Tracking New-Hire Nurses' Progress and Experiences Through Orientation

Background: Personalized new-hire nurse orientation increases nurse satisfaction and retention. Nurse turnover negatively impacts patient care. By monitoring the progress of new-hire nurses, support can be provided for their individual needs. Nurse leaders at St. Mark's Hospital are provided a one-size-fits-all timeframe for new-hire nurse orientation. This approach does not take into consideration the unique experiences of each nurse. High-quality patient care is at risk due to staffing shortages from this one-size-fits-all approach, which is exacerbated with the lack of tracking and monitoring of the new-hire nurses' progress. St. Mark's Hospital did not have a standardized approach to track and monitor new-hire nurses' progress and experiences. Methods: A quality improvement project was developed to track and monitor new hire nurse progress and experience through orientation using the Orbit Rounding Tool®. Nurse leaders and professional development specialists were surveyed prior to the project beginning (Survey 1) and again at the end of the project (Survey 3). Nurses that were hired and completed orientation during the project were surveyed to gather feedback regarding their experiences and any inequities or biases that may have existed (Survey 2). Results: Survey 1 revealed that 48% of nurse leaders and professional development specialists stated that the standard nurse orientation timeframes were followed, with the majority of departments using a Competency-Based Stage Orientation (CBSO) program. Although new-hire nurse participation in Survey 2 was low with only four respondents, half of the respondents reported their new-hire nurse orientation was personalized and supported. The results also showed that one new-hire had biweekly visits and that CBSO was used during the orientation. Two new-hire nurses reported bias or inequity in their experience but did not provide details. Survey 3 found that on a scale of 1 to 5 (5 being the best), the ratings of nurse leaders and the professional development specialists ranged between 4.0 - 4.4 regarding the feasibility, usability, and satisfaction of using the Orbit Rounding Tool® for tracking and monitoring new-hire nurses' progress. Conclusions: Nurse leaders and professional development specialists felt that using the Orbit Rounding Tool® for tracking and monitoring the new-hire nurse progress and experience through orientation had high feasibility, usability, and satisfaction. Half of the new-hire nurses felt supported through new-hire nurse orientation and that their onboarding was personalized. Continuing the project over a longer period to capture data from an increased number of new- hire nurses is recommended.