An analysis of restructuring orientation to enhance nurse retention

Onboarding New Graduate Nurses Using Assessment-Driven Personalized Learning to Improve Knowledge, Critical Thinking, and Nurse Satisfaction

Effective onboarding is key to new nurse success; however, many programs lack evidence-based support. The current study compared knowledge, critical thinking, and nurse satisfaction between cohorts before and after implementation of personalized learning for onboarding. Results showed better knowledge, critical thinking, and nurse satisfaction in the personalized learning cohort compared to prior cohorts. Nurse educators should use evidence-based personalized learning for onboarding to fully support new nurses as they transition from the classroom to practice.

Outcomes of a senior RN student virtual clinical practicum

Closing the academic-practice gap during a global pandemic.

Using action research to evaluate a nursing orientation program in a multicultural acute healthcare setting

Objectives

Competence motivates newly employed nurses to provide high-quality care, which leads to appropriate patient care and satisfaction. A nursing orientation program can have a positive impact on new nurses who are joining healthcare organizations. The research examined the orientation program for new nurses in a multicultural setting to redesign the program.

Methods

The study was carried out in a multicultural tertiary setting. Action research was used as a research strategy with qualitative content analysis and quantitative evaluation. Seventy nurses were part of the orientation program. The competence of the nurses was assessed using the Nurse Competence Scale. Focus-group discussions were also conducted to find the views of the beneficiaries about the program.

Results

The study revealed that the overall competence was high, and there was an overall gain in the competence score (5.48%) among the nurses. Among their competence in different dimensions, new nurses had a maximum gain in competence for the dimension of ensuring quality. However, they showed low competence gain in teaching coaching. The results show that the difference in the overall pre- and post-test scores was statistically significant (P < 0.05) in all dimensions except teaching coaching and managing situations, and the program was effective. However, a few challenges were identified in the program.

Conclusions

New nurses were found to be competent, and the orientation program had a significant impact on the competence of the nurses. The findings emphasized the need for modification of some content and strategy for future programs. The strategies developed from the findings were presented. This helps hospitals to consider examining specific aspects of the orientation program and redesigning it so it can enrich the experiences of new nurses.

Improving Retention of Home Health Nurses: Fostering Outcome Sustainability Through an Innovative Orientation and Mentorship Program

Home healthcare plays an increasingly vital role in contemporary postacute healthcare. Staffing instability and lack of perceived organizational support is a stimulus for nursing attrition from the organization with far-reaching impact on staff morale, patient care, agency budgets, and relationships with other healthcare settings. The purpose of this article is to describe a redesign of an agency's nursing orientation and the development of a mentorship program for newly hired home healthcare nurses within a large Midwestern integrated health system. During this time frame, 154 nurses completed the newly designed orientation program and, of those, 91 participated in the mentorship program. In this article, we evaluate 1-year new-hire nursing retention rates over a 4-year period, examine new-hire job satisfaction and perceptions of preceptors and mentors during their first year, and discuss issues of outcome sustainability. Agency-wide turnover rates for all home healthcare nurses decreased from 15.4% in 2016 to 10.1% in 2018, demonstrating the associated impact of these initiatives on staffing stabilization.

Concept analysis of nurse retention

Nurse retention is widely acknowledged as a crucial international workforce issue, yet the concept remains ambiguous. This study focuses on a concept analysis in an effort to clarify the attributes of nurse retention, including its antecedents and consequences. The Walker and Avant approach was applied to analyze the concept of nurse retention. Four key attributes of nurse retention were identified in the analysis, specifically motivation, intention, and individual decision; strategy and intervention; geographic context; and attachment to work. Antecedents of nurse retention included the healthcare system at the macro level, the health care facility, health personnel, and living conditions. Retention has consequences for individual nurses, the healthcare organization, and the overall health system. Our concept analysis provides clarification to better understand nurse retention along with its implications for the healthcare workforce. The analysis further emphasizes the importance of retention as a comprehensive priority issue for human resources when recruiting and maintaining the nursing workforce internationally.

Orientation Process for Newly Credentialed Athletic Trainers in the Transition to Practice

CONTEXT

  Orientation is an important part of socialization and transition to practice, yet the orientation process for newly credentialed athletic trainers (ATs) is unknown.

