Digital Repository Masters Projects Spring 2023 Structured Orientation Program for Newly Hired Nurses Judi Crook Weber State University Follow this and additional works at: https://dc.weber.edu/collection/ATDSON Crook, J. 2023. Structured orientation program for newly hired nurses. Weber State University Masters Projects. https://dc.weber.edu/collection/ATDSON This Project is brought to you for free and open access by the Weber State University Archives Digital Repository. For more information, please contact scua@weber.edu. WSU REPOSITORY MSN/DNP Structured Orientation Program for Newly Hired Nurses Project Title by Judi Crook, RN, BSN, MSN Student Student’s Name A project submitted in partial fulfillment of the requirements for the degree of MASTERS OF NURSING Annie Taylor Dee School of Nursing Dumke College of Health Professions WEBER STATE UNIVERSITY Ogden, UT April 2, 2023 Date April 2, 2023 Student Name, Credentials (electronic signature) Date April 14, 2023 MSN Project Faculty (electronic signature) Date Melissa NeVille Norton (electronic signature) Date DNP, APRN, CPNP-PC, CNE Graduate Programs Director Note: The program director must submit this form and paper. 1 Structured Orientation Program for Newly Hired Nurses Judi Crook, BSN, RN, MSN Student Weber State University Annie Taylor Dee School of Nursing 2 Abstract Structured orientation programs are essential in providing a safe and supportive environment that enables nurses to learn, improves the quality of patient care, and decreases nurse turnover to protect the financial health of an organization. The orientation program focuses on guiding new nurses transitioning from school to the workforce and experienced nurses transitioning from one specialty to another. This paper aims to show the importance of a structured orientation program to reduce nurse turnover, improve patient safety, and provide the tools necessary for the success of the orienting nurse. The recommendations include utilizing evidence-based research to create a structured orientation program. The evidence supports the need to invest in nurses' orientation through increased education, mentoring, skills training, frequent check-ins, and feedback. Continuous evaluation of the nurses' progress, in addition to the progress of the orientation program, will be tracked and adjusted as evidence suggests. Keywords: Orientation programs, onboarding, orientation, evidence-based practice, skills, mentoring, safety, decreased nurse turnover 3 Structured Orientation Program for Newly Hired Nurses Nurses are a critical part of the healthcare team, often being the first and last contact a patient has during their healthcare visit. Unfortunately, the nurse turnover rate is near 18.7%, causing financial burdens for the healthcare facility due to the average cost of replacing a nurse being approximately $40,038 per nurse (Becker’s Healthcare, 2021). This high replacement cost requires the healthcare company to focus 5% to 5.8% of the annual budget on nurse replacement (Kurnat-Thoma et al., 2017; Slate et al., 2018). In addition to the financial benefits of nursing retention, orientation programs increase knowledge retention and develop overall skills, experience, and competence that positively impact the outcomes of patients (Hayton et al., 2021; Lalithabai et al., 2020; Slate et al., 2018). Providing adequate training to newly hired nurses is essential to empower nurses to provide high-quality patient-centered care by building relationships and improving clinical judgment skills (Lalithabi, 2020). Statement of Problem With nurse retention decreasing and nurse turnover increasing, healthcare facilities are faced with a high ratio of new nurses working simultaneously or having new nurses training new nurses, diminishing the quality of the orientation process. The highest turnover rate occurs within the first one to three years of hire, creating a need to focus on the newly hired nurses and their orientation process (Kurnat-Thoma et al., 2017, Walden et al., 2021). The nursing unit will begin posting and interviewing candidates to fill a nursing position as quickly as needed. Constraints with the hiring process include a low number of applicants and high wage expectations outside the facility’s financial capability. High compensation expectations cause an inability to hire experienced nurses, as seen with an increase in travel nursing, expecting three times the hourly 4 rate compared with a traditional nursing job (Lee, 2022). These expectations draw more nurses into the travel nursing jobs, decreasing the applicant pool available to fill the standard nursing position. Within the last year of hiring, the average newly hired nurse’s experience is approximately one year. Because of the immediate need to hire, nurses are rushed through orientation, creating opportunities for bad habits to creep into patient care, including incomplete charting, absent follow-through, and decreased confidence. With most newly hired nurses having one year of nursing experience or less, these inadequacies are magnified and often compound