When Change is GREAT!

Purpose:
SERMC's most recent National Database of Nursing Quality Indicators (NDNQI)survey revealed the satisfaction item “Orientation Adequate” was below the NDNQI top quartile and below the average of reporting units. Our goal was to increase the quality and satisfaction of our orientation program.

Significance:
A national shortage of nurses continues. The literature identifies orientation and training as root causes of Sentinel Events. Quality orientation can increase job satisfaction, confidence, competency and retention contributing to the solution for the nursing shortage and safe quality patient care.

Strategy and Implementation:
Data from the NDNQI survey prompted the Nursing VP to hold forums to discuss issues that had been identified. Orientation improvement was an opportunity identified. An orientation task force was created with nurses from units throughout the hospital. Utilizing a change process the key areas for development were identified. The Task Force reviewed the literature and generated a body of knowledge. Empowered with the evidence a new transition program was developed for newly hired nurses, components that were already present such as the mentor and preceptor programs were evaluated and improved. The Graduate Retention Education and Transition (GREAT) Program was created. Change can be great when the staff involved identify the problem, provide the input, evaluate the literature and accept the responsibility and accountability to improve the nursing profession. Initial data would suggest the program will have a positive impact on our nurses.

Evaluation:
The intervention group(transition program)and the comparative group(traditional orientation from previous 12 months)will be given the Casey-Fink Graduate Nurse Experience Survey©. We will also compare retention numbers, and satisfaction using our "Building Bridges tools and the NDNQI survey.

Implications for Practice:
We purpose that quality orientation will increase job satisfaction, retention, competency and decrease adverse patient events. Nursing practice implications include retaining valuable nurses in the nursing profession, decreasing institutional turnover, and increasing safe quality patient care.