The Yellow Brick Road to Success: An Intensive and Focused Orientation Program Skyrockets Retention & Staff Satisfaction

Purpose:
An educational initiative was introduced through the vehicle of shared governance to reduce novice RN Turnover and increase the knowledge, competence, and accountability of the bedside clinician on the Intermediate Cardiology Unit.

Significance:
In a high volume patient care environment challenges are placed on the novice RN. Educational preparation prior to the acute patient setting does not always incorporate the practical needs required to manage patient clinical presentations and patient flow.

Strategy and Implementation:
RN's recently off of orientation were surveyed of how well they were prepared to come off of orientation. The majority had specific concerns related to their educational readiness to manage patients without the clinical support of the preceptor. The Unit educator developed in collaboration with the bedside clinician's an innovative and informative orientation process that includes consistent primary and secondary preceptors, weekly meetings with unit educator, specific didactic skills required to manage patient presentation, peer evaluation of orientees' progress as well as classroom and hands on educational sessions.

Evaluation:
NDNQI survey revealed the following: Job Enjoyment Scale:2010 42.39 vs. 2011 61.45 with a rating of high satisfaction. Perceived Quality of Care the 2010 rating 2.93. In 2011 increased to3.73 a good to excellent perception. Retention of nurses participating increased from 63%to76%.

Implications for Practice:
Our intensive and focused nursing orientation model can be implemented at any organization through a shared governance vehicle and bedside clinician input, drive, and application, support by leadership.