Comparing a General RN Orientation and a Transitional RN Orientation to Facilitate Quality Improvement

Abstract

Most hospitals orient new graduate nurses and experienced nurses in the same generalized orientation programs. To address the cost of orientation to specialty units, a pediatric hospital developed a tailored transitional residency orientation program for experienced nurses. The purpose of this project was to describe, compare, and evaluate the existing generalized orientation program and the transitional orientation program to determine how the orientations differed in structure, process, and outcomes. Donabedian’s model assessing quality of care services and Benner’s novice-to-expert theoretical framework served as guides in evaluating the orientation outcomes. Qualitative data about residency classroom time, preceptor selection and time, mentor selection and time, debriefing, and total length of orientation were collected for the generalized and transitional programs. The findings were that interview process and time, classroom time, mentor time, debriefing time, and length of orientation were decreased in the new transitional orientation program. Orientation costs were less for the transitional program than the generalized program ($20,000 to $30,000 versus $50,000 per nurse, respectively) and nursing staff retention was better for the transitional program than the generalized program (90% versus 68%). The generalized orientation and separate transitional orientation have resulted in a social change by delivering cost-effective orientation to both novice and experienced nurses. Outcomes will be of interest to hospital human resource departments and nurses who conduct orientation programs.