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Winslow SA, Britt CP, Dorrell JJ, Gentry DJ, Gillis DD, Hochmiller KL, Smith CV, McGee GW, Wilkerson JS. Building on Early Coronavirus (COVID-19) Pandemic Orientation Modifications to Improve Competency Validation for Newly Hired New-to-Practice and Experienced Nurses. J Nurses Prof Dev 2022; 38:139-144. [PMID: 36449990 PMCID: PMC9060819 DOI: 10.1097/nnd.0000000000000859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Nursing professional development and human resource leaders revised general nursing orientation content and structure based on changes because of COVID-19 in length, focus, and platforms from the early stages of the pandemic. The aim of this quality improvement project was to incorporate best of pandemic modifications with key stakeholders and new-to-practice and experienced nursing hire needs emerging from COVID-19 realities on the workforce. The benefit for nursing professional development practitioners is relatability of general nursing orientation revisions for sustainability of clinical excellence and safety.
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Affiliation(s)
- Susan A. Winslow
- Susan A. Winslow, DNP, RN, NEA-BC, is System Director, Professional Practice and Clinical Education, Sentara Healthcare, Chesapeake, Virginia
| | - Cherika P. Britt
- Cherika P. Britt, MSN, RN, is System Director, Patient Experience, Sentara Healthcare, Norfolk, Virginia
| | - Jolene J. Dorrell
- Jolene J. Dorrell, MSN, RN, NPD-BC, PCCN-K, is System Manager, Education, Sentara Healthcare, Chesapeake, Virginia
| | - Deborah J. Gentry
- Deborah J. Gentry, BA, MA, is Director, Team Member Development, Sentara Healthcare, Norfolk Virginia
| | - Debra D. Gillis
- Debra D. Gillis, MSN, RN, NPD-BC, CEN, CHSE, is Team Coordinator, Simulation, Sentara Healthcare, Chesapeake, Virginia
| | - Kathy L. Hochmiller
- Kathy L. Hochmiller, MS, BSN, RN, is System Manager, Simulation, Sentara Healthcare, Chesapeake, Virginia
| | - Catherine V. Smith
- Catherine V. Smith, DNP, RN, CCNS, CCRN, is System Director, Advanced Nursing Practice and Patient Outcomes, Sentara Healthcare, Norfolk, Virginia
| | - Genemarie W. McGee
- Genemarie W. McGee, MS, BSN, RN, NEA-BC, is Corporate Vice President and Chief Nursing Officer, Sentara Healthcare, Norfolk, Virginia
| | - Julie S. Wilkerson
- Julie S. Wilkerson, BSN, RN, is System Manager, EMR Education, Sentara Healthcare, Chesapeake Virginia
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Rogers A, Fultz J, Clements-Hickman AL, Davies CC. The Baptist Health Lexington Nursing Orientation Progression Tool: A Methodological Study. J Nurs Adm 2021; 51:439-447. [PMID: 34432736 DOI: 10.1097/nna.0000000000001043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study was to develop and test a tool to monitor a nursing orientee's progress to competence. BACKGROUND The literature suggests that, during orientation, consistent documentation and communication among educators, preceptors, and nurse leaders facilitate a timely progression to independent practice for new nurses. METHODS A 2-phase methodological study was conducted. Nurse educators clarified goals, identified essential competencies, and developed the Baptist Health Lexington Nursing Orientation Progression Tool (OPT). The tool was used to monitor orientees' progression through orientation. RESULTS Content validity assessment of the OPT (content validity index = 0.98) demonstrated strong validity. Testing of the tool revealed 31 nurses completed orientation early, 12 completed orientation on time, and 18 nurses required extended orientation time. All requiring an extension were new graduates. CONCLUSION The OPT guided preceptors to facilitate timely completion of orientation among newly hired nurses. Findings suggest that new graduates may need more assistance than experienced nurses.
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Affiliation(s)
- Allison Rogers
- Author Affiliations: Professional Development Specialist (Ms Rogers), Professional Development Specialist (Ms Fultz), Research Fellow (Ms Clements-Hickman), and Research Consultant (Dr Davies), Baptist Health Lexington, Kentucky
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Increasing the Efficiency of Critical Care Orientation: A Four-Phased Quality Improvement Approach. J Nurses Prof Dev 2021; 37:285-293. [PMID: 34392260 DOI: 10.1097/nnd.0000000000000790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
More nurses without critical care experience are being hired by intensive care units. Eleven newly hired nurses participated in a phased program designed to improve the efficiency of intensive care unit orientation. A pre-post implementation design demonstrated that although there was a 14% reduction in orientation time, there were no statistically significant changes in new hire or preceptor satisfaction nor in first-year registered nurse turnover rates. Expansion of the program is needed to demonstrate its impact.
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Improving Retention of Home Health Nurses: Fostering Outcome Sustainability Through an Innovative Orientation and Mentorship Program. Home Healthc Now 2019; 37:256-264. [PMID: 31483357 DOI: 10.1097/nhh.0000000000000782] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
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.
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Thrasher AB, Walker SE. Orientation Process for Newly Credentialed Athletic Trainers in the Transition to Practice. J Athl Train 2018; 53:292-302. [PMID: 29466070 PMCID: PMC5894381 DOI: 10.4085/1062-6050-531-16] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
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.
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