with one another, diminishing opportunities for success and eliminating the possibility of nurse buy-in and engagement. The effects of inadequate training and support are seen across the entire team as more focus is placed on filling in the nursing knowledge gaps instead of focusing on face-to-face patient care. Experienced nurses bring their life and professional experiences to a job in addition to the desire to understand why they are doing a task (Rogers & Burke, 2021). Since experienced nurses are not applying and new nurses are filling the positions, the charge nurse is pulled to support the inexperienced nurses and cannot support the entire team. The intended outcomes involve creating a structured orientation program to guide each nurse through their orientation process. The orientation process will increase knowledge, build confidence, improve employee engagement, and decrease nurse turnover by participating in structured classes, setting clear expectations, empowering nurses through education, and providing a mentor to help guide them through the first three months of employment. Ways Project Contributes to Intended Recipients This project will support the nurse manager, charge nurses, and nursing team by orienting new nurses to the unit and supporting the newly hired nurses in reaching their full potential. This 5 project aims to improve the orientation process for new nurses, thus decreasing the turnover rate. Orienting new nurses to the unit supports these nurses giving them the best chance for success through education, training, and mentoring. In addition to contributing to the success of the nursing team, the healthcare facility will also benefit from decreased costs seen with lower nurse turnover. Rationale for Importance of Project With the average nurse hired at this healthcare facility within the first twelve months of their nursing career, this project is valuable because studies show that the intention to leave a nursing position is the highest for new nurses with zero to twelve months of experience (Walden et al., 2021). This project will also encourage competence for new and newly hired nurses by building knowledge, enhancing patient care, building communication among the team, and learning to be aware of their environment (Trossman, 2017). Financial responsibility is another important aspect of decreasing nursing turnover. Kurnat-Thoma et al. (2017) reported that only 28-49% of newly hired nurses who left their position reported that the orientation program provided the tools necessary to succeed. With turnover affecting the overall financial health of an organization, a focus should be on decreasing the rate of newly hired nurses leaving. Researchers have reviewed data showing that nurse engagement reduces nurse turnover, compassion fatigue, and burnout, improving job satisfaction (Dempsey & Assi, 2018). By participating in a structured orientation program, nurses decide to stay, decreasing turnover by guiding orientation programs focusing on what nurses need. (Keith, Warshawsky, & Talbert, 2021). Nursing needs include coworker relationships, autonomy, and recognition (Keith, Warshawsky, & Talbert, 2021). 6 Literature Review and Framework A literature review was completed, assessing for evidence regarding the effects of orientation programs on new and newly hired nurses and their retention in the healthcare profession. The information in the literature review concerning a structured orientation program can be utilized to engage nurses, improve their competency skills, empower nurse trainers, and standardize training for all newly hired nurses. The framework Plan-Do-Study-Act will be utilized to test and trial evidence-based changes, fine-tune each change within the orientation program, and improve the efficiency and efficacy of the orientation program. Framework The Plan-Do-Study-Act (PDSA) model helps document change by focusing on a goal to accomplish, setting parameters to understand when a change is showing improvement, and how to continually improve the change (Institute for Healthcare Improvement, 2022). The cyclical model keeps the improvement process flowing, continuously planning, implementing, studying, and acting on each improvement. Important fundamentals of this model include introducing the problem, forming a team, setting goals, establishing measures, choosing the change, testing the change, implementing the change with a small group, and then implementing the change across the organization (Institute for Healthcare Improvement, 2022). Additionally, this framework is valuable as it helps identify processes for what works and what does not (Connelly, 2021). The Plan-Do-Study-Act framework provides direction for change by organizing each step into single steps to test, create and implement the change. In the “Planning” phase, a concise statement is made with expectations of what will change and the steps to execute the change (AHRQ, 2020). The “DO” phase will take the plan and trial the orientation program with observations on the progress (AHRQ, 2020). The “Study” phase reviews