A Competency-Based Orientation (CBO) Protocol Enhances Competency Among Newly Hired Perianesthesia Nurses

PURPOSE

The purpose of this quality improvement project was to develop a competency-based orientation (CBO) protocol based on the American Society of PeriAnesthesia Nurses Nursing Standards and CBO for perianesthesia nurses.

DESIGN

Feasibility study with pre-post survey design.

METHODS

A CBO protocol that included nursing care workflows for 11 common surgical cases was developed and used in orienting newly hired perianesthesia nurses. Newly hired nurses completed a pre-post self-assessment on their level of competency in caring for surgical patients.

FINDINGS

Using Wilcoxon signed rank test, improved competency was found in all service areas except for pediatric care.

CONCLUSIONS

Nursing competency in the perianesthesia area is critical in fulfilling one's role as a nurse. A robust CBO protocol for the perianesthesia nurse is important when integrating an employee into the organization and preparing the nurse for success.

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.