Implementing an Evidence-Based Preceptor Program to Improve the Orientation Process

This Quality Improvement project conducted at a 245-bed acute care hospital in the southeastern United States, aimed to develop an evidence-based preceptor program to improve retention rates. Specific goals were to create a positive experience for preceptors and preceptees by improving the training, support, and recognition. Secondary goal was to increase the number of trained preceptors. The training focused on safe practice, employee satisfaction, and self-efficacy. Retention data supplied by HR for 2020 showed increasing trend of nursing turnover with a 33% total nursing turnover, and 50.25% turnover rate for nurses with less than three years of experience. A 2019 Stay Survey administered to all newly employed nurses, graded attitudes regarding the facility on a 5-point Likert scale, with 1 indicating strongly disagree, 2 indicating disagree, 3 indicating neither disagree or agree, 4 indicating agree, and 5 indicating strongly agree. Analysis of data revealed scores below the benchmark (M 4.0) in a number of critical areas: intent to stay (M 3.21), job expectations, ability to perform integral work functions, and nursing satisfaction. During the initial implementation, 10 preceptor-preceptee pairs participated and evaluated the effect of the program on self-efficacy, intent to stay and preceptor experience and engagement. The results showed no statistically significant difference pre and post intervention in any category except preceptor intent to stay, which decreased from baseline (M 13, SD 13.4) to 1-month post (M 6.74, SD 4.7) (Z = -2.04, p = .041). Preceptee intent to stay (in years) did indicate clinical significance with an increase from baseline (M 7.8) to 1-month post (M 9.1). After participating in the program and finishing the orientation project, it appears that preceptees intent to stay increased by slightly more than 1 year, which may be attributed to participation in the program, or the preceptee’s comfort level and assimilation in the organization. This project was implemented during the rapidly rising Covid Omicron variant (October to December 2021) which placed significant strain on the healthcare system. Preceptors and preceptees reported high total self-efficacy scores at baseline and 1-month. All preceptors reported a desire and sense of duty to continue precepting