A significant nursing shortage exists in the United States, which is compounded by high turnover rates. Skilled nurse preceptors are needed to train and assimilate nurses, which would improve retention of nurse preceptors, facilitate transition of nurses to the practice environment, and increase the number of preceptors within the organization. A preceptor preparation program in a 300-bed hospital was developed to promote nurse preceptor success while enhancing learning outcomes and creating a supportive work environment. The organization's leaders are interested in the successes of the program and its long-term role in retaining nurse preceptors who completed the preceptor preparation program. Therefore, the purpose of this doctor of nursing practice (DNP) project was to develop a program evaluation model where the institution could assess the retention rate of preceptors and the overall effectiveness of the program. The evaluation framework consisted of the Benner's model skill acquisition, from novice to expert, which will assist in assessing outcomes of retention of nursing preceptors as they evolved through the program. The project question for this DNP project asked whether a program evaluation to identify methods to capture current rate of retention of preceptors and overall program effectiveness could be developed. A survey tool was successfully developed and the pilot study was accepted by the facility to capture and evaluate the program information. This project provides a model for program evaluation and may increase the nursing literature on preceptor retention programs. Preceptor program outcomes are important to evaluate and can create positive social change regarding the number of quality preceptors available to train new nurses in practice.

The purpose of this project was to evaluate the impact of a quality improvement strategy to implement an RN clinical learning and development specialist (CLDS) with the intent to reduce high turnover in novice nurses and low nurse engagement. The CLDS served as expert, role-model, coach, and mentor. Benner'€™s model of novice-to-expert was used as the conceptual framework to monitor progression of nurses mentored by the CLDS. The Institute for Healthcare Improvement model for improvement was reviewed to assess the effectiveness of the CLDS on turnover rates and nurse engagement. At the time of program evaluation, the CLDS role had been operational at the project site for 8 months in inpatient and perioperative service lines. An analysis of turnover rate by headcount of 1510 RNs within the practice environment was completed. The change from the preintervention period to the postintervention period was statistically significantly lower. A nonparametric test to compare the monthly rates was used (z = -2.613; p = .005). To evaluate nurse engagement, the practice environment scale was deployed to all RN nurse residents from 9/2018 through 3/2019. A total of 166 surveys were deployed. There were 86 responses; 62 respondents were RNs with an assigned CLDS. There were no statistically significant differences in the scores between these 2 groups. The social impact of this project is important to share with nursing and operational leadership as an intervention to reduce RN turnover across healthcare settings, specifically in acute care practice areas. The issues of RN turnover and satisfaction with the practice environment are relevant across organization types and settings.

Many healthcare organizations are investigating the reasons for nurse turnover and seeking ways to retain the nurses they already employ. The primary deliverable of the DNP project was a nurse retention plan. In order to devise the plan, the DNP student conducted a literature review, collected qualitative data from representative nursing staff members, and assembled an expert panel of senior leaders to secure permissions to implement the nurse retention plan. The purpose of the project was to develop a nurse retention plan for the emergency department and propose it to an expert panel of nursing administration at the project site. The concepts of nursing satisfaction, theory of human capital, nurse dissatisfaction, and nurse turnover were used for this DNP project. At the practicum site, 36.7% of the emergency department nurses (n =22) participated in the DNP student's focus groups. Coding was used and the themes that emerged from the focus groups were that nurses feel stuck and want the opportunity to advance, there was a lack of communication and pay was a determining factor regarding whether nurses plan to stay employed in the project site's emergency department. Recommendations to decrease voluntary nursing turnover included more flexible scheduling, forming a scheduling committee in the department, providing for more nursing autonomy, and the sharing of emergency department staff throughout the health system all of which were accepted by the expert panel for evaluation and implementation. This project contributes to positive social change, as nurse satisfaction and decreased nursing turnover has been linked to increased patient satisfaction and better patient outcomes.

Nurses' job satisfaction affects work performance at the point of care in hospitals. The incoming nurses who are able to receive a comprehensive patient report at shift change are more prepared in comparison to incoming nurses who are not able to receive a comprehensive patient report to provide care that is safe. The purpose of this project, guided by the theory of organization change, was to explore whether the use of a bedside handover process impacts nurses' satisfaction in an adult postoperative orthopedic and spine unit. A post-implementation survey of the bedside handover process was conducted after one month and two months to examine registered nurses' (RN) (n = 50) satisfaction using a 7-question self-designed instrument with a reliability coefficient of 0.80. The Bedside Handover Report Staff Nurses' Satisfaction Survey consisted of 5-item Likert scale with scores ranging from 1 (strongly disagree) to 5 (strongly agree). The survey results found that RNs were satisfied with the bedside handover report process. Matched-pair t tests revealed significant differences between the first and second months after the handover report process was implemented. Specifically, 'Bedside handover report provides time for the incoming RN to verify patient's health issues' (p = .05),' I am satisfied with the handover report process conducted at the patient's bedside' (p = .01), and total score (p = .03) improved from the first to second month. A longitudinal study spanning 6 months to a year is recommended when the project will be implemented in the entire facility. A bedside handover report increases nurse satisfaction because the process allows the nurses to verify and address patient health issues that are essential for positive social change.

No description available.

Nurses believe that more liberal visitation policies will cause greater work overload and decrease the quality of patient care. The purpose of this study was to investigate the effect of a liberal visitation policy on work satisfaction, beliefs, and retention of nurses. In this study, nurses were asked to complete a survey before and after implementation of a more liberal visitation policy. The nurses were surveyed using Stamps (1997) Index of Work Satisfaction and the Boswell Beliefs Inventory. Statistical analyses were conducted to discover nurses level of satisfaction and beliefs related to the new policy. Results indicate that nurses were more dissatisfied with the components of pay, task requirements, and organizational policy six months after the new policy was implemented. Beliefs about the new policy did not change over the six month period. Increased dissatisfaction with work indicates that the policy did have an effect on work satisfaction of nurses.