the measurements of 7 the orientation program and if nurse retention is working within the unit (AHRQ, 2020). The “Act” phase reviews how the cycle went and whether improvement is necessary (AHRQ, 2020). Each step of the orientation program is placed into the PDSA cycle for reviewing effectiveness. Aspects of the orientation program are evaluated through the PDSA model, including a new hire checklist, new hire check-in form, PowerPoint training module, and postorientation survey. The evaluations will monitor the effectiveness of nurse turnover by ensuring each nurse is provided with the tools for success. Strengths and Limitations Strengths of the Plan-Do-Study-Act (PDSA) model include a structured approach to trial and evaluate processes that change quickly (Connelly, 2021). Additionally, trials are completed among a small group instead of a large group. The small groups enable close visualization of the process, providing the ability to fine-tune changes in the next cycle (Connelly, 2021). Fast-paced timing is a limitation of the Plan-Do-Study-Act (PDSA) model. Due to the quick cycle of this model, changes and improvements are not made during the current cycle and will be made on the next cycle causing the process to possibly not move straight forward, and backtracking may occur (Connelly, 2021). Analysis of Literature Providing adequate training to new and newly hired nurses is vital in building an organization through empowering nurses to provide high-quality patient-centered care, building relationships, and improving clinical judgment and skills (Lalithabi, 2021). This literature review will provide evidence of the importance of a structured onboarding program that creates a smooth transition and improves nurse retention, employee engagement, and patient safety (Kiel, 2020). 8 Search Strategies A search was performed to find current and relevant literature within the past five years, 2017-2022. The databases searched include Weber State University Stewart Library’s OneSearch, Google Scholar, OVID, CINAHL, Medline, PubMed, Nursing and Allied Health, Google.com, and EBSCOhost. Keywords used in the search included onboarding, nurse onboarding, nurse orientation, healthcare orientation, importance of an orientation program, onboarding qualitative and quantitative study, orientation quantitative and qualitative study, nurse retention, nurse turnover, newly hired nurses, nurse preceptor, nurse mentor, healthcare safety, employee engagement, nurse residency. Onboarding and orientation are used interchangeably. Different variations of these words and multiple Boolean phrases were created and used to search the databases for relevant information about the stated PICO question. Limited articles were found addressing the exact PICO question, so other words and phrases were used to search for additional data. The literature search found three themes related to the PICO question: Does a structured orientation process improve retention rates for newly hired registered nurses? The first theme is; A structured orientation program can improve competency and safety. The second theme is; Orientation programs decrease nurse turnover. Lastly, the third theme is; Design of the orientation program and mentors/preceptors. These themes address the PICO question and provide evidence supporting a structured orientation program. A Structured Orientation Program Improves Nurse Competency and Safety According to Lalithabai et al. (2021), a mixed study evaluating a nurse orientation program, the quantitative section of the study (n=70) used an independent sample t-test with a two-tailed p-value < 0.05 and purposive sampling, showed a statistically significant impact on 9 nurse competence in the helping role (0.05), diagnostic function (0.02), therapeutic intervention (0.03), ensuring quality (0.01), and work role (0.03). Additionally, a qualitative interpretive descriptive study (n=28) focused on person-centered learning showed that a positive learning environment increases knowledge retention (Hayton et al., 2021). Knowledge retention develops overall knowledge, experience, and competence, positively impacting the outcomes of patients (Hayton et al., 2021; Lalithabai et al., 2020; Slate et al., 2018). Improved nurse competency improves patient safety. If a nurse is not engaged in their work or is not satisfied with their work, the patient experience is affected in addition to the patient's safety (Dempsey & Assi, 2018). Also, disengaged nurses can cost a healthcare organization thousands of dollars in lost productivity (Dempsey & Assi, 2018). A Structured Orientation Program Decreases Nurse Turnover Nurse orientation programs play a critical role in improving nurse retention. KurnatThoma et al. (2017), Walden et al. (2021), and Kiel (2020) report that the highest turnover rate is within the first one to three years of hire. However, Keil (2020) looks deeper into the turnover stating that age also plays a role, with 25 to 34-year-old nurses having a 28% turnover rate compared to a 12% turnover rate with 45 to 54-year-old nurses. By adding a