Incorporating Practice Changes into Orientation Jill Stonesifer, MSN, RN-BC, CPN Nursing Professional Development

Objective Describe a collaborative method to incorporate new knowledge and skills into the orientation process.

Background 1 Continuous need for staff education 2 Growing institution Healthcare advances Regulatory requirements 1 Continuous need for staff education More nurses in more specialized roles Staff movement to new locations Turnover 2 Growing institution

Examine Educational Processes Policy updates New equipment/products Practice changes 1 Educators coordinate staff education for incumbent staff 2 How can we ensure future employees gain the same knowledge and skills?

Literature Search 1 Power of collaboration 2 Leadership support (Fleiszer, Semenic, Ritchie, Richer, & Denis 2016; Deber, 2014; Greenhalgh, MacFarlane, Barton-Sweeney, & Woodard, 2012). Leverage strength of educational structure Integral to the role of an educator (Harper & Maloney, 2016; World Health Organization, 2016) 2 Leadership support (Fleiszer, Semenic, Ritchie, Richer, & Denis, 2016; Scheirer, 2013) Education process refinements Educational initiatives we coordinate 3 Indoctrinate practice changes (Chambers, Glasgow, & Stange, 2013; Scheirer, 2013) Become part of institution’s culture Policies & procedures, practice guidelines

Process Steps Sustainability of Practice Changes Through Orientation 1 Review Required Training Topics with On-boarding Advisory Team Will the practice become standard procedure? Learning resource needed, i.e. policy, online module 2 Make notes of their recommendations 3 Update orientation documents to reflect practice changes

Outcomes 1 Engagement of On-boarding Advisory Team Express satisfaction with process Thoughtful consideration before adding online courses Preceptor/orientee feedback Suggestions for streamlining orientation paperwork 2 Advisory team members take ownership of process Helping their staff get the education that is right for them Makes the educators’ jobs easier

Collaborative spirit of process = Positive change for staff education at TCH! Outcomes 3 Educators are liaisons between Nursing Professional Development & staff Involvement strengthens their ability to reinforce education with staff Increases staff completion compliance 4 Teamwork inherent to role of educator Institutional growth created opportunity Tap into decentralized educators’ expertise

References Chambers, D. A., Glasgow, R. E., Stange, K. C. (2013). The dynamic sustainability framework: addressing the paradox of sustainment amid ongoing change. Implementation Science, 8(11), 1-11. doi: 10.1186/1748-5908-8-117 Deber, R. B. (2014). Thinking about accountability. Healthcare Policy, 10,12-24. Fleiszer, A. R., Semenic, S. E., Ritchie, J. A., Richer, M. C., & Denis, J. L. (2016). A unit-level perspective on the long-term sustainability of a nursing best practice guidelines program: An embedded multiple case study. International Journal of Nursing Studies, 53(2016), 204-218. doi: 10.1016/j.ijnurstu.2015.09.004 Greenhalgh, T., MacFarlane, F., Barton-Sweeney, C., & Woodard, F. (2012). If we build it, will it stay? A case study of the sustainability of whole-system change in London. Milbank Quarterly, 90(3), 516-547. Harper, M. G., & Maloney, P. (2016). Nursing professional development: Scope & standards of practice, 3rd edition. Chicago, IL: Association for Nursing Professional Development. Hayes, L. J., O’Brien-Pallas, L., Duffield, C., Shamian, J., Buchan, J., Hughes, F., Spence Laschinger, H. K., North, N. (2012). Nurse turnover: A literature review – an update. International Journal of Nursing Studies, 49(7), 887-905. http://dx.doi.org/10.1016/j.ijnurstu.2011.10.001. The Joint Commission. (2013). Program: Hospital. human resources chapter. Retrieved from https://edition.jcrinc.com/Common/PopUps/PrintChapter.aspx?rwndrnd=0.17495940402896093

References Levine, J., & Johnson, J. (2014). An organizational competency validation strategy for registered nurses. Journal for Nurses in Professional Development, 30(2), 58-65. Rus, L., Cheesebro, K., Nagra, E., & Neff, A. (2013). Traffic control: Nursing practice calendar. Journal for Nurses in Professional Development, 29(2). 70-72. Scheirer, M. A. (2013). Linking sustainability research to intervention types. American Journal of Public Health, 103(4), e73-e80. Strader, M., & Di Giacomo-Geffers, E. (2017). Keeping up with education and training with The Joint Commission and CMS. Retrieved from http://www.strategiesfornursemanagers.com/ce_detail/252237.cfm# Texas Children’s Hospital. (2017). About us. Retrieved from http://www.texaschildrens.org/about-us Van Achterberg, T. (2013). Nursing implementation science: 10 ways forward. International Journal of Nursing Studies, 50(4), 445-447. doi:10.1016/j.ijnurstu.2013.02.004 World Health Organization. (2016). Nurse educator core competencies. Retrieved from http://who.int/hrh/nursing_midwifery/nurse_educator050416.pdf Wright, D. (2015). Competency assessment field guide: A real world guide for implementation and application. Minneapolis: Creative Health Care Management.

Thank You!