Community RN Extender Onboarding Program: A Covid-19 Surge Response Strategy
Topic of Interest
Role of CNS in COVID-19 Pandemic
Abstract
Purpose: The purpose of this onboarding program is to ensure safety and resilience of Acute Care and PCU nursing staff during pandemic-related surge capacity.
Relevance/ Significance: Even in the early stages of the pandemic, healthcare organizations expressed concerns on staff availability to meet the projected demands. Lessons from the past pandemic responses indicated that healthcare organizations should prioritize training reserve staff and acquire the needed resources to expand capacity. Community RN extender are external staff working collaboratively with the primary RN to care for a group of patients and assume care and responsibilities within their scope of practice.
Strategy and Implementation: The Community RN Extenders onboarding program included an 8-hour knowledge and skills class and two clinical orientation shifts (one in M/S unit and one in PCU). The class covered the overview of the extender role, scope of practice, onboarding pathway, documentation expectations, recognition of signs of early deterioration and information on prevention of hospital-acquired conditions. Additionally, the class included skills competency validation and tour of the Covid units and the entire hospital.
Evaluation/Outcomes: Using the Kirkpatrick’s Training Evaluation Model (Levels 2 and 3), a retrospective pre-post survey revealed improvement in the participants’ understanding of surge staffing plan, guidelines of care, scope of practice, roles and responsibilities, and ability to perform necessary and critical skills.
Implications for Practice: Safety and resilience of nurses during a pandemic is an essential component of disaster preparedness. Effective staff onboarding established trust and confidence among team members and allow healthcare organizations to be more prepared for this unprecedented public health crisis.