Finding the right fit: redesign of orthopaedic orientation for a medical-surgical unit

At most small community hospitals, orthopaedic patients are cared for on general medical-surgical units rather than on dedicated orthopaedic units. The mixed patient population of a typical medical-surgical unit limits the amount of exposure a new graduate nurse has to care for orthopaedic patients during the unit-based orientation. In 2006, a 20-bed medical-surgical unit at a community hospital in the northeast was expecting to orient eight new graduate nurses over the course of the year. The project team recognized a need to enhance the orthopaedic portion of the unit-based orientation to prepare the graduate nurses to provide "knowledgeable and safe care" (P. ) to orthopaedic patients. This article describes the development, implementation, and evaluation of a standardized, evidence-based orthopaedic curriculum piloted in 2006. The project increased the orthopaedic competency of the preceptors, provided the new graduate nurses with a standardized introduction to orthopaedic patient care, and had an unintended benefit of improving overall staff orthopaedic knowledge that improved the consistency and quality of care for orthopaedic patients at this community hospital.