Date of Conferral



Doctor of Nursing Practice (DNP)


Health Services


Sue Bell


Competency-based nurse orientation programs focus on the new nursing graduate and experienced nurse employees' ability to perform skills necessary in a new work setting. The purpose of this project was to develop a learner-focused and competency-based orientation program for new nursing employees at a large urban hospital to enhance patient safety and nurse retention. The Johns Hopkins nursing evidence-based practice model and guideline were used in the selection of articles with higher levels of evidence and research quality for the critical appraisal of literature in support of the program development. The best practices for nursing orientation content and delivery for positive effects on hospital finances, nurse turnover rates, and patient safety were the focus of the literature review. Benner's model of 5 levels of skill development was the theoretical framework for advancing skills of nurses who enter the orientation program with different expertise and skill sets. Nurse orientation materials and processes, comprising a collaborative team approach to orientation and a guideline for preceptor selection, were developed as the essential components for successful orientation at the project hospital. A nursing orientation based on the evidence may provide an infrastructure and operational process for the organization in developing the competencies of all levels of nurses, including experienced nurses transitioning to new units or duties. The social change resulting from the project will be a supportive and seamless transition of nurses into the new practice role and work environment. When implemented, this project is anticipated to increase nurse satisfaction, improve quality of health care delivery, decrease anxiety related to the new nursing role, and improve collegiality among all levels of nurses.