Digital Repository Masters Projects Spring 2025 Empowering Rural Nurses: The Impact of Mentor Training on Confidence in Indian Health Service Facilities Jereesha Peacock Weber State University Follow this and additional works at: https://dc.weber.edu/collection/ATDSON Peacock, J. 2025. Empowering Rural Nurses: The Impact of Mentor Training on Confidence in Indian Health Service Facilities. 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 Empowering Rural Nurses: The Impact of Mentor Training on Confidence in Indian Health Service Facilities Project Title by Jereesha Peacock 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 April 20, 2025 Ogden, UT Date Jereesha Peacock, BSN, RN, MSN Student 04/20/2025 Student Name, Credentials (electronic signature) Date Anne Kendrick, DNP, RN, CNE 04/25/2025 MSN Project Faculty Date (electronic signature) Anne Kendrick, DNP, RN, CNE (electronic signature) DNP, N, CNE MSN Program Director Note: The program director must submit this form and paper. 04/25/2025 Date 1 Empowering Rural Nurses: The Impact of Mentor Training on Confidence in Indian Health Service Facilities Jereesha Peacock, BSN, RN, MSN Student Annie Taylor Dee School of Nursing Weber State University MSN Project 2 Abstract Purposes/Aims: This project explores the potential impact of implementing a structured mentorship program by training nurse mentors to enhance nurse confidence in rural Indian Health Service (IHS) facilities, where staff retention and job satisfaction are ongoing challenges. Rationale/Background: Rural IHS facilities face persistent staffing shortages, professional isolation, and high turnover rates, which can negatively impact nurse confidence and patient care. Research suggests that structured mentorship programs improve job satisfaction, retention, and professional development; however, there is limited evidence regarding their effectiveness in rural IHS settings. Methods: The mentorship program will follow the Model for Evidence-Based Practice Change, training nurse mentors in communication, leadership, and mentorship skills. A three-month pilot program is proposed, during which selected nurse mentors undergo structured training and assessment. Pre- and post-surveys will evaluate changes in their confidence as mentors and their preparedness to support mentees in rural IHS facilities. Results: Anticipated outcomes include increased nurse mentor confidence, improved job satisfaction, and more substantial retention within IHS facilities. The mentorship program is expected to create a supportive professional environment, develop leadership, and reduce burnout among rural nurses. Conclusions: Establishing a structured mentorship program within IHS facilities can enhance nurse confidence, improve retention, and strengthen the quality of person-centered care provided to Native American communities. Keywords: nurse mentorship, Indian Health Service, rural healthcare, nurse retention, job satisfaction, evidence-based practice 3 Empowering Rural Nurses: The Impact of Mentor Training on Confidence in Indian Health Service Facilities Nursing staff retention and satisfaction are critical to high-quality healthcare, particularly in rural settings such as the Indian Health Service (IHS). Nurses are at the forefront of patient care, especially in underserved populations like Native American communities. The stability and functionality of rural healthcare facilities need to ensure that staff are confident in their roles and have access to adequate support systems, such as mentorship programs. However, nurses' unique challenges in rural IHS facilities, such as isolation, limited resources, and high patient loads, often result in lower confidence, increased turnover, and burnout (Weng et al., 2019). A welldesigned mentorship program can be pivotal in addressing these issues by enhancing job satisfaction, promoting retention, and increasing nurse confidence (Melnyk et al., 2021). Nursing mentorship programs stimulate professional development, support knowledge transfer, and provide emotional backing for nurses, particularly those new or facing challenging work environments (Kramer et al., 2021). Mentors serve as role models, provide guidance, and offer a support system that helps mentees navigate complex healthcare settings. In rural healthcare settings, where nurses may have limited access to professional development opportunities and peer support, mentor training can bridge critical gaps in education and enhance communication skills and overall confidence (Yusandra & Diana, 2022). These programs also support the development of leadership skills, promoting a culture of shared responsibility and continuous improvement in patient care (Kawar et al., 2021). The question, however, remains whether providing structured mentor training to nurses, specifically within rural IHS facilities, can significantly impact their confidence levels over time. With limited research addressing 4 mentorship in rural, resource-constrained environments, this project seeks to evaluate the impact of providing mentor training to nurses compared to no training, precisely over three months. Statement of Problem In rural IHS facilities, nurse retention and confidence have become significant challenges due to the demanding nature of the job and the isolated work environment. These facilities often face high turnover rates, making it difficult to maintain consistent, high-quality care for Native American communities. The lack of structured support systems, such as mentorship programs, leaves nurses, especially newer hires, without the necessary resources to adapt and thrive in such environments (Weng et al., 2019). Despite evidence supporting the positive influence of mentorship on nurse job satisfaction, confidence, and retention in urban or well-resourced hospitals (Melnyk et al., 2021), more research needs to be conducted to examine these effects in rural healthcare settings, especially in IHS facilities. Nurses' unique cultural and logistical challenges in these environments require tailored solutions. With proper mentorship and support, nurses in these facilities may maintain the confidence needed to provide high-quality patient care, potentially leading to increased job satisfaction