Increasing Retention of Newly Hired Nurses and Improving Quality of Care: A Post Orientation Education Program

Purpose:
High turnover rates lead to decreased nurse retention which impacts patient care outcomes within hospitals. The goal of the Post Orientation Education Program (POEP) is to increase retention of newly hired nurses (NHN) and thus positively impact patient care outcomes.

Significance:
Coupled with national nursing shortages, nursing turnover rates are very high and new graduates are leaving their position within the first year. Retaining staff post orientation is a must for nurse leaders. Mentoring programs have shown to increase retention and ultimately improve patient care.

Strategy and Implementation:
The Post Orientation Education Program (POEP) was designed to mentor all newly hired nurses (NHN) post orientation. The POEP focuses on continuing education regarding common diagnoses of the primary patient population, while fostering supportive relationships among colleagues. The program spans a ten week period, and includes weekly thirty minute one on one reviews of common diagnoses between a NHN and a leadership nurse on the unit. The interactive sessions utilize open ended questions pertaining to pathophysiology, etiology, labs, treatments and symptoms. The sessions also provide a safe environment for the NHN to connect with leadership nurses as a mentor and develop supportive relationships.

Evaluation:
The average pretest score was 66% with an increase post-test to 92%. Qualitative program evaluation reflects an increase in communication skills, critical thinking skills, and confidence. Success was measured via retention rates 1 year after hire which increased from 41% (2006-08) to 100% (2008-10).

Implications for Practice:
Patient safety, staffing morale, and quality of care are directly linked to turnover rates and retention rates. The Post Orientation Education Program ensures that newly hired nurses have the clinical competence to administer quality patient care while being mentored by leadership nurses.