structured orientation program, Kurnat-Thoma et al. (2017) reported that 58% of nurses were more likely to stay on a unit after completing the onboarding process. Walden et al. (2021) used a cross-sectional quantitative study to view newly licensed nurses' career intentions and adaptability (n=277). They found that a focused review was needed to look at retaining nurses within an organization instead of focusing on unit-specific retention (Walden et al., 2021). A study by Dempsy and Assi (2018) showed that out of an 852participant survey organization-wide, 37% reported the desire to leave within two years, and 10 68.6% planned to leave within five years. Knowing nurses' intentions can be used to focus on opportunities to decrease the reason for leaving. Improving nurse engagement can also decrease nurse turnover by encouraging autonomy, inclusion, and growth. A survey identified engagement, high-quality care and service, respect, a good environment, career development, skill utilization, appropriate resources, fair pay, and ethical decisions within the organization as areas to focus on employee engagement (Dempsy and Assi, 2018). Brooks-Carthon et al. (2019) also show that research supporting improving nurse engagement through participation in nurse-led committees and boards increases patient safety. Design of the Orientation Program and Mentors/Preceptors The design of the orientation program affects how successful a new or newly hired nurse can be, including the timing, areas of focus, and styles of learning and mentorship. The timing of the orientation programs varies. Hall et al. (2019) report that new nurses require a twenty-twoweek program within one year of hire, and experienced nurses must complete a twelve-tosixteen-week program within the first six months of hire. Mijares and Radovich (2020) also chose a six-month time frame for mentorship during their orientation. A mentor can increase staff satisfaction, in turn improving nurse retention. A qualitative study by Mijares and Radovich (2020) showed that 86% of the structured mentorship participants were more engaged and satisfied with mentoring, building a healthy environment, improving job satisfaction, and employee retention. However, the mentor needs appropriate support and education to be successful. Hardacker et al. (2022) state that out of one hundred and four (n=104) mentors, 51% had received no formal training and did not feel prepared to be in the 11 role, causing decreased satisfaction. Without appropriate mentor training, new employee training will not be adequate. Types of learning affect how well the knowledge is retained. Rogers and Burke (2021) analyzed quantitative and qualitative data (p< 0.0001), showing that interactive orientation improves knowledge retention. The MSN project will use an interactive approach utilizing a PowerPoint presentation in a staff meeting setting and one-on-one meetings between the nurse and leader. Summary of Literature Review Findings and Application to the Project Evidence-based research shows that a structured onboarding process improves nurse retention, nurse competency, and patient safety by empowering and educating newly hired nurses, decreasing the chance of nurse turnover. The onboarding program will have a higher success rate by identifying organization-specific gaps and directing the program's structure with the program's design to focus on decreased turnover and patient safety. Improving nurse turnover decreases the financial burden by adequately training newly hired nurses, strengthening the organization's overall health. Limitations noted within the literature include small sample sizes in the research, structured programs need to be organization-specific, and the variety of reasons nurses leave an employer. Project Methodology This project aims to prepare newly hired nurses, regardless of experience, to provide high-quality, safe, patient-centered care through a robust orientation program. This preparation includes providing education and training to newly hired nurses as they begin their employment in an ambulatory surgical center focused on endoscopy services. Creating an orientation program includes four deliverables used to educate, empower and train nurses, providing the tools 12 necessary to be a successful endoscopy nurse. The deliverables include (a) a new hire checklist, (b) a new hire check-in form and scheduled meeting, (c) a PowerPoint training module, and (d) post orientation survey. These deliverables will support the orientation process and provide knowledge to newly hired nurses. Description and Development of Project Deliverables Four deliverables were created for this project to aid in developing the newly hired nurse. These deliverables are tools that will ensure proper orientation and training of new hires for the endoscopy unit. In the following sections, each deliverable is described in addition to the rationale supporting the utilization of the deliverables for this project. New-hire Checklist The new-hire checklist will provide visual guidance for the requirements of the orientation