and decreased turnover. A lack of research represents a critical gap in understanding the role of mentor training in improving nurse confidence in rural IHS facilities. Providing structured mentor training could be a transformative strategy to address these issues, but empirical evidence is needed to substantiate these claims. By investigating the impact of mentor training on nurse confidence over three months, this project seeks to contribute valuable insights to the broader discussion of healthcare improvement in rural Native American communities. Significance of the Project 5 The Indian Health Service is a lifeline for many Native American communities, particularly those in rural areas where access to healthcare is limited. However, the effectiveness of IHS facilities depends on the nurses who provide frontline care. Nurses in these settings must often overcome significant obstacles, such as staffing shortages, a lack of continuing education opportunities, and limited access to specialized medical resources. These challenges can wear down their confidence and lead to feelings of professional isolation. As a result, nurse retention is a significant issue that directly impacts the quality of care provided to Native American patients (Horner, 2020). Mentor training programs provide a critical solution to this problem. Research shows mentoring improves job satisfaction and nurse retention by facilitating professional relationships and providing a sense of community (Kramer et al., 2021). Mentorship offers an essential bridge between academic learning and clinical practice, helping new nurses build confidence in their skills and decision-making abilities. In rural settings, where nurses have limited opportunities for collaboration and learning than in urban hospitals, mentorship is even more critical (Yusandra & Diana, 2022). By offering mentor training, rural IHS facilities can equip nurses with the tools and support they need to thrive, which could have a lasting positive impact on nurse retention, job satisfaction, and, ultimately, patient outcomes (Melnyk et al., 2021). Furthermore, the significance of this project extends beyond the immediate impact on nurse confidence and retention. The broader healthcare system, particularly in underserved areas, faces a critical need for innovation in supporting and developing nursing staff. If successful, mentor training programs could serve as a model for improving healthcare outcomes in other rural or resource-constrained environments (Kawar et al., 2021). Additionally, the cultural sensitivity required in these programs, given the unique needs of Native American populations, 6 would provide valuable insights into how mentorship programs can be adapted to serve diverse communities better. This project aims to fill a crucial gap in the literature on mentorship in rural healthcare settings, particularly within IHS facilities. By examining the effect of mentor training on nurse confidence over three months, it seeks to offer evidence-based recommendations for improving nurse retention and job satisfaction. The success of this project could lead to lasting improvements in the quality of care provided in Native American communities, ultimately helping to address healthcare disparities and promote the well-being of both patients and healthcare providers. Review of the Literature This literature review explores the evidence supporting structured mentorship programs, the challenges nurse mentors face, and the variability in mentorship models that influence program effectiveness, nurse confidence, and organizational commitment. The PICOT Question, a vital component of the model, is as follows: In rural Indian Health Service facilities, does providing mentor training to nurses, compared to no training, impact their confidence over three months? This section discusses the project framework, analysis of the literature, search strategies used, synthesis of the literature, and a summary of the literature review findings and application to the project. Framework The Model for Evidence-Based Practice Change, a cornerstone of this MSN project, was chosen for its practicality in implementing change and its six-step guide for transitioning evidence into practice. It underscores the importance of organizational culture, stakeholder involvement, and evaluation of the focus of changes (Melnyk & Fineout-Overholt, 2023, p. 486). 7 Applying this model to nurse mentors in a nurse mentorship program aims to enhance nurse confidence and job satisfaction in rural IHS facilities. Nurses in these settings frequently experience lower confidence levels due to insufficient professional development and support (Van Patten & Bartone, 2019). Strengths and Limitations The Model for Evidence-Based Practice (EBP) Change offers several strengths that make it practical for improving practice within healthcare settings, such as rural Indian Health Service (IHS) facilities. One key strength is its structured, step-by-step approach, which provides a clear roadmap for implementing change and transitioning evidence into practice. This structured method fosters systematic evaluation, ensures stakeholder involvement, and emphasizes the importance of organizational culture (Melnyk & Fineout-Overholt, 2023). The model's focus on collaboration promotes comprehensive insights from diverse perspectives, improving the likelihood of successful interventions tailored to specific healthcare settings such as rural health, where nurses face unique challenges. However, there are limitations to the EBP Change model that could affect its application in the MSN project. One challenge is its reliance on a highly collaborative and resource-intensive approach, which may be difficult to sustain in resource-limited rural IHS facilities (Melnyk et al., 2021). The model requires considerable organizational support, resources, staffing, interdepartmental collaboration, training material, and incentives for the steps to be thoroughly implemented, and stakeholders engaged. Furthermore, the model's linear approach may limit flexibility when addressing rural healthcare settings where cultural and logistical barriers often arise. While the structured approach is beneficial, it may need to adapt