MAPS to Quality Improvement in Nursing Orientation

Purpose:
Developing an orientation program to meet the needs of each new RN can be daunting! Education Nurse Specialists (ENS) identified a need to provide a structured, consistent yet individualized orientation process that was easily navigated by the new RN employee, Preceptors, and Clinical Educators.

Significance:
The orientation process was costly in time and resources. Preceptors had difficulty assuring the lists of skills and assignments to be mastered during orientation were completed. Educators had difficulty tracking documentation of the new RN's progress. RNs voiced frustration with the process.

Strategy and Implementation:
With input from Education Nurse Specialists to assure patient safety, quality measures and individualization of action plans, Clinical Educators mapped a consistent structure of orientation over an 8-12 week timeframe based on the new RN's experience and their orientation assessment action plan. MAPS provides a framework which includes: Management of Care, Assessment, Policies/Procedures/Protocols, Safety. Specific criterion checklists and clinical assignments were prioritized. Timelines for completion of assignments were routinely assigned. Assignments included reinforcement of documentation skills with the Electronic Health Record Specialist. Orientation maps include meetings with the new RN at 30 and 60 days, at the completion of orientation and at 6 months. To implement the new orientation process, ENS consulted with each Clinical Educator to develop unit MAPS. The ENS met with each Clinical Educator and new RN to review the MAPS and agree on the individualized plan.

Evaluation:
Outcomes will be determined by using a qualitative focus group with a convenience sample of Clinical Educators. RN Preceptors, Managers and newly hired RNs will be surveyed with an online questionnaire. Changes made to the MAPS program will be based on the results of the evaluation.

Implications for Practice:
A well defined, organized and individualized orientation plan is imperative to assure patient safety, positive patient outcomes, new employee satisfaction and RN retention