OBJECTIVE

  To determine how newly credentialed ATs are oriented to their roles.

DESIGN

  Cross-sectional study.

SETTING

  Online survey.

PATIENTS OR OTHER PARTICIPANTS

  Three hundred thirty-two of 1835 newly credentialed ATs (18%) certified and employed between January and September of 2013 completed the survey (129 men, 203 women; age = 23.58 ± 2.54 years).

DATA COLLECTION AND ANALYSIS

  The survey consisted of demographic information (eg, employment setting, job title) and 2 sections: (1) orientation tactics and (2) usefulness of orientation tactics. For the first section, participants identified if various orientation tactics were included in their orientations (eg, policies and procedures review). For the second section, participants identified how useful each orientation tactic was on a Likert scale (1 = not useful, 4 = very useful). Descriptive statistics were calculated for each survey item. Mann-Whitney U and Kruskal-Wallis tests were used to determine differences between demographic characteristics and orientation tactics. A Bonferroni correction accounted for multiple comparisons. A panel of experts established the content validity of the survey. The Cronbach α was used to establish internal consistency (α = 0.802) Results:  The most common orientation tactics were meeting with supervisors (n = 276, 82.9%) and staff members (eg, coaches; n = 266, 79.9%) and learning responsibilities (n = 254, 76.2%). The least common orientation tactics were simulation of the emergency action plan (n = 66, 19.8%) and preceptor development (n = 71, 21.3%); however, preceptor development was not applicable to many participants. The most useful orientation tactics were simulating the emergency action plan (3.45/4.0) and meeting with staff members (3.44/4.0). Participants who felt their orientation prepared them for their roles were exposed to more tactics during orientation (Mann-Whitney U = 17 212, P < .001).

CONCLUSIONS

  Many tactics were used to orient newly credentialed ATs to their roles, but orientations varied based on the practice setting.

Facilitating a Major Staffing Transition in a State Psychiatric Hospital With Changes to Nursing Orientation

BACKGROUND

A large state psychiatric hospital experienced a state-mandated Reduction in Force that resulted in the abrupt loss and rapid turnover of more than 40% of its nursing and paraprofessional staff. The change exemplified current national trends toward downsizing and facility closure.

OBJECTIVE

This article describes revisions to the nursing orientation program that supported cost containment and fidelity to mission and clinical practices during the transition.

DESIGN

An existing nursing orientation program was reconfigured in alignment with principles of rational instructional design and a core-competencies model of curriculum development, evidence-based practices that provided tactical clarity and commonality of purpose during a complex and emotionally charged transition period.

RESULTS

Program redesign enabled efficiencies that facilitated the transition, with no evidence of associated negative effects.

CONCLUSION

The process described here offers an example for hospitals facing similar workforce reorganization in an era of public sector downsizing.

Newly hired nurses' and physicians' perceptions of the comprehensive health care orientation process: a pilot study

AIM

To examine newly hired nurses' and physicians' perceptions of their orientation process in two Finnish hospitals, and to explore correlations between the background variables and the four aspects of a comprehensive orientation process.

BACKGROUND

Internationally, health care organisations are being challenged to recruit and retain a competent workforce. Although health care orientation programmes increase retention and provide safe and quality care, studies examining it are limited.

METHOD

A cross-sectional, descriptive questionnaire survey of registered nurses (n = 145) and physicians (n = 37) working in two specialised hospital settings was conducted in 2009-2010.

RESULT

Nurses' and physicians' perceptions regarding the orientation process ranged from low to moderate. The results showed that 'appointed preceptor', 'duration of orientation' and 'profession' correlated positively and significantly with a comprehensive orientation process.

CONCLUSION

The orientation process needs to be updated constantly and refined by evaluation data. In addition, incentives and effective support from the hospital organisation must be considered in order to perform the orientation process in a more comprehensive manner.

IMPLICATIONS FOR NURSING MANAGEMENT

The results indicate that investment is needed to improve the orientation process in health care. Health care managers are in a crucial position to support the orientation process in practice and value it as a retention strategy.