quickly to the shifting realities in rural IHS environments. Despite these limitations, the model's focus on using 8 evidence to drive practice improvements aligns well with the MSN project's goals of enhancing nurse confidence and job satisfaction through mentorship training in rural settings. Analysis of Literature This literature review was undertaken to explore and synthesize current evidence on the impact of structured mentorship programs on nurse confidence to help with nurse retention and job satisfaction, particularly within rural IHS facilities. The unique challenges in these environments emphasize the importance of understanding the effectiveness of mentorship programs. The review will explore the associated literature themes of structured mentorship programs, the challenges and needs of nurse mentors, and the variability of mentorship models. This understanding is crucial for developing strategies to improve nurse retention and job optimism and increase nurse confidence and satisfaction. Search Strategies A comprehensive literature search was conducted using Ovid, PubMed, Medline, and CINAHL databases. The search focused on articles published within the last five years to ensure current evidence. Keywords included "mentorship programs," "nurse mentorship," "nurse retention," "job satisfaction," "rural healthcare," and "Indian Health Service." The articles reviewed were selected based on their relevance to the mentorship of nurses in rural or underserved areas and their focus on job satisfaction and retention outcomes. The search for articles related to IHS posed a significant challenge, limited peer-reviewed literature addresses mentorship programs or nurse retention strategies within IHS facilities. This gap emphasizes the need for more research in IHS settings, given their unique organizational structure and the limited research focus on federally managed healthcare systems compared to other healthcare settings. 9 Synthesis of the Literature The literature review underscores the pivotal role of structured mentorship programs in nursing, revealing three main themes central to their effectiveness and the challenges they address: the structure of mentorship programs, the challenges and needs of nurse mentors, and the variability in mentorship models. These themes will be further explored in the following sections. Structured Mentorship Programs The literature strongly supports structured mentorship programs to enhance nurse satisfaction, confidence, and retention. Studies by Hoover et al. (2020), Horner (2020), and Kauari (2021) have demonstrated that such programs not only improve retention but also boost nurse satisfaction, particularly in environments with limited professional support. Khunou and Matlhaba (2023) and Dawson (2020) have stressed the importance of organizational support in enhancing nurse satisfaction through effective mentorship. Their work underscores the broader role of institutional backing in mentorship success. In contrast, Wang et al. (2024) focused on individual factors, showing how a mentor’s motivation, attitude, and practices directly shape their engagement in the mentorship process, making the audience feel personally invested in the mentorship process. Similarly, Sedigh et al. (2024) examined the impact of peer mentorship, finding that it significantly boosts self-confidence, reduces stress, and enhances clinical skills security. While Khunou, Matlhaba, and Dawson emphasized the importance of organizational support, Wang et al. (2024) and Sedigh et al. (2024) stressed how personal motivation and peer mentorship can foster a positive mentorship experience, benefiting both mentors and mentees on an individual level, beyond the organizational goals. 10 Tailored mentorship programs, such as Hookmani et al. (2021), developed in which mentorship responsibilities can be integrated into job descriptions and institutional performance management systems when developing mentorship programs, can better address the specific needs of rural nurses, leading to improved satisfaction and patient care outcomes. Nurses who participated in mentoring programs demonstrated higher career optimism, increasing organizational commitment (Gong et al., 2022). Following a successful mentorship program, the positive outcomes of mentees and mentors are retention and job satisfaction (Yusandra & Diana, 2022). Challenges and Needs of Nurse Mentors While structured mentorship programs offer significant benefits, addressing nurse mentors' challenges is essential. Effective mentorship requires the expertise and willingness of experienced nurses and robust support systems. Khunou and Matlhaba (2023) identified critical needs such as adequate time, resources, and organizational backing, emphasizing that mentors may struggle to guide their mentees effectively without sufficient support. This issue is especially pressing in healthcare settings where nurses face heavy workloads and competing demands. When mentors are stretched thin, they may be unable to provide the consistent guidance and feedback new hires need to acclimate to their roles effectively. This can leave new employees feeling unsupported, leading to increased stress, slower skill development, and diminished confidence. Also, insufficient mentorship during onboarding can contribute to higher turnover rates. New nurses may struggle to meet expectations in an environment that lacks the structured support critical for their success. Dawson (2020) highlighted the lack of formal training and resources as a primary challenge, often leading to mentor burnout and feelings of inadequacy. Additionally, Morris and 11 Bosque (2021) pointed out that the quality of the mentor-mentee relationship is crucial to the success of mentorship programs. These studies show the need for healthcare organizations to create and sustain a supportive environment that fosters solid mentor-mentee relationships. For future IHS nurse hires, a well-structured mentorship program is essential for skill development, boosting confidence, reducing stress, and promoting long-term job satisfaction. Weng et al. (2019) further provided that healthcare facilities should consider the mentor's expertise, abilities, and professional attitudes about