Utilization-focused evaluation: evaluating the effectiveness of a hospital nursing orientation program

A group orientation model for new graduate nurses

A local hospital implemented a unique, fiscally resourceful orientation strategy constructed by a nursing faculty professor designed to accommodate the needs of the graduate nurse (GN) in making the transition from academia to practice. The nurse faculty provided a reliable "hands-on" small group orientation to four new graduates simultaneously. This group orientation strategy provided these GNs with a preceptor, mentor, and role model to assist in their transition.

Gradually Guiding Nursing Students through Their Capstone Course: Registered Nurse Preceptors Share Their Experiences

Professional precepted immersion courses (capstone) have become the standard as a means to prepare senior nursing students to enter the workforce. Preceptors have a significant role in developing the student nurse, yet exactly how to prepare preceptors for this role has been an ongoing discussion. This qualitative inquiry explored the educational needs of clinical registered nurse (RN) preceptors who work directly with senior nursing students in a professional precepted immersion (capstone) course. A descriptive qualitative design was used to examine preceptors responses to a prepared set of questions about their educational needs. Results showed that preceptors have three distinct sets of learning needs: the need to know the expectations of their role, wanting to know how best to role model for the student, and knowing how to socialize the student into the profession of nursing. Overall, preceptors communicated their desire and commitment to doing the best job possible. They also clearly stated their expectation of faculty to have a physical presence on the nursing unit that included being proactive in resolving mismatches and exposing the student to the roles of provider of care, leader and manager of care, and member of profession.

Providing orientation programs to new graduate nurses: points to consider

Staff educators know the importance of orientation for nurses and strive to develop effective orientation programs in both general and specialized clinical areas. However, little is written about what constitutes a 'good' orientation, especially for the new graduate. This article provides a summary of the current literature on nursing orientation and provides an overview of various timelines utilized in different settings, frameworks to guide the development and implementation of an orientation and a brief description of the mentor and preceptor roles. Implications for staff educators, nurse managers, and the organization are described.

Integrating traditional nursing service orientation content with electronic medical record orientation

Traditional nursing service orientation classes at an acute care hospital were integrated with orientation to the electronic medical record to blend the two components in a user-friendly format so that the learner is introduced to the culture, processes, and documentation methods of the organization, with an opportunity to document online in a practice domain while lecture and discussion information is fresh.

Evaluating Canada's Compassionate Care Benefit using a utilization-focused evaluation framework: successful strategies and prerequisite conditions

A utilization-focused evaluation (Patton, 1997) framework was used in 2004-2005 to conduct a pilot evaluation of Canada's newly unveiled Compassionate Care Benefit from a family caregivers' perspective. This paper presents a description of the successful utilization-focused evaluation process. Successful strategies are summarized in three main categories: (1) motivated leadership; (2) regular, planned communication; and (3) consistent and continued commitment of all parties involved. Three main prerequisite conditions for success were found to include: (a) have in place a widely representative Evaluation Taskforce with as many, if not all, key stakeholders represented; (b) have the program of concern and the focus of the evaluation flexible enough to actually accommodate change; and (c) adhere to a pre-determined timeline.

An outcomes-based approach to improve registered nurse retention

A 230-bed facility determined that 64% of its registered nurse (RN) voluntary turnover rate occurred with newly hired RNs. Inadequate orientation processes and practices were determined to be the root cause. The pilot project's 36% reduction in newly hired RN departures results in an annual savings of over $1 million. Details of the plan, the pilot project, the cost-benefit analysis, and the spread to the system are described. Evaluation of year-end data provides nurse leaders with critical information as RN retention is a priority.

Evaluation of learning and program effectiveness

This article describes the evaluation of learning as an integral and critical component of educational program evaluation and one determinant of effectiveness. Various concept, models, processes, and research findings offer practical options for conducting learning and program evaluation. The article discusses how predetermined goals or outcomes guide organizational processes to determine effectiveness. The article further reinforces the importance of valid and reliable data collection used to conduct evaluation processes, then subsequently determine the worth, effectiveness, and success or failure of learning and program outcomes. Key evaluation and effectiveness elements and their relationships are shown.

