Page 224 - HA Convention 2016 [Full Version]

HOSPITAL AUTHORITY CONVENTION 2016 Service Enhancement Presentations

F7.3 Committed and Happy Staff 13:15 Room 421

Retention of Newly Graduated Nurses through an Enhanced In-house Comprehensive Orientation and
Preceptorship Programme in Department of Orthopaedics and Traumatology, Queen Mary Hospital
Choi YY, Fung YF, Chan PL, Ng SLJ
Department of orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong

Introduction

Development of a formal orientation programme in healthcare is crucial in the recruitment and retention of nursing staff.
Orientation is the process of helping employees become part of an organisation’s culture; support its mission, vision, and
values; and fulfill specific job responsibilities that enhance organisational effectiveness. An orientation programme that
encourages new nurses to feel welcomed, safe, valued and nurtured eases transition and enhances their overall satisfaction.
Several authors have recognised the importance of a supportive practice environment for new graduates (Beeman, Jernigan
& Hensley, 1999; Lavoie-Tremblay et al., 2002; Winter-Collins & Mc Daniel, 2000). In the past three years, our unit had 26%
to 35% newly graduated nurses every year and 35% to 47% of our nurses have less than two years’ experience. Therefore, a
supportive comprehensive orientation and preceptorship programme is essential.

Objectives

(1) To decrease the turnover rate in Department of Orthopaedics and Traumatology; (2) to standardise teaching materials; (3)
to increase the sense of belonging among new graduates; and (4) to enhance patient safety.

Wednesday, 4 May Methodology

In order to enhance a comprehensive orientation and preceptorship programme, existing orientation programme was
evaluated by preceptors and preceptees in 2012. The programme was piloted in August 2013 and implemented from 2014.
(1) After gathering all the feedback, an orthopaedic handbook for nurses was developed. This provided information on
basic nursing management on common orthopaedic problems and handling daily work activity. (2) Three-day in-house
comprehensive orientation programme were developed instead of one-day programme and more clinical practice were
added. (3) On top of the preceptor in ward, an advanced practice nurse was allocated to each new graduate nurse for on-
site coaching. (4) Monthly sharing sessions were organised and focused on complex orthopaedic topics/issues and sharing
among staff. This could be a platform to express stress and ask for help. (5) The in-house comprehensive orientation and
preceptorship programme and the monthly sharing sessions were evaluated by questionnaires. (6) The medications incidents
were reviewed via Advanced Incident Reporting System.

Results

The overall evaluation on the programme was good. 79.1% participants agreed that the programme was interactive and
stimulating in 2014 and it was increased to 88.3% in 2015. The overall satisfactory rate was increased from 91.6% in 2014 to
94.2% in 2015. The turnover rate was decreased from 33% in 2014 to 5% in 2015. 100% participant agreed that the monthly
sharing sessions were useful and 94.2% agreed that the shared knowledge and skills could be applied to daily work. The
medication incidents were kept at two incidents per year even with increased percentage of new graduate nurse. A further
improvement is needed in this area. We do not only hope to reduce stress, enhance satisfaction and transition of new nurses
but also want to ensure a safe and quality care practice for patients.

References

Beeman, K.L., Jernigan, A.C. & Hensley, P.D. (1999). Employing new grads: A plan for success. Nursing Economics, 17(2), 91-
95. Lavoie-Tremblay, M., Viens, C., Forcier, M., Labrosse, N., La France, M., Laliberte, D.,& Lebeuf, M. (2002). How to facilitate
the orientation of new nurses into the workplace, Journal for Nurses in Staff Development, 18(2), 80-85. Winter-Collins, A. &
McDaniel, A. (2000). Sense of belonging and new graduate satisfaction. Journal for Nurses in Staff Development, 16(3), 103-
111.

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