nursing care to improve their mentoring abilities and strengthen the mentoring programs' role modeling functions. Investing in resources, providing formal training, and offering emotional and administrative support are essential for helping nurse mentors succeed. Alves (2021) reviewed organizational barriers, such as clinician resistance to EBP, and ways to improve the implementation of EBP in mentor development programs. Addressing these challenges ensures that mentorship programs improve nurse retention, confidence, job satisfaction, and competency. Variability in Mentorship Models The variability in mentorship models, as discussed by Perumal and Singh (2022) and Spector et al. (2020), indicated that more than a one-size-fits-all approach may be needed. Mentorship programs in healthcare vary widely in structure, delivery, and outcomes, with their effectiveness mainly depending on how well they are tailored to the specific needs of the nursing group. Perumal and Singh (2022) emphasized that in diverse and challenging environments, like rural healthcare settings, successful mentorship programs must be customized to address the unique needs of the nurses involved. In ruralIHS facilities, where cultural and professional challenges are distinct, a flexible and adaptable mentorship model is likely more effective than a rigid, standardized approach. Expanding on this idea, a review by Spector et al. (2020) discussed 12 Transition to Practice (TTP) programs, a structured form of mentorship designed to ease the transition of new nurses into their professional roles. These TTP programs vary in duration, level of support provided, and so forth. The variability demonstrates that no single approach is universally practical. The variability in mentorship models, including TTP programs, indicates that the effectiveness of these programs is contingent upon how well they are tailored to the specific needs and circumstances of the healthcare setting. This insight is critical for developing successful mentorship programs in rural IHS facilities, where the context demands a nuanced approach to mentoring that considers the nurses' professional and personal development needs. Summary of Literature Review Findings and Application to the Project The literature reviewed provided strong evidence supporting the implementation of structured mentorship programs to improve nurse job satisfaction, confidence, and retention in rural IHSfacilities. Studies such as those by Hoover et al. (2020), Horner (2020), and Kauari (2021) highlighted that structured mentorship not only improves nurse retention but also significantly enhances nurse satisfaction, particularly in environments where professional support is limited. Increased nurse satisfaction, in turn, contributes to better job performance, reduced burnout, and a more positive work environment, which are critical for maintaining high standards of patient care in these settings. Wang et al. (2024), Sedigh et al. (2024), and Gong et al. (2022) reviewed that nurse mentorship programs are a vital component of healthcare leadership and development strategies. These programs can improve nurse confidence and retention, improving patient care and organizational stability. However, the challenges nurse mentors face, as discussed by Khunou and Matlhaba (2023) and Dawson (2020), emphasized the need for adequate organizational support to ensure 13 the success of mentorship programs. With proper backing, mentors may provide the guidance and emotional support necessary to improve nurse satisfaction. The variability in mentorship models, as explored by Perumal and Singh (2022) and Spector et al. (2020), suggested that a one-size-fits-all approach may need to be revised. Instead, mentorship programs should be tailored to meet the specific needs of the nurses and address the unique challenges of the rural IHS setting. The on-the-job mentorship program developed by Hookmani et al. (2021) is an exemplary model, demonstrating how structured mentorship can significantly enhance nurse satisfaction and patient care. The potential benefits of mentorship programs in rural healthcare environments are instrumental in boosting nurse satisfaction, essential for staff retention and high-quality care. These programs' success in increasing participation rates, enhancing nurse satisfaction and confidence, and improving patient care outcomes further highlights the importance of tailored mentorship programs in rural healthcare settings. Project Plan and Implementation This section provides a comprehensive plan for implementing a nurse mentorship program to improve nurse confidence and retention in a ruralIHS facility. The literature review and the project emphasize mentorship as a key strategy to address challenges such as professional isolation, limited resources, and high staff turnover. The implementation will involve an interdisciplinary team, strategic planning, and tailored deliverables to meet the facility's unique needs. Plan and Implementation Process The mentorship program targets nurses in rural IHS facilities, particularly those new to the organization or early in their careers. The setting presents unique challenges, including 14 geographic isolation, cultural sensitivities, and resource limitations, which the mentorship program is designed to address. Advocacy will be crucial in securing the program's institutional and community support. By emphasizing the long-term benefits of mentorship—such as improved nurse retention, enhanced patient care, and cost savings—advocacy efforts can engage stakeholders at all levels. Presentations, meetings, and outreach to organizational leaders will be conducted to build momentum and commitment to the program. The implementation plan begins with a needs assessment conducted through surveys and interviews with nursing staff to identify specific areas requiring support, such as skill development, confidence building, and adaptation to the organizational culture (Melnyk et al., 2021). Mentors will be identified and trained. The process of mentor selection is rigorous and transparent. It involves a review of the mentor's tenure, peer recommendations, and demonstrated commitment to professional development. Experienced nurses who