Optimizing Transition to Practice Through Orientation: A Quality Improvement Initiative

- New nursing hires demonstrated improved entry-level competencies and confidence through experiential learning.
- It was identified that 23.42% of new hires were unprepared to meet the expectation for nursing practice at London Health Sciences Centre.
- Also 0.53% of the new hires were determined to be at risk and unable to meet entry to level competencies following educational support.
- Orientation length was shortened by one 8-hour day with the potential savings of $156,000 in the two-year period based on entry-level nursing wages.

BackgroundWith dwindling nursing student placements in acute care facilities, increased pressure and responsibility have been placed on students to facilitate their transition to practice. Through the strategy of simulation-based orientation programs, the preparation to practice gap can be reduced.MethodsIn 2013, London Health Sciences Centre embarked on a quality improvement initiative to revise their Central Nursing Orientation through the use of simulation and experiential learning.ResultsFive hundred twenty-one new nurse hires participated in the revised orientation program and were compared with 749 who participated in the original program. New nursing hires commented on improved confidence and preparation for the unit. Summative assessments resulted in 23.4% of new hires unsuccessful in their first attempt, 6% in their second attempt, and 0.5% in their third.ConclusionsThe successful development of a simulation-based orientation program provided our new nursing hires with a standardized approach for a successful transition to practice. Through this process, we also identified the continued learning needs during transition and the opportunity to engage with our academic institutions to better prepare our future nurses.