2.50
Hdl Handle:
http://hdl.handle.net/10755/162559
Type:
Presentation
Title:
Critical Thinking: New Graduate Orientation Innovation from Day One
Abstract:
Critical Thinking: New Graduate Orientation Innovation from Day One
Conference Sponsor:Emergency Nurses Association
Conference Year:2010
Author:Beckman, JoAn, RN, BSN, CCRN, CEN
P.I. Institution Name:Spectrum Health
Title:Staff Educator Emergency Services
Contact Address:100 Michigan MC 49, Grand Rapids, MI, 49503, USA
Contact Telephone:616-391-8717
Leadership Conference - Evidence-Based Practice Abstract: Critical Thinking: New Graduate Orientation Innovation from Day One

Purpose: The greatest challenge for new graduate nurses hired into an Emergency Department is the development of critical thinking skills. Critical Thinking skills come from clinical experiences and exposure to patient care situations. New graduate nurses are hired directly into the Emergency Department. The purpose of this Staff Development Project was to explore innovative ways to help develop critical thinking skills during orientation to the emergency department.

Design: This was a Staff Development improvement project for ED new graduate orientation.

Setting: Project completed at a Regional Tertiary Magnet hospital that has 135,000 ED patient visits per year, Level 1 Trauma Center, with an ED residency program in the Mid-West region of the United States.

Participants: ED new graduate nurses, staff educators, manager, supervisor, director, preceptors.

Method: A needs assessment was completed, followed by a literature review of staff development methods. Standardized orientation format and material was developed that is utilized by all preceptors and new graduate nurses. Designed ED core classes that are held weekly, utilizing simulation experiences to practice triage, assessment, technical skills, interventions, and protocol implementation and documentation skills. Electronic medical records and electronic tracking board are utilized for concurrent case reviews in a private non-patient care area to review ôrealö cases to challenge critical thinking and knowledge integration.

Outcomes: New graduates improved on their critical thinking skills, mastery of technical skills, and transition to new role. This resulted in decreased RN turnover, orientation time, costs and improved staff satisfaction, patient satisfaction, and RN competency. New graduates comprise approximately 50% of all new RN hires. RN turnover decreased from 66% in 2007 (12 of 18 new graduate nurses) to 10% (2 of 16 new graduates) in 2008. Time spent in the classroom was adjusted from 40 hours the first two weeks of orientation to a total of 60 hours over 10 weeks. This resulted in less time spent with the preceptor at the bedside allowing a ôbreakö for the preceptors in the process. Total orientation time decreased by an average of 3 weeks resulting in lower orientation costs. The new graduate nurses from 2008 are actively engaged in the department and many are studying for their CEN. A preceptor survey is currently being developed.

Implications: Providing a safe, engaging, innovative orientation for new graduate nurses results in improved critical thinking skills, patient safety, RN confidence, and patient satisfaction, decreased RN turnover rates and total orientation costs. New graduate orientation should promote not only skill acquisition, socialization to the RN role, but promote their sense of safety within the workforce and professionalism. Increased knowledge, critical thinking skills, and confidence will provide a successful transition into a busy emergency department.

Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleCritical Thinking: New Graduate Orientation Innovation from Day Oneen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162559-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Critical Thinking: New Graduate Orientation Innovation from Day One</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Beckman, JoAn, RN, BSN, CCRN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Spectrum Health</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Staff Educator Emergency Services</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">100 Michigan MC 49, Grand Rapids, MI, 49503, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">616-391-8717</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">joan.beckman@spectrum-health.org</td></tr><tr><td colspan="2" class="item-abstract">Leadership Conference - Evidence-Based Practice Abstract: Critical Thinking: New Graduate Orientation Innovation from Day One<br/><br/>Purpose: The greatest challenge for new graduate nurses hired into an Emergency Department is the development of critical thinking skills. Critical Thinking skills come from clinical experiences and exposure to patient care situations. New graduate nurses are hired directly into the Emergency Department. The purpose of this Staff Development Project was to explore innovative ways to help develop critical thinking skills during orientation to the emergency department.<br/><br/>Design: This was a Staff Development improvement project for ED new graduate orientation. <br/><br/>Setting: Project completed at a Regional Tertiary Magnet hospital that has 135,000 ED patient visits per year, Level 1 Trauma Center, with an ED residency program in the Mid-West region of the United States.<br/><br/>Participants: ED new graduate nurses, staff educators, manager, supervisor, director, preceptors.<br/><br/>Method: A needs assessment was completed, followed by a literature review of staff development methods. Standardized orientation format and material was developed that is utilized by all preceptors and new graduate nurses. Designed ED core classes that are held weekly, utilizing simulation experiences to practice triage, assessment, technical skills, interventions, and protocol implementation and documentation skills. Electronic medical records and electronic tracking board are utilized for concurrent case reviews in a private non-patient care area to review &ocirc;real&ouml; cases to challenge critical thinking and knowledge integration.<br/><br/>Outcomes: New graduates improved on their critical thinking skills, mastery of technical skills, and transition to new role. This resulted in decreased RN turnover, orientation time, costs and improved staff satisfaction, patient satisfaction, and RN competency. New graduates comprise approximately 50% of all new RN hires. RN turnover decreased from 66% in 2007 (12 of 18 new graduate nurses) to 10% (2 of 16 new graduates) in 2008. Time spent in the classroom was adjusted from 40 hours the first two weeks of orientation to a total of 60 hours over 10 weeks. This resulted in less time spent with the preceptor at the bedside allowing a &ocirc;break&ouml; for the preceptors in the process. Total orientation time decreased by an average of 3 weeks resulting in lower orientation costs. The new graduate nurses from 2008 are actively engaged in the department and many are studying for their CEN. A preceptor survey is currently being developed.<br/><br/>Implications: Providing a safe, engaging, innovative orientation for new graduate nurses results in improved critical thinking skills, patient safety, RN confidence, and patient satisfaction, decreased RN turnover rates and total orientation costs. New graduate orientation should promote not only skill acquisition, socialization to the RN role, but promote their sense of safety within the workforce and professionalism. Increased knowledge, critical thinking skills, and confidence will provide a successful transition into a busy emergency department. <br/><br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:30:14Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:30:14Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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