Outcome-Focused Critical Care Orientation Program: From Unit Based to Centralized.

BACKGROUND: An effective orientation ensures that new nurses are prepared to deliver competent care to patients. In organizations with several critical care units, opportunities exist to achieve standardization of core content applicable to all critical care areas. PURPOSE: This quality improvement project, conducted in a large children's hospital with multiple critical care units, was designed to centralize critical care orientation and standardize its content, as well as to measure learning outcomes of the revised program. METHODS: Before initiation of this project, a 2-day critical care orientation class was held regularly for newly hired critical care nurses. Nurses attended this class at different time points in their orientation. Critical care units also held unit-based orientation classes. Nursing professional development specialists and representatives from each critical care unit collaborated to redesign the 2-day critical care orientation class in order to standardize content taught across the organization, increase attendance at the class, and reduce redundancy of topics covered in unit-based classes. INTERVENTIONS: The redesigned program included online modules followed by 4-hour sessions that built on the knowledge gained in the modules. The sessions used multiple learner engagement strategies. Learning outcomes were evaluated using pretests and posttests. RESULTS: Between June 2017 and March 2018, a total of 150 nurses completed the redesigned program. Median posttest scores increased significantly from median pretest scores for each critical care orientation session. CONCLUSION: The program achieved the goal of standardizing education and increasing critical care nurses' knowledge.

Onboarding advanced practice nurses: development of an orientation program in a cardiac center.

The advanced practice nurse (APN) is critical to continuity of patient care, particularly in an innovative and research-intensive environment. The intensity of the environment, steep learning curve, and lack of a structured orientation can lead to difficulties in role assimilation and feelings of disconnectedness. This led the authors to undertake an improvement project to develop an onboarding program for APNs and develop strategies to orient them to their role. The authors describe the program and discuss how it was perceived by the APNs. Program evaluation and suggestions for future nursing research are identified.