On-Boarding Nursing Excellence: Hiring Strategies to Improve Performance and Nurse Retention

Purpose:
The purpose of this presentation is to present an Exemplary Practice Cognate utilized for hiring New Staff Nurses at the bedside and examine how the implementation of this newly developed exemplary cognate has yielded a significant decrease in Nurse Turnover during the 2011-2013 years.

Significance:
The significance of this presentation is to illustrate how on-boarding excellence in the hiring of new staff nurses is critical to patient outcomes, nursing outcomes and organization outcomes. Hiring Nurses with Certain Skills and knowledge leads to better retention and decreases nurse turnover.

Strategy and Implementation:
In December 2011, Bronx Lebanon Hospital Center, a 600 bed teaching Center in the South Bronx of New York initiated a change in the hiring practices of Front-Line Staff Nurses in order to meet and exceed the standards of the magnet paradigm and the benchmarking requirements for Magnet. In January 2012, the Department of Nurse Recruitment initiated the Exemplary Practice Cognate for Hiring Excellent and qualified Registered Nurses to Front-Line hospital positions. The exemplary Practice Cognate requirements included the following pre-boarding job requirements needed PRIOR to hire for ALL Staff RN's, including Novice Nurses and New Graduate Nurses. BCLS ACLS NDNQI Pressure Ulcer Training Certificate NY State : Infection Control Certificate NY State: Mandatory Child Abuse Certificate National League for Nursing (NLN) Math Proficiency Examination. Behavioral Interviewing Techniques with NDNQI Nurse Sensitive questions regarding CLABSI,CAUTI,HAPU,FALLS,VAP. BSN:Preferred Education status

Evaluation:
In 2011, the RN turnover rate for Staff Nurses at Bronx Lebanon Hospital Center was 31 %. HAPU rates were above the NDNQI benchmark rates at comparison teaching hospitals. In 2012, the RN turnover rate is reported at 13 %. The overall HAPU rates for the units have decreased.

Implications for Practice:
On-Boarding Nursing excellence is a key concept for RN Staff Turnover and can lead to better patient outcomes. Hiring Staff RN's with specific credentials and increasing the rigor of the on-boarding practice led to hiring nurses who could produce better patient outcomes and improved nurse retention.