ICU nursing orientation and postorientation practices: a national survey

A survey was conducted to obtain information regarding adult intensive care unit (ICU) orientation and postorientation practices throughout the nation. This article presents the results of a random sampling of ICUs throughout the nation regarding orientation practices of newly licensed registered nurses (RNs), experienced RNs new to the ICU setting, and experienced ICU RNs. Twenty-four hospitals from 7 geographic regions within the United States were surveyed. Classroom training remains the predominant method of instruction outside the ICU. Most hospitals offer a formalized training for new preceptors. When provided, preceptor incentives include both monetary recognition and professional growth/recognition. Postorientation support for new ICU nurses varied. Geographic regional differences in orientation practices were not found. The major limitation of this study was the small sample size. Results from this survey are the beginning steps in understanding a national perspective of comprehensive orientation practices for new ICU nurses.

Moving Forward

Discovering ways to engage new employees and make the orientation period prior to unit orientation more meaningful is a challenge for staff development educators. This important period focuses on patient safety and employee introduction to the organization. This article describes the redesign of a nursing services orientation program that led to increased employee satisfaction and an increased level of comfort with preparedness to deliver safe patient care.

Learning Communities

The professional learning community is a strategy to help staff development educators address recruitment and retention and organizational culture. The purpose of this article is to analyze the concept of learning communities and discuss their potential to increase the recruitment and retention of new graduate nurses and returning practitioners to the nursing profession. Incorporating learning communities into the healthcare organization will decrease the number of nurses leaving nursing, foster retention, and thus, enhance recruitment.

Facilitating the Transition Into Nursing Practice

In today's healthcare market, current trends in the nursing population are posing problems in the workforce. With the present nursing shortage, hospitals are competing for the hiring of new graduate nurses. To recruit, retain, and foster personal and professional growth, employers must be aware of the gaps between skills and knowledge acquired in school and those gained through experience. Employer expectations of new graduate nurses and concepts to support new graduate nurses are explored. From these concepts, components of a specialty orientation program are described to assist the transition from student to nurse.

Structured orientation for new graduates: a retention strategy

This program sought to increase retention rates through the use of a structured, progressive orientation program. Twenty new graduate nurses participated in the 13-week program. Tools used to evaluate success were Performance Based Development System, American Society for Training and Development Evaluation Tool, the Professional Judgment Rating Form-Novice/Internship Level, and Retention Rates. Results of the program suggest that an orientation program focused on development of critical thinking skills, patient care management, and enhancement of self-esteem directly influenced retention.

Nurse internship pathway to clinical comfort, confidence, and competency

The purpose of this article is to report the outcomes of a nurse internship program initiated at a U.S. Navy hospital designed to increase new graduate nurses' clinical competence, confidence, and comfort. Using a quasi-experimental design, the experimental group scored significantly higher on organizational core competencies than the control group. These nurses were more comfortable with their leadership and management roles following the intervention. Organizations may wish to consider a nursing internship program as a means of improving the work environment.

Early Socialization of New Critical Care Nurses

• Background Critical care nurses provide care to acutely ill patients, yet little is known about the early socialization processes of new nurses to critical care units from the nurses’ perspectives.

• Objectives To explore the early socialization processes of critical care nurses.

• Methods A grounded theory design was used to generate a local theory of how critical care nurses experience socialization. Interviews and journals of participants (N = 10) during the first 4 to 5 months of the socialization experiences were collected. Preceptors were interviewed to triangulate data. Orientation materials and field notes were examined.

• Results A process of 5 phases was uncovered: the prodrome, welcome to the unit, disengagement/testing, on my own, and reconciliation. Participants experienced difficulty while being evaluated by preceptors early in the orientation process because of changing expectations. Participants also expressed disappointment in their level of comfort at the end of the orientation. The theory termed “navigating the challenge” explains the nature of the changing expectations that new critical care nurses face during their socialization process.

• Conclusions This exploratory study defines the phases that new critical care nurses experience during the early socialization process. Phase-specific recommendations are made on the basis of the results of the study.