program in addition to supporting requirements set forth by the Centers for Medicaid and Medicare (CMS) (see Appendix A). According to Earnhart (2020), a Medicare survey requires proper orientation checklists, documenting that the employee is oriented and can perform the required duties. The orientation checklist requires a supervisor to review the document and include any comments in each area reviewed (Earnhart, 2020). The employee and mentor must then sign the form that all areas were reviewed within thirty days of hire (Earnhart, 2020). New-hire Check-in Form The new-hire check-in form allows a manager to evaluate the employee's progress and performance through intervals scheduled at thirty, sixty, and eighty-five days of employment (see Appendix B). The new-hire check-in form guides the nurse to formulate goals, be aware of their attendance, receive constructive feedback, and ensure they have a clear understanding of 13 their progress. The new-hire check-in form provides opportunities to set goals, show their progress, and identify needs throughout the orientation process. PowerPoint Training Module The manager utilizes the PowerPoint training module to train mentors on the orientation program during the mentor training meeting (see Appendix C). The PowerPoint guides the mentors through why the orientation program is being implemented, reviews the mentors' requirements, and trains the mentors on the new-hire checklist, new-hire check-in form, and post-orientation survey. The timeline is also clearly outlined to keep the progression of the new nurse moving forward, as well as training on the framework Plan-Do-Study-Act. Post-Orientation Survey The post-orientation survey will be given to the new nurse at their eighty-five-day newhire check-in appointment to provide feedback on the orientation process and to evaluate the employee’s readiness post-orientation (see Appendix D). The post-orientation survey results will be tracked to assess for strengths and limitations of the orientation program. Plan and Implementation Process Implementing an orientation program requires planning, approval, buy-in, and obtaining funding from the board of directors. Collaboration with other ambulatory surgical centers locally and nationally will help guide the development of a successful program and provide examples of their orientation program to help guide this facility to stay within the CMS and ambulatory surgical center’s accrediting body’s guidelines. Quarterly meetings will be held with the board of directors and quality team. Monthly staff meetings and biweekly nurse mentor meetings will be held to discuss the program progress, employee progress, and quality improvement opportunities of the orientation process. The quality improvement team will utilize the Plan-Do-Study-Act 14 framework. Implementation of the program will be presented to all the nursing staff to set clear roles, expectations, and responsibilities. During the nursing staff training, deliverables will be distributed, and staff will be trained on how to use the forms. After completing the training among the nursing staff, the post-orientation survey will be discussed along with directions for its use and purpose. Each nurse will review all educational materials, team up with another nurse, and practice educating one another through role play, as they would with a new orienting nurse. The final step with the implementation is evaluating the project. Evaluations will be performed through bi-weekly mentor meetings and new hire check-ins at thirty, sixty, and eighty-five days. Also, reporting retention rates quarterly to management and assessing for an increase in nurse retention rates after one year will be performed. Interdisciplinary Teamwork Providing interdisciplinary teamwork is essential when creating change. Interdisciplinary teamwork improves patient outcomes by bringing specialized care together and focusing on the patient (Jozefowicz, 2018). Implementing a structured orientation program using interdisciplinary teamwork gives nurses the tools and education necessary to make safe, patientcentered decisions. Standardizing nurse training supports patients and improves outcomes without concern for variation in care provided. Coordination and collaboration will be ongoing with the healthcare professionals listed below. Board of Directors. The board of directors is responsible for approving all changes and financial support for a new orientation program. The board will be updated quarterly with progress to continue to obtain support for the program. 