Effects Of A Preceptorship Program On Turnover Rate, Cost, Quality And Professional Development

Clinical ladder programs are often based on Patricia Benner’s Novice to Expert model.  The program offers nurses the opportunity for professional growth about the achievement.  Advancement through the program offers recognition and rewards, most often in an increase in salary and job responsibilities.   Hospitals often adopt clinical ladder programs as a  recruitment and retention tool for experienced nurses (Murphy, 2012)

The report encouraged the assessment of NRPs’ efficacy, predominantly their capability to enhance patient outcomes, nurse retention, and professional proficiency. Despite the increasing amount of research on residency program outcomes, best practices for implementation are still changing. Therefore, this paper focuses on the best practice recommendations. NRPs have made a tremendous impact on the nursing field to both novice nurses as well as the expert nurse. The main themes appearing when reviewing the literature were reports about clinical competency, preparing new graduates for interprofessional teamwork, training, orientation, and mentorship for newly graduated nurses. These topics will be discussed in this paper as they pertain to nurse residency programs and newly licensed

Transitioning from nursing school to working in a hospital setting can be a challenging time for a new graduate. Due to the nursing shortage, new graduate nurses are being hired with little to no experience. This is overwhelming for new nurses, especially when they are not getting adequate support or training from the hospital. The amount of stress, pressure, and lack of training is leading to a high turnover rate for new graduate nurses. With patient acuity on the rise, new graduate nurses that are filling these vacancies in the hospitals, need to be competent nurses to provide proper and safe care to the patients.

staff, the skill level of the nursing staff, and the education/certification of nursing staff” (ANA, 2015). These

Over the last several years, the majority of graduating medical students (90%) has been focused on careers in specialized care. (Pickert, 2009) This is because they will make more money in comparison with doctors that are working in a primary care environment. As a result, a shortage has developed with many health care providers turning to Nurse Practitioners. These are nurses with some kind of advanced degree in Nursing. Their job is to diagnose / treat patients and prescribe medication. To fully understand what is happening requires looking at how this trend is having an impact on accountability, quality, costs / health promotion and risk reduction. These different

Across the United States, hospitals are experiencing a nursing shortage. Yet, according to the American Association of Colleges of Nursing, 63,857 students graduated from nursing school in 2015 alone and enrollment is increasing. It seems like a lot of new nurses to fill those vacancies, does it not? Studies show, however, that within a year, about thirty percent of those new graduates have voluntarily left their job (Hillman). Further studies have attributed the high turnover rate to new nurses’ lack of competency to handle conflict, make critical decisions, and function autonomously (Bratt). Many of the new graduates are disappointed with the hospital’s orientation, or lack thereof. Lack of knowledgeable preceptors and lack of nursing staffing in general has led to new nurses being thrown into autonomous function more quickly. Without proper training, these nurses must make sound clinical judgements and provide competent care to patients, which anyone can imagine is stressful. Today, Nurse Residency Programs (NRPs) are being instituted in numerous hospitals as a way to improve new graduate nursing skill, but research shows many other benefits to these programs. NRPs also reduce hospital spending costs, increase patient safety, and most importantly increase new nurse retention rates.

Staff satisfaction is empirical in retention of nurses in any healthcare setting. Although a slight turnover is necessary to maintain the diversity of ideas, too much of it causes instability that might affect patient and employee satisfaction negatively (Marquis & Huston, 2015). The planned change is to be executed at a small, private hospital (SPH) in Los Angeles with a 200-bed capacity, which offers emergency and medical-surgical services for adults. After a six-week hospital orientation, only 20% of new RNs hired at SPH in 2015 rated their confidence levels at >70% (Appendix A). Out of 32 new hires, 7 left during orientation, and 12 left before reaching 1 year- leading to 41% retention or a 59% turnover (Appendix B). The RN turnover of SPH is thrice the

The professionalism goal that I set was to develop a preceptorship program for my clinic that would provide socialization, team support, and clearly defined expectations of professional behavior and performance for new nursing staff. To achieve this goal, my plan was to seek

