Date of Conferral

2021

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Amelia Nichols

Abstract

Due to a nationwide shortage of neonatal nurse practitioners (NNPs), chronic short staffing shifted priority away from hiring novice and newly graduated NNPs in favor of recruiting experienced NNPs and contracting temporary locum tenens to expeditiously fill gaps in NNP staffing. Provision of formal orientation and an infrastructure that supported successful role transition became devalued and inconsistency in clinical approach and decision-making amongst providers raised concerns for patient safety. The goal of this Doctor of Nursing Practice (DNP) project was to develop a formal orientation program for NNPs in a Level III Neonatal Intensive Care Unit. The purpose was to provide sound evidence-based infrastructure for specialty-specific training of newly hired NNPs with emphasis on measures to support newly graduated and novice NNPs into the role. Program development was guided by recommendations of regulatory bodies surrounding validation of competency of nurse practitioners and the standards set forth by the National Association of Neonatal Nurse Practitioners (NANNP). Support of role transition, a distinguishing feature of the orientation program, was accomplished using Benner’s from novice to expert theory to underpin the delineated path that guided role development along this continuum and use of the Nurse Practitioner Role Transition Scale to measure outcome. Positive social change was demonstrated in the merit of formal orientation as a conduit to improved patient safety and health care reliability by ensuring NNPs practice at the highest level of competency and in the program’s ability to widen opportunities for those new to the field of advanced practice neonatal nursing and in cultivating a full-time dedicated team of NNPs who were more likely to be retained.

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