2021 Annual Conference

CNS Improving Outcomes

Background: 

Literature shows successful nursing orientation is key to nursing retention. Unsuccessful orientation cost approximately 1-1.5 time the employee’s salary, however the rate of successful orientations increases when nurses are provided orientation pathways. In two outpatient oncology services, the Clinical Nurse Specialist (CNS) noted extremely variables orientations occurring and no standard pathway.

Intervention:

Using the literature, an orientation pathway and preceptor guide for new outpatient nurses was implemented. The pathway includes an overview of orientation, preceptor and orientee expectations, weekly goals and readings, observations and classes. Each week, goals became more complex, growing upon previously developed skills. Routine check-ins are done with the CNS, Nurse Manager and Nurse Educator. The CNS educated preceptors on the appropriate use of the pathway and reviewed it with the orientee during week one of orientation. 

Outcome:

Nurses who completed orientation two years prior to implementation (n=5) and those who used the pathway (n=7) were surveyed on their satisfaction with orientation and preparation to practice. Preliminary data shows a medium-large effect size for readiness to work independently and satisfaction with readings. Those who used the pathway reported improved disease understanding, satisfaction with observations and weekly goals. Final presentation will include pathway, goals and data outcomes.

Conclusions/Implications:

Literature consistently shows that successful orientations positively correlates with nurse retention. Providing a disease-specific pathway with weekly goals and check-ins increases satisfaction and readiness to practice. CNSs have a role in establishing these learning environments and can use pathways to provide structure and support for new nurses.