committee Member
Dr. Jodie Dunkelberger
Faculty
Dr. Amanda Thaxton-Wiggins
Faculty
Dr. Tammy Williams
Abstract
Objective: To evaluate the effect of a competency-based cross-training program on perinatal nurses’ preparedness to care for medical-surgical (med-surg) overflow patients and to support patient flow.
Design: Quality improvement project using a quasi-experimental pre–post design.
Setting: A 44-bed perinatal unit within a university-affiliated medical center in the United States.
Participants: Registered nurses employed in the perinatal unit for ≥6 months; 24 completed the preintervention survey and 28 completed the postintervention survey.
Interventions: A competency-based cross-training program consisting of e-learning modules, simulation-based competency validation, and structured policy and procedure review.
Main Outcome Measures: Self-reported comfort, perceived clinical skill, and satisfaction related to care of med-surg patients, measured using Likert-scale surveys.
Results: A total of 52 responses were analyzed. Mean scores for comfort, skill, and satisfaction remained stable from pre- to post-intervention, with no statistically significant differences (p > .05). Scores were near the upper range at both time points. Qualitative findings identified ongoing challenges, including limited clinical exposure, communication barriers, and workload concerns, as well as facilitators such as teamwork, prior experience, and targeted education. Conclusions: Competency-based cross-training alone was insufficient to improve perceived comfort, skill, or satisfaction. Sustained competency may require ongoing education, consistent clinical exposure, and strong interdisciplinary support to optimize nurse preparedness and patient flow.
Clinical Implications: Health systems implementing cross-training should incorporate ongoing skill reinforcement, structured communication processes, and supportive staffing models to ensure nurses are prepared to safely care for patients outside their specialty.
Recommended Citation
Shanklin, Jill E., "Implementing a Competency-Based Cross-Training Program to Enhance Patient Flow" (2026). DNP Projects. 510.
https://uknowledge.uky.edu/dnp_etds/510