exhibit strong leadership, clinical expertise, and interpersonal skills will be selected as mentors. This ensures that the mentors are well-equipped to guide and support their mentees effectively (Kramer et al., 2021). The mentorship program is underpinned by evidence-based frameworks, ensuring its effectiveness in improving nurse confidence and retention. A structured training program developed for mentors focuses on effective communication, cultural competence, and strategies for supporting mentees' professional growth. This training draws on evidence-based frameworks, such as the Model for Evidence-Based Practice Change. The mentorship program will be initiated as a three-month pilot, with each mentor paired with a mentee and biweekly check-ins to ensure alignment with program goals. Ongoing support and resources, including collaboration with key stakeholders, will be provided to address challenges and enhance program effectiveness. Pre- and post-program surveys will be conducted to assess nurse mentor 15 confidence, job satisfaction, and retention rates. This evidence-based approach instills confidence in the audience about the program's potential to make a significant impact. Interdisciplinary Team The project's success relies on the contributions of an interdisciplinary team, which will collaborate to ensure the mentorship program's sustainability and effectiveness. Key team members include the MSN project content expert, who will provide academic oversight and ensure alignment with evidence-based practices and goals with the MSN student. The Safety Officer will provide advice or suggestions for the mentor reference guide on compliance with safety protocols and risk management standards, ensuring that the mentorship program is conducted in a safe and secure environment. The CNO will support resource allocation and advocate for institutional buy-in from high turnover areas of the facility, such as the emergency, inpatient, and outpatient departments. The Quality Management Officer will be sought to advise the program outcomes and evaluate its impact on nurse performance and patient care. Finally, this project's most valuable perspectives will be from the mentors and mentees. The selected mentors will be at the forefront of gathering information about needs, skill-building, and identifying solutions. This collaborative approach leverages a shared responsibility for improving nurse confidence and retention to enhance patient outcomes. Teamwork among these professionals ensures that expertise and resources are effectively leveraged to address the unique challenges of rural healthcare settings (Kawar et al., 2021). Description and Development of Project Deliverables The project's deliverables were designed to support the successful implementation and evaluation of the mentorship program. Evaluation tools include nurse mentor recruitment flyer, pre- and post-surveys, PowerPoint overview of the program's necessity for stakeholders, and a 16 program timeline. These tools will systematically assess the program's impact (Hookmani et al., 2021). Flyer. Recruiting nurse mentors is critical in establishing a successful mentorship program within the IHS. The flyer (see Appendix A) is a strategic outreach tool to attract experienced nurses willing to take on mentorship roles. With a clear call to action, “Volunteer to Become a Nurse Mentor,"—this flyer effectively communicates the importance of mentorship in shaping the future of nursing within IHS facilities. Finding appropriate mentors requires selecting experienced nurses and ensuring they align with the program's mission to facilitate professional growth and retention. Through targeted outreach, such as flyers and informational sessions, the program can identify and recruit dedicated mentors with the necessary skills and commitment to guide new nurses. The flyer helps build awareness about the mentorship initiative at the Health Center within IHS, encouraging seasoned nurses to share their expertise and contribute to a sustainable nursing workforce. This recruitment effort is vital in gaining traction within the IHS nurse mentorship program. By strategically utilizing this recruitment flyer, the program enhances visibility and attracts a pool of motivated mentors. This structured approach can increase program participation, strengthen mentor-mentee relationships, and improve nurse retention and job satisfaction within IHS facilities. Pre- and Post-Surveys. The mentor pre- and post-surveys at the Health Center are essential tools for assessing the effectiveness of the IHS nurse mentorship program. The presurvey (see Appendix B) establishes a baseline by measuring mentor confidence, preparedness, job satisfaction, and perceived leadership support before the program begins. It also evaluates 17 whether mentors feel they have access to the necessary resources to succeed. This data helps identify initial gaps in mentorship readiness and informs program enhancements. Following program completion, the post-survey (see Appendix C) reassesses these metrics to determine improvements in mentor confidence, job satisfaction, and likelihood of retention. The results provide valuable insights into the program’s impact, allowing administrators to refine training materials and mentorship strategies. By comparing pre- and post-survey findings, the IHS nurse mentorship program can make data-driven decisions to strengthen mentor support, improve nurse retention, and foster a more engaged and confident nursing workforce. Stakeholder Presentation. The PowerPoint presentation (see Appendix D) for stakeholders is a critical tool for communicating the value of nurse mentorship within the IHS. It overviews how structured mentorship programs enhance nurse confidence, job satisfaction, and retention, ultimately improving patient care outcomes. The presentation outlines key components of a successful mentorship program, including the need for strong mentor-mentee relationships, institutional support, and evidence-based mentorship practices. Research findings from studies such as Wang et al. (2024) and Weng et al. (2019) reinforce the positive impact of mentorship on job satisfaction and organizational commitment, demonstrating the program's necessity in addressing nursing workforce challenges. Designed for hospital leadership, policymakers, and key decision-makers, this presentation builds a clear case for implementing and sustaining mentorship initiatives. It highlights mentorship as a cost-effective strategy to reduce turnover, support nurse development, and enhance workplace culture in IHS facilities. The presentation encourages leadership to invest in mentorship programs, ensuring their long-term integration into IHS healthcare settings. 