Date of Conferral

2021

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Barbara B. Barrett

Abstract

In the United States, the registered nurse turnover rate was 17.2% in 2018, a 0.4% increase from 2017. The nursing turnover rate at a small out-patient clinic in the northeast United States was 19.1% in 2019 and has not improved to date. The administrator at the out-patient clinic further indicated that the turnover rate has been approximately two nurses per month for the last 6 months and that the facility did not have a formalized nurse orientation program. Nursing orientation is one of the strategies for increasing the confidence levels and retention of newly hired nurses. The purpose of this project was to develop an evidence-based clinical practice guideline to orient newly hired nursing staff in a small outpatient clinic. The project question addressed whether the development of an evidence-based clinical practice guideline could serve as a resource for orienting new nurses at a small outpatient clinic in the northeast United States. Kurt Lewin's theory of organizational change was used to guide this project by mirroring that change evolves through unfreezing, changing, and refreezing stages. The Appraisal of Guidelines for Research & Evaluation II instrument was also used to guide, develop, and appraise the guideline. An expert guideline three-person review panel provided feedback through email to revise the guideline draft to yield the final guideline. The panel had two nurse educators and one nurse manager. Nurses with experience in orienting and supervising new nurses were selected. The panel shared their plan to recommend that clinic administrators incorporate the guideline. This clinical practice guideline has the potential to increase the clinical practice skills, critical thinking skills, interpersonal relationships, and technical skills of newly hired nurses, which can positively impact social change.

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