Evaluation of an orientation system for newly employed registered nurses.

In this article, the authors discussed the successful evaluation of an orientation system for newly employed registered nurses in a large teaching hospital using the IOP model. This methodology can be successfully applied to any educational program that is consolidated into an organization's goals. Although not well examined, orientation has been reported to be costly (Bethel, 1992; del Bueno, Weeks, Brown-Stewart, 1987). The system presently used at this hospital uses at least 1 week of a nurse educator's time, 3-10 weeks for a newly employed registered nurse, and 3-10 weeks for a preceptor RN. Such an investment of personnel resources mandates examination of the processes and outcomes of the program to ensure newly employed RNs become competent practitioners as efficiently as possible. The use of the IOP model particularly was useful in examining a complex orientation system in a multicentered hospital. Use of this systematic program evaluation separated the overall orientation process into workable components. Tools, such as the algorithm, allowed for easy visualization and comprehension of the process steps. This was indispensable because of the number and scope of people involved in the orientation program. The evaluation process was impartial and focused on the program steps, not on the individuals. Because of this impartiality, people were able to gather and work cohesively to improve the overall program. Use of the IOP model assisted the nurse educators in determining that PBDS was not achieving the goal of identifying individual learning needs. Rather, PBDS was a useful tool in establishing baseline competency of newly employed RNs. The system clearly identified those individuals who had above average knowledge bases and those individuals who had more learning needs. For those with more learning needs, PBDS provides a starting point for planning a structured orientation. Thus, a Phase II PBDS assessment could be used as a more unit-specific assessment to validate whether the RN has achieved the orientation objectives. Although the IOP model is not a strict research methodology, it is appropriate for examination of a program as fluid and ongoing as this. Finally, ongoing run charts or statistical trends will assist the nurse educators in monitoring the quality and effectiveness of the orientation program.