18 Following the launch of this program, a comprehensive mentorship training guide outlining mentorship techniques, cultural considerations, and strategies for building mentee confidence will be developed. This guide will be a reference for mentors throughout the program (Yusandra & Diana, 2022). Interactive workshop materials will be created, including a PowerPoint presentation of the program outline, case studies of evidence-based practice of mentorship program efficacy, and communication exercises tailored to rural healthcare's cultural and logistical challenges. Timeline The proposed implementation of the mentorship program at the rural IHS facility will take place over six weeks, ensuring a structured yet efficient process. The timeline (see Appendix E) follows a four-phase approach: planning and preparation, recruitment and training, program implementation, and evaluation and sustainability planning. This compressed timeline allows for rapid integration of the mentorship program while focusing on quality improvement and measurable outcomes (Melnyk & Fineout-Overholt, 2023). During week one, the project will begin with planning and preparation. A needs assessment will be conducted using pre-evaluation surveys to gather data on nurses' confidence in the rural IHS setting. This phase will also involve identifying experienced nurses to serve as mentors, developing mentorship training materials, and securing approval from leadership and key stakeholders. According to Yusandra and Diana (2022), mentorship programs require structured preparation to ensure effectiveness, particularly in settings with limited resources. Week two will focus on recruitment and training, where mentors will undergo training workshops covering effective communication, cultural competence, and mentorship strategies based on evidence-based practice (Kramer et al., 2021). Mentors will take a pre-survey to assess 19 their knowledge and confidence as a mentor before the training. They will receive an orientation session to introduce them to the program's goals and expectations. Research indicates that structured mentorship training significantly enhances mentor effectiveness and mentee confidence, particularly in resource-limited settings (Hookmani et al., 2021). The implementation phase will occur during weeks three to five, where mentor and evaluator relationships will be established and developed through biweekly check-ins, structured discussions, and real-time problem-solving (Kawar et al., 2021). Ongoing support will be provided through resource-sharing and program oversight to ensure mentors receive the necessary guidance. Challenges will be identified and addressed through regular feedback loops, allowing adjustments to the mentorship approach as needed. Studies have shown that continuous support and adaptability are critical in ensuring the success of mentorship programs in healthcare settings (Perumal & Singh, 2022). Finally, in week six, the evaluation and sustainability planning phase will assess the program's effectiveness. The mentors will complete the project’s post-survey. Pre- and postprogram surveys will measure mentor and mentee confidence, job satisfaction, and retention rates, providing quantitative data for analysis (Weng et al., 2019). Focus groups and qualitative feedback will also be gathered to capture personal experiences and areas for improvement (Horner, 2020). The findings will be shared with key stakeholders, including facility leadership, nurse managers, and quality improvement officers, to discuss long-term sustainability and potential expansion. Research highlights that data-driven evaluation and stakeholder engagement are crucial for sustaining mentorship initiatives in rural healthcare environments (Gong et al., 2022). This structured six-week timeline ensures that the mentorship program is effectively 20 implemented within a short but impactful period, allowing for meaningful improvements in nurse confidence, job satisfaction, and retention. Project Evaluation The IHS nurse mentorship program's effectiveness will be evaluated using formative and summative assessment methods to measure its impact on mentor confidence, job satisfaction, and nurse retention in rural IHS facilities. Formative evaluation will occur throughout the six-week mentorship program, ensuring that feedback from mentors is continuously collected and used to refine the mentorship strategies. Regular biweekly check-ins will allow for adjustments based on real-time challenges, while structured discussions will provide insights into mentors' evolving experiences and concerns. The summative evaluation will focus on pre- and post-survey analysis to measure mentor confidence and job satisfaction changes over the three-month mentorship period. The mentor pre-survey (see Appendix B) will establish a baseline by assessing initial confidence levels, preparedness, and perceived support. The mentor post-survey (see Appendix C) will be administered after the program to evaluate improvements in these areas, comparing responses to determine the program's effectiveness in enhancing mentor competency and satisfaction (Melnyk & Fineout-Overholt, 2023). Additionally, retention rates of participating nurses will be tracked over the following year to assess the long-term sustainability of the mentorship program. Qualitative data from future potential focus groups and open-ended survey responses will provide further insights into personal experiences, allowing for a comprehensive understanding of mentorship challenges and successes (Weng et al., 2019). Ethical Considerations 21 The IHS nurse mentorship program will uphold ethical principles of social responsibility, including cultural sensitivity, confidentiality, and