Effective onboarding of new graduate nurses using a preceptor/orientation nurse model
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Carol N. Tulley, MSN, RN, CEN, CPEN; Rhonda Bergstrom, MSN, RN, CEN
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Purpose: Onboarding of new graduate nurses in a fast paced emergency department environment can be stressful in the critical thinking skills and knowledge they must possess. Although a six month orientation was provided, the new grad can become overwhelmed and transfer before orientation is completed, or shortly after. This project focuses on a new grad orientation redesign using a preceptor and orientation nurse model to increase knowledge and retention of new grads in the emergency department.
Design: Quality improvement project comparing pre and post intervention of a new grad orientation model.
Setting: Community based hospital emergency department in suburban Chicago. Our emergency department sees 78,000 plus visits annually. We are a level 2 trauma center, Magnet designated, Lantern recognized, and a comprehensive stroke center.
Participants/Subjects: All new graduate RNs in the emergency department over a one year period.
Methods: New graduate nurses were scheduled for a five days per week, eight hour shift model. In this model, each new grad spent three days per week with a primary preceptor to teach the flow of the department, time management and to build critical thinking skills. Each new grad spent the remaining two days per week with an orientation nurse to focus on the “why” of the concepts learned. New grads also attend experiential based advanced competency classes for low volume high risk skills seldom seen while on orientation. The ENO assessment test was administered to previous new grads to measure retention of knowledge. This was used to compare those scores to the new grads following this model. Qualitative data includes input from physicians, preceptor/orientation nurses, PDS/CNS and fellow staff members.
Results/Outcomes: The outcome data shows the group that followed this model scored as high on the ENO test scores measuring knowledge retention after a four month orientation period as the new graduate group that spent a traditional six months. In addition, a survey of the physicians, nurses and preceptor/orientation nurses feel the new grads are much more prepared in knowledge and critical thinking skills to function as a competent ED nurse. Orientation time was also shortened from the historical six month time frame to a four month orientation.
Implications: Using the new orientation model, we were able to increase critical thinking skills in a shorter orientation time, while providing a more in depth orientation. Recommendations: New grads will continue to follow this model as the outcomes prove beneficial both in knowledge and retention of new graduate nurses in the emergency department.
Emergency Nursing 2019. Held at the Austin Convention Center, Austin, Texas, USA
Type | Poster |
Acquisition | Proxy-submission |
Review Type | Abstract Review Only: Reviewed by Event Host |
Format | Text-based Document |
Evidence Level | Quality Improvement |
Research Approach | N/A |
Keywords | Orientation; New Graduate; Quality Improvement |
Name | Emergency Nursing 2019 |
Host | Emergency Nurses Association |
Location | Austin, Texas, USA |
Date | 2019 |
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