Comprehensive Orientation Program for new join nurses in Surgical Department

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Authors (including presenting author) :
Li MC (1), Lau SY(1), Lee MF(1), Lee SM(1), Wong KY(1), Yu PL(1), Wu KM(1), Cheng LS(1), Yung HC(1)
Affiliation :
(1) United Christian Hospital
Introduction :
According to the workforce status of Surgical Department, over 30% of nursing staff are newly joined to department every year (1st and 2nd rotation). Nurses with insufficient knowledge and clinical skills, together with unfamiliar working environment, would affect their clinical decision, eventually patient safety would be at risk. Therefore, a comprehensive program was organized to enhance their competencies and consolidation their clinical skills in handling surgical patients. The program also facilitates new joined nurse smooth transition and integration into work duties.
Objectives :
 To equip new join nurses with professional practice skills to deliver safe and quality care through clinical knowledge and skills teaching session, hands on training and stimulation training  Increase the sense of belongs  To build up the knowledge and skills to cope with daily operation in ward environment  Provide knowledge in surgical related care  To develop the awareness of preceptee and enhance the competency on delivering care in high risk nursing procedure
Methodology :
For 1st year preceptee, 4 days structural orientation program was held in 3Q (3 days) and 4Q (1 days) 2017. For 2nd year preceptee, 2 days modified orientation program was held in 4Q 2017. 14 experienced nurses (Including 1 DOM, 4 WMs, 6 NOs/APNs and 3 RNs) were invited to conduct 26 lectures. The training theme composed 4 parts: sense of belongs, nursing assessment and care, quality and safety care and critical care. 3 hours hands on practice with several clinical audits were conducted during the program. Also, 3 hours stimulation training with specialty-related scenarios was designed to consolidate their clinical skill at the last day. A booklet of quick guide for preceptee was designed which included the contents of protocol and guideline related to surgical care, summary of booking procedure and patient preparation for common surgical intervention and specific care for surgical patients. A pre and post-test questionnaire was designed to evaluate the effectiveness and feasibility of the program. And, an evaluation form was also designed to collect the feedback from participants and mentors.
Result & Outcome :
Response rate of the questionnaire was 96% (mentors) and 100% (Mentees). Respondents agreed that the program achieved its stated objectives and the mean score was 3.05 (mentors) and 3.32 (mentee) (Max score was 4). They also agreed that the program is useful (Mean score was 3.09 for mentors and 3.48 for mentees). 92% of preceptees agree and strongly agreed that the program strengthens their confidence in handling daily operation at work. Preceptees feel learn most topics related to pain management/ PCA / PCEA care, Stoma/drain/wound care, pre and post operation care, common procedure for different investigation and procedure, common procedure and practice in surgical department, nursing care and knowledge for high risk procedure. However, respondents suggested longer duration for the program. And, they also suggested more practical hour and scenario based content. In summary, the organizer should pay more attention to the following key elements for better training outcome. - Interactive scenario-based contents related to current nursing care. - More practical hour for demonstrate and return demonstrate the skill of nursing care. - Well organization of the program with ongoing evaluation.

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