data integrity, ensuring that all participants are prepared and respected. Given the culturally diverse setting of IHS facilities, special consideration will be given to incorporating culturally competent mentorship practices that align with Native American traditions and values (Melnyk et al., 2021). To ensure equity and inclusivity, the program will be voluntary, and all participants—mentors and mentees—will be allowed to withdraw at any time without penalty. To maintain confidentiality and data integrity, all pre- and post-survey responses will be anonymized, and only aggregate data will be reported. Participants' personal information will be stored securely, ensuring compliance with HIPAA and institutional privacy policies (Kramer et al., 2021). Informed consent will be obtained from all mentors and mentees before participation, clearly outlining their rights, expectations, and program objectives. Additionally, measures will be taken to minimize bias, ensuring all mentors receive equitable training and resources regardless of their background, experience level, or department. By adhering to these ethical considerations, the program can foster professional growth and create a trustworthy and inclusive environment that prioritizes nurse well-being and patient care quality in rural IHS facilities. Discussion This study aims to assess the impact of structured mentor training on nurse confidence in rural IHS) facilities. The expected findings are anticipated to suggest that implementing a mentorship program can significantly enhance nurse confidence, job satisfaction, and retention in these underserved settings. The discussion will explore the implications of these findings, recommendations for future improvements, and potential areas for further research. Evidence-Based Solutions for Dissemination 22 To ensure the findings of this project reach a broad audience, the project will be diseeminated through multiple avenues. A poster presentation summarizing key results and best practices will be displayed at academic nursing conferences and institutional meetings within IHS facilities. The poster will also be presented to faculty and colleagues in the academic setting. A podium presentation will be conducted for stakeholders, including nurse executives, policymakers, and hospital administrators, to emphasize the importance of mentorship programs in nurse retention and satisfaction. Lastly, a publication in a peer-reviewed nursing or healthcare journal is planned to provide a scholarly contribution to the field and encourage further research on mentorship in rural healthcare settings (Spector et al., 2020; Wang et al., 2024). Significance to Advance Nursing Practice Mentorship programs play a crucial role in the professional development of nurses, particularly in rural settings where support systems are often limited. By providing structured mentor training, this project contributes to advancing nursing practice by fostering a culture of continuous learning, collaboration, and leadership development. Enhanced mentorship can improve patient outcomes, as confident and well-supported nurses are more likely to provide high-quality care (Melnyk et al., 2021; Gong et al., 2022). Additionally, this project stresses the need for evidence-based strategies to address nurse turnover and burnout, reinforcing the necessity of institutional support for mentorship initiatives (Kramer et al., 2021; Perumal & Singh, 2022). Implications The project highlights several strengths and potential limitations. One major strength is that it provides empirical evidence supporting mentorship as a tool to enhance nurse confidence in rural healthcare settings. Additionally, the structured nature of the program ensures scalability 23 across different IHS facilities. However, resource limitations, staff shortages, and administrative buy-in remain challenges that could affect the program's sustainability. To mitigate these challenges, strategies such as integrating mentorship responsibilities into job descriptions, securing administrative support, and utilizing virtual mentorship platforms can help sustain the program despite staffing constraints (Yusandra & Diana, 2022; Horner, 2020). Furthermore, incorporating cultural competency training into mentorship programs will ensure that the program aligns with the unique needs of Native American nurses and communities (Khunou & Matlhaba, 2023). Recommendations Based on the study's findings, several recommendations emerge. Expanding the mentorship program beyond the initial three-month implementation phase would provide insights into the long-term effects on nurse confidence and retention. Developing standardized mentor training materials adapted to rural healthcare environments would ensure consistency and effectiveness across diverse settings (Hookmani et al., 2021). Integrating mentorship into nursing education would familiarize nurses with mentorship principles early in their careers, preparing them for mentor and mentee roles (Morris & Bosque, 2021). Further analysis should be conducted to assess the impact of mentorship in different rural and underserved healthcare settings, mainly focusing on long-term retention and patient care outcomes (Sedigh et al., 2024). Institutional support and funding are critical to ensuring mentorship programs become a permanent component of professional development within IHS facilities, reinforcing their sustainability and continued success (Dawson, 2020). Conclusion 24 This project reinforces the positive impact of structured mentorship training on nurse confidence, job satisfaction, and retention in rural IHS facilities. By addressing rural nurses' unique challenges, mentorship programs can provide critical professional and emotional support. The dissemination of findings, ongoing evaluation, and continued advocacy for mentorship integration in nursing practice will be essential for long-term sustainability. Future research should explore how mentorship can further bridge healthcare disparities in underserved communities, ultimately improving nurse well-being and patient care outcomes. 