Congress Abstracts 2006

56

NEW GRADUATE ORIENTATION TO AN INPATIENT HEMATOPOIETIC STEM CELL TRANSPLANT UNIT: A PROCESS IMPROVEMENT PROJECT. Terrie Paine, RN, BSN, OCN^®, University of Washington Medical Center, Seattle, WA; and Mihkaila Wickline, RN, MN, AOCN^®, Seattle Cancer Care Alliance, Seattle, WA.

As the nursing shortage intensifies, Hematopoietic Stem Cell Transplant (HSCT) units are hiring new graduate nurses. Due to the complexity of the patient population, the orientation program is important to ensure adequate training for patient safety, job satisfaction and nurse retention.

We had two main objectives for improving our orientation program. The first was to prepare new graduates who, with strong mentoring and resources, could safely care for HSCT patients after 6 weeks and the second was to strengthen our preceptor pool.

Our team for this process improvement project was composed of the Nurse Manager, Staff Development Specialist, Clinical Nurse Specialist, Nurse Educator and Assistant Nurse Managers. We began by evaluating the previous orientation model through focus groups with recently oriented nurses and preceptors. From there we developed a 6-week orientation grid that includes weekly goals, steps for implementation and a comprehensive list of available resources/references. We developed a daily 'brain sheet' for the new graduate that included prompts for patient care, information for report, and reminders of daily work. A final point was the assignment of each orientee to a member of the management staff for a weekly meeting to ensure that they are on-track with their orientation and successfully becoming a member of our team. We developed an eight hour Preceptor Workshop to standardize the role of the preceptor, reinforce the importance of using policies and procedures, educate about the new orientation grid and provide support.

A tool was developed for the orientee to evaluate their orientation and give feedback to their preceptors. The project team has continued to evaluate the program and incorporate feedback that is gathered through these evaluations and discussions at the Preceptor Workshops.

The 'orientation grid' has been so successful that we have used it as a template to develop ICU and telemetry orientation programs on our oncology unit. Providing references on the grid is critical to our philosophy that nurses with clinical questions must access the policy and procedure manual for answers. Our goal is to standardize clinical practice amongst all nurses and to emphasize that from the first day of orientation.