15 ASC Clinical Manager. The ASC clinical manager is an RN with nurse manager responsibilities. The ASC clinical manager is responsible for scheduling meetings with the nurse mentors, staff, quality team, and board of directors. In addition to scheduling the meetings, the ASC clinical manager is responsible for presenting information to the board of directors for structural and financial approval. The ASC clinical manager oversees all functions of the endoscopy center and must be open to rapid change as the program is implemented. Nurse Mentors. Nurse mentors are staff nurses specially trained to orient new staff members. The nurse mentors have a broad knowledge of the nursing role and will require additional training in the new orientation program. The nurse mentors are the resources to new employees and help guide and direct the newly hired nurse to gain knowledge and feel included in the team. Timeline Creating a timeline to implement a structured orientation program will keep the plan in motion and provide a timeline showing progress to support the program (see Appendix E). The ASC clinical manager will schedule a meeting with the board of directors for approval. The next step will be scheduling the nurse mentors' training within one week of approval. At this time, the deliverables will be presented in addition to training on the handouts for nurse mentors to utilize. The training of all nurse mentors will be completed within one week. Next, the ASC clinical manager will schedule a staff meeting within one week to discuss the plan and timelines for initiating the new orientation program. By week four, implementation of the project will begin with the first newly hired nurses. Plan for Evaluation of Project 16 Evaluation of the project includes new hire check-ins to review their progression throughout the program at thirty, sixty, and eighty-five days. Also, a post-orientation survey will be given to the orienting nurse to complete at their eighty-five-day evaluation. The evaluation provides opportunities to express topics and tasks that were beneficial to the growth of the nurse and what was not as effective. In addition to the post-orientation surveys, data will be collected and reviewed quarterly with the board of directors, and after one year, the program's effectiveness will be evaluated by reviewing the retention rates of registered nurses. Ethical Considerations Ethical considerations will be addressed throughout the implementation and evaluation of this project. First, nurse mentors will be voluntary and may choose to decline to be a mentor without fear of retribution. The nurse mentors will be required to attend training sessions. However, scheduling conflicts will be reviewed and accommodated if possible. Second, the orienting nurse and nurse mentor will be protected with confidence when any personal conflicts arise between the two nurses. All requests to change mentors or orienting nurses will be kept confidential and will be reviewed on an individual basis. However, scheduling and training locations may cause limitations on available mentors. Third, the post-orientation survey is encouraged but not required. Information will be used to improve the success of the orientation program. The employee will not be discriminated against for anything documented in the survey, and survey comments will be kept confidential between the nurse manager and the quality team. Discussion The evidence-based research found in this project supports the solution for decreasing nurse turnover through a structured orientation program. The solution will be disseminated 17 through multiple routes providing opportunities to improve the orientation program and review its strengths and weaknesses. As research continues, the advancement of nursing practice will continue forward. Addressing the need to improve nurse retention and ensuring nurses will be provided with the skills and knowledge necessary for personal success translating into organizational stability. Evidence-based Solutions for Dissemination Dissemination of this project will begin through a poster presentation to MSN faculty and students of Weber State University. The poster will be delivered through a web-based meeting where the information will be presented, followed by an opportunity for faculty and students to ask clarifying questions. Another dissemination opportunity for this project will be a presentation to the endoscopy facility's quality team and board of directors to provide information to help guide the decision-making process of implementing an orientation program to improve nurse retention. Significance to Advance Nursing Practice This project will benefit all nurses transitioning from school to practicing as registered nurses and transitioning from one specialty to another (Hall et al., 2019). The nursing field has a wide range of specialties that require various specialized skills. Supporting registered nurses through orientation increases nursing knowledge and promotes safety (Zair, 2017). Implications The strengths of this project include improving the experience provided to registered nurses as they transition into practice or move from one specialty to another. This program provides clear expectations of unit-specific requirements and facility policies and procedures. A 18 continuous improvement framework provides strength as weaknesses are identified, and changes are implemented throughout the program. The limitations of this project include recognizing that nurses have many different learning styles. Because of the different learning styles adjusting teaching