25 References Alves, S. L. (2021). Improvements in clinician, organization, and patient outcomes make a compelling case for evidence-based practice mentor development programs: An integrative review. Worldviews on Evidence-Based Nursing, 18(5), 283–289. https://doi.org/10.1111/wvn.12533 Dawson, A. J. (2020). Nurse mentorship: A vital pathway for developing a strong workforce. University of Maryland. http://hdl.handle.net/10713/12939 Gong, Z., Van Swol, L. M., & Wang, X. (2022). Study on the relationship between nurses' mentoring relationship and organizational commitment. International Journal of Environmental Research and Public Health, 19(20) https://doi.org/10.3390/ijerph192013362 Hookmani, A. A., Lalani, N., Sultan, N., Zubairi, A., Hussain, A., Hasan, B. S., & Rasheed, M. A. (2021). Development of an on-job mentorship programme to improve nursing experience for enhanced patient experience of compassionate care. BMC Nursing, 20(1), 175. https://doi.org/10.1186/s12912-021-00682-4 Hoover, J., Koon, A. D., Rosser, E. N. & Rao, K. D. (2020). Mentoring the working nurse: A scoping review. Humane Resources for Health, 18, 52. https://doi.org/10.1186/s12960020-00491-x Horner D. K. (2020). Mentoring: Positively influencing job satisfaction and retention of new hire nurse practitioners. Plastic and Aesthetic Nursing, 37(1), 7–22. https://doi.org/10.1097/PSN.0000000000000169 26 Kauari, V. E. (2021). Quality improvement initiative: Implementing a nurse peer mentorship program. The George Washington University. https://hsrc.himmelfarb.gwu.edu/cgi/viewcontent.cgi?article=1098&context=son_dnp Kawar, L. N., Lynes, L. C., Dunbar, G. B., Mendoza, R. G., Tsai, Q., & Do, L. (2021). The power of mentoring clinical nurses: A strategy to advance nursing research. International Journal for Human Caring, 25(2), 100–109. https://doi.org/10.20467/HumanCaring-D20-00037 Khunou, S. H., & Matlhaba, K. L. (2023). The support needs of the nurse mentors in their mentoring role. Jurnal Ners dan Kebidanan (Journal of Ners and Midwifery), 10(2), 288301. https://doi.org/10.26699/jnk.V10i2.ART.p288-301 Kramer, D. S., McCue, V. Y., Butler, E., Prentiss, A. S., Ojeda, M. M., Tugg, K. K., Fuentes, V., & Bonet, S. (2021). The art of nurse mentoring: A framework of support. Nursing and Health Sciences Research Journal, 4(1), 16-25. https://doi.org/10.55481/2578-3750.1097 Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing & healthcare: A guide to best practice (5th ed.). Wolters Kluwer. Melnyk, B. M., Tan, A., Hsieh, A. P., & Gallagher, F. L. (2021). Evidence‐based practice culture and mentorship predict EBP implementation, nurse job satisfaction, and intent to stay: Support for the ARCC© model. Worldviews on Evidence-Based Nursing, 18(4), 272– 281. https://doi.org/10.1111/wvn.12524 Morris, A., & Bosque, E. (2021). Do we nurture our young? Qualitative conceptual analysis of worst and best mentorship experiences among neonatal advanced practice providers. Advances in Neonatal Care, 21(5), E129-E137. https://doi.org/10.1097/ANC.0000000000000843 27 Perumal, R. V., & Singh, M. D., (2022). Mentorship in nursing in Canada – A scoping review. Nurse Education in Practice, 65. https://doi.org/10.1016/j.nepr.2022.103461 Sedigh, A., Bagheri, S., Naeimi, P., Rahmanian, V., & Sharifi, N. (2024). The effect of peer mentoring program on clinical academic progress and psychological characteristics of operating room students: A parallel randomized controlled trial. BMC Medical Education, 24, 438. https://doi.org/10.1186/s12909-024-05424-z Spector, N., Blegen, M. A., Silvestre, J., Barnsteiner, J., Lynn, M. R., Ulrich, B., Hooper, J.I., Squires, A., Ojemeni, M., & Alexander, M. (2020). Transition to practice programs: Effective or not? Journal of Nursing Regulation, 10(4), 4-14. https://doi.org/10.1016/S2155-8256(20)30075-2 Wang, Y., Hu, S., Yao, J., Pan, Y., Wang, J., & Wang, H. (2024). Clinical nursing mentors' motivation, attitude, and practice for mentoring and factors associated with them. BMC nursing, 23(1), 76. https://doi.org/10.1186/s12912-024-01757-8 Weng, R. H., Huang, C. Y., Tsai, W. C., & Chang, L. Y. (2019). Exploring the impact of mentoring functions on job satisfaction and organizational commitment of new staff nurses. BMC Health Services Research, 10, 240. https://doi.org/10.1186/1472-6963-10240 Van Patten, R. R., & Bartone, A. S. (2019). The impact of mentorship, preceptors, and debriefing on the quality of program experiences. Nurse Education in Practice, 35, 63-68. https://doi.org/10.1016/j.nepr.2019.01.007 Yusandra, E., & Diana, H. A. H. (2022). Effectiveness of mentorship program for nurse retention, job satisfaction, and intention to stay. The Malaysian Journal of Nursing, 14(2), 38-45. https://doi.org/10.31674/mjn.2022.v14i02.007 28 Appendix A Mentorship Recruitment Flyer 29 Appendix B Mentor Pre-Survey Pre-Survey I feel confident in my ability to mentor and support less seasoned nurses. I feel prepared to handle the challenges of a mentorship role in my current work environment. I am satisfied with my current role and responsibilities as a nurse mentor. I feel supported by leadership and colleagues in my role as a nurse mentor. Strongly Agree Agree Neutral Disagree Strongly Disagree 30 I am likely to continue working in this facility over the next two years. I have access to the necessary resources and tools to succeed as a nurse mentor. Comment: 31 Appendix C Mentor Post-Survey Mentor Training Evaluation Form Mentorship Program 2025 Please carefully read each question and rate your experience with us. Post-Survey Strongly Agree Agree I feel confident in my ability to mentor and support less seasoned nurses. I feel prepared to handle the challenges of a mentorship role in my current work environment. I am satisfied with my current role and responsibilities as a nurse mentor. I felt supported by leadership and colleagues in my role as a nurse mentor. Neutral Disagree Strongly Disagree 32 I am likely to continue working in this facility over the next two years. I have access to the necessary resources and tools to succeed as a nurse mentor. Comment: Thank you for taking the time to participate in this survey. We value your input and feedback. If you have any additional comments, please email me at jereeshapeacock@mail.weber.edu 33 Appendix D PowerPoint for Stakeholders 34 35 36 37 38 Appendix E Mentorship Program Timeline