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Related Experiment Video

Updated: Apr 10, 2026

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The Implementation Journey to a Tier and Competency-Based Orientation Model.

Kristen Peterson, Meredith McGuffey, Kelsey Cao

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    Summary
    This summary is machine-generated.

    A new structured orientation model improved nurse satisfaction and confidence. This initiative significantly reduced registered nurse (RN) turnover in a healthcare system.

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    Area of Science:

    • Healthcare Management
    • Nursing Education
    • Quality Improvement

    Background:

    • Implementing effective orientation programs is crucial for healthcare systems.
    • High registered nurse (RN) turnover impacts patient care and organizational costs.
    • Standardized orientation models can enhance new nurse integration and retention.

    Purpose of the Study:

    • To implement and evaluate a structured, tier-based orientation model for registered nurses (RNs).
    • To assess the impact of the orientation model on orientee and preceptor satisfaction.
    • To determine the effect of the model on RN confidence and organizational turnover rates.

    Main Methods:

    • A structured, tier-based orientation model was developed and implemented.
    • The Plan-Do-Study-Act (PDSA) Quality Improvement (QI) framework guided the implementation process.
    • The model was piloted on two units and scaled across the academic healthcare system over four years.

    Main Results:

    • 97% of orientees and 84% of preceptors reported feeling supported.
    • 89% of orientees experienced a structured orientation process.
    • 99% of orientees reported increased confidence in providing safe patient care.
    • Organizational RN turnover decreased from 7% to 3%.

    Conclusions:

    • The structured, tier-based orientation model positively impacted orientee and preceptor satisfaction.
    • The implemented model enhanced orientee confidence and contributed to a significant reduction in RN turnover.
    • This QI initiative demonstrates the effectiveness of structured orientation in academic healthcare settings.