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2021 Poster Presentations

P07 - An Innovative Approach to Orienting New Grads: A Skill-Based Intensive Orientation on a Medical Unit


Description

Graduate nurses (GN) coming into health care may lack confidence in skills contributing to a challenging and lengthy orientation. Tenured nurses leaving health care led to an “experience complexity gap” noted by the advisory board. GNs are required to take care of higher acuity patients with little experience and lack confidence in basic skills. A literature search was completed, and many low-level, high-quality articles were found.

Many of the articles noted institutions completing a quality improvement for the orientation. The recommendations of the evidence were to provide GNs time to practice skills including daily tasks, medication pass, assessments, computer systems, and
high-risk/low-volume scenarios (blood, falls, codes). Ideally the learning environment would be a safe place outside of an assignment, led by an intensive leader, and cohorts of four or less.

An intensive period (IP) curriculum was created with an intensive leader overseeing a cohort of GNs. Each IP was 10 eight-hour days. Curriculum was based upon the literature, quality indicators, and system orientation checklist for competencies. GNs completed “task objectives” as listed in the curriculum and received a binder with policies, standard work, or handouts that complimented the tasks. Both didactic and clinical methods were utilized during the IP. Skills that required hands-on would be completed on the clinical unit by utilizing a “pop-up skills” list where the staff could identify opportunities for the GNs. Debriefing was completed at the end of each day and homework was assigned to prepare for the next day.

Seven GNs over three months participated in this skills-based intensive orientation and reported satisfaction with the program. Further evaluation of their confidence and competence will be collected throughout the first year. Preceptor perception was evaluated using new graduate nurse performance survey with additional encouragement of the GN’s overall preparedness.

References
• Marcum EH, & West RD. (2004). Structured orientation for new graduates: a retention strategy. Journal for Nurses in Staff Development, 20(3), 118–126.
•    Gavlak S. (2007). Centralized orientation: retaining graduate nurses. Journal for Nurses in Staff Development, 23(1), 26–30.
•    Gregg, J. C. (2020). Perceptions of Nurse Managers and Nurse Preceptors. Journal for Nurses in Professional Development, 36(2), 88-93.
•    Shahsavari, H., Ghiyasvandian, S., Houser, M. L., Zakerimoghadam, M., Kermanshahi, S. S. N., & Torabi, S. (2017).
•    Effect of a clinical skills refresher course on the clinical performance, anxiety and self-efficacy of the final year undergraduate nursing students. Nurse Education in Practice, 27, 151–156.
•    Santucci, J. (2004). Facilitating the Transition into Nursing Practice: Concepts and Strategies for Mentoring New Graduates. Journal for Nurses in Staff Development (JNSD): 20(6), 274–284.
•    Salera-Vieira J. (2009). The collegial clinical model for orientation of new graduate nurses: a strategy to improve the transition from student nurse to professional nurse. Journal for Nurses in Staff Development, 25(4), 174–183.

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