According to Shellebarger & Edwards (2012), Nurse Educators help shape the future of nursing by educating future novice nurses. Nurse Educators have a core curriculum to follow to ensure lifelong learning in their role. They help shape critical thinking skills in our future nurses by giving them the knowledge needed to think critically. “ Evidence has found that hospital based nurse educators influence safe patient outcome through contemporary evidence based teaching and their contribution of policy development supports safe practice” (Sayers,2012, p. 45). Nurse Administrators take on the role of patient advocates, by ensuring that patients are receiving the highest level of care (Hamic, Hanson, Tracy, & O’Grady, 2014). Nurse Administrators are an important part of management of nurses , they help develop policies and procedures and are change agents in their fields. The Nurse Educator and the Nurse Administrator should be

A positive force for change centers on the nurse’s strong desire to change current practices. The combination of the turnover rate, low morale, and higher percentage of new nurses, is the driving

The Carnegie Foundation reports that nurses today “are undereducated for the demands of practice” (Benner, Sutphen, Leonard, & Day, 2009, ¶ 17). Education of the ADN centers around the hands-on skills needed to care for a patient at bedside and less on the scientific theories that allow the holistic treatment of a patient. A report by the Milbank Memorial Fund in 2001 reports that nurses educated at the ADN level have a higher incidence of mistakes made while performing their duties (Rosseter, 2011, ¶ 24). Registered nurses who graduate with the two year degree lack research skills, leadership and managerial skills as well as informatics needed to deliver quality medical care within today’s health care system (Orsolini-Hain & Waters, 2009, p. 269).

A review of the literature was performed and yielded 26 articles relevant to precepting programs for novice nurses and advanced practice providers (APPs). For the sake of brevity, only the literature regarding novice APPs will be evaluated in this paper: six studies. Two had a date range exceeding 10 years, and were included in an attempt to fully explore the applicable literature. All of the articles reviewed can be found in Appendix A. The Johns Hopkins Evidenced-Based Practice Evidence Rating Scale was used to evaluate the literature (Newhouse, Dearholt, Poe, Pugh, & White, 2007).

There are “more than 3 million members” that are in nursing profession taking part in “the largest segment of the nation’s health care workforce” (Health and Medicine Division, 2015). Along with some of the barriers to improve nurses’ skills and knowledge, fragmentation of the health care system, high rates of turnover among nurses, difficult school transitioning to practice and aging workforce and other demographic challenges are also being noticed by health care system (Nap.edu, 2011). The IOM report allow nurses such as nurse practitioners to see patients and prescribe medications without collaboration and supervision of a physician. Another program that assist on nursing high turnover rates is the versant or nurse residency programs. It was developed to provide a comprehensive time to train and acquire safe and standard knowledge and skills for high quality of patient’s care. A decrease turnover rates for versant program from 35 to 6 percent at 12 months and 55 to 11 percent at 24 months (Nap.edu, 2011).

A critical component of any evaluation is how success and failure are defined. Covelli (2012) states that evaluation is an important component of determining both the success of a program, but also understanding ways in which the programs can improve. There are two fundamental goals for this program to be successful, a rise in retention for first year nurses and an increase in the same employee population’s job satisfaction scores. The evaluation of this project will require data from several sources, much of this data is generated by the nursing resident participants themselves.

Nursing care delivery is defined as the way task allocation, responsibility, and authority are organized to achieve patient care. Tiedeman and Lookinland (2004) suggested that systems of nursing care delivery are a reflection of social values, management ideology, and economic considerations. (Tiedeman&Lookinland, 2004) According to Fewer (2006), the quality of nursing care delivery systems affects continuity of care, the relationship between nurse and patient, morale, nurse job satisfaction and educational preparation.(Fewer, 2006) Nurses are essential human resources to provide medical services with professional knowledge and skills in the healthcare setting. However, the registered nurse turnover rate has increased in recent years resulting