methods, and time frames, in addition to offering various teaching styles and activities to capture the variances, may be required. Another limitation includes the small unit size causing the survey responses to be minimal. However, a larger-scale implementation can follow if success is seen within the first unit. Recommendations Continuous quality monitoring and improvement are recommended to fine-tune the orientation program by utilizing additional evidence-based research, reviewing the program data, and identifying holes to fill in throughout the implementation. Secondly, research on different learning styles is needed for increased knowledge retention to address most nurses' styles. Conclusion Nurses are trained to provide patients with high-quality care. Unfortunately, the quality of patient care is affected due to high nurse turnover and absent or inadequate orientation programs, which can diminish the chance of nurses being successful. A focus must be placed on structured orientation programs to improve retention and patient outcomes by increasing knowledge and skill competency to address turnover rates (Hayton et al., 2021; Lalithabi, 2020). The orientation program also improves the financial responsibility of a healthcare facility by retaining nurses and avoiding the high cost of hiring and onboarding nurses (Slate et al., 2018). The orientation program's success is dependent on the design of the orientation program, in addition to the training of the mentor (Hall et al., 2019; Hardacker et al., 2022). 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AAACN Viewpoint, 39(1), 10. 24 Appendix A Orientation Checklist Registered Nurse Orientation Checklist – Endoscopy Unit Pass Off Date Complete Mentor initials Unit Layout/Safety Emergency Operations Plans Exit door locations Code definitions Fire pull and extinguisher locations Emergency contact numbers Oxygen main shut off valve Spill kit Crash cart/Ambu bags Evacuation route and meeting place Emergency water and food supply Safety data sheet location Hazardous materials binder Admit set up/flow Recovery set up/flow Emergency alert button Equipment Use Stretcher Ambu bag Monitor Computer Thermometer Wheelchair Supplies/Linen Linen storage locations Soiled linen storage Damaged linen Linen delivery/pick-up schedule Supply closet locations and flow process Office supplies Pass Off Date Completed Mentor initials Medications Narcotic location Narcotic check-out process Narcotic count process Narcotic cabinet key location Medication cabinet Medication administration NS bag/tubing set-up Medication labeling Crash Cart O2 tank use Security tag management Monthly cart checks Defibrillator use Daily cart/defibrillation checks Documentation forms Team responsibilities Mock Code Supply locations, airway, meds,IV Admit/PACU Charting/Reporting Admission Charting PACU/Recovery Charting Incident reporting Pre and post-procedure calls Post procedure admission/infection Miscellaneous Locker location Scrub voucher Time Clock Use Time off/Sick call policy I have completed all sections within the orientation checklist Employee Signature: __________________________________________________________ Date:________________________________________ 25 Appendix B New Employee Progress Plan Registered Nurse Date:____________ Employee Information Name: ____________________________________ Tardies: ____________________________ Position: __________________________________ Sick Calls: __________________________ Start Date: _________________________ PTO Requests: _____________________ Status: (circle one) PTO Hours: ________________________ Full Time: 36-40 hr/week or 4-5 days/week Holiday Hours: ________________ Permanent Part Time: 30-35 hr/week or 3-4 days/week 30 – 60 – 85 Day:__________ Part Time: 24-29 hr/week or 2-3 days/week Chart Reviews:_________________ PRN: 1-23 hr/week with 4 x months minimum Attendance, Reliability, and Grooming ฀ ฀ ฀ Reports to work on time, ready to work Dependable/Reliable Exhibits good time management including time worked and managing prescheduling PTO ฀ ฀ Maintains professional appearance in grooming and attire, wears GP uniform Flexible and willing to work extra when staffing needs require it Goal: Quality of Work/Job Functions ฀ ฀ Goal: Performs assignments thoroughly, accurately and meets deadlines Understands and promotes quality assurance, patient safety and a safe work environment ฀ ฀ Maintains and ensures compliance to regulatory standards Demonstrates knowledge of the duties, methods and procedures required for their job 26 27 Appendix C 28 29 30 31 32 33 Appendix D Post-Orientation Survey 1. Do you feel the orientation program prepared you for independent work? a. Yes b. No 2. Are the unit expectations clear? a. Yes b. No 3. Do you feel like you have the tools and resources needed to be successful at your job? a. Yes b. No 4. Did the 30, 60, 85-day check-ins help with your job clarification? a. Yes b. No 5. What did you like most about the orientation program? 6. Are there improvements that would make the orientation program better? 34 Appendix E