Date of Award

4-29-2024

Document Type

Restricted Access Thesis

Degree Name

Master of Arts in Nursing (MAN)

Department

Nursing

First Advisor

Joyce P. Miller, DNP, RN

Second Advisor

Amy Nelson, Ph.D., RN

Third Advisor

Lisa Sansgaard, MSN, RN, SCRN

Abstract

Ineffective new graduate registered nurse (NG RN) orientation models have grim effects on individuals and health care systems and can result in unsuccessful completion and termination of employment, which is costly and can present safety implications. Joswiak’s Tiered Skills Acquisition Model (TSAM) is an evidence-based practice (EBP) nursing orientation model that utilizes Benner’s Novice to Expert theory as a theoretical foundation. The Tiered Skills Acquisition Model allows NG RNs to progressively advance through orientation by using tiers of skills and nursing competencies with specialty-trained TSAM RN preceptors. This project illustrates how a nursing leader of an acute care unit in the Midwest identified a gap with the traditional ineffective NG RN orientation model, advocated, and was offered system support for the development of a TSAM pilot program guided by change management methodologies. A TSAM pilot group was developed to include RN preceptors, an NG RN, and a TSAM leadership team, including a system project manager, chief nursing officer (CNO), nursing director, nursing educator, and nursing manager. Measures to evaluate success include outcomes related to cost savings, patient safety, and burnout/retention rates. Data collection to measure the success of the pilot utilizes Likert scale pre and post surveys to evaluate the TSAM pilot, NG RN confidence levels, and RN preceptor satisfaction. New graduate registered nurse first-year turnover rates, critical safety events, orientation hours, and number of patient interactions will also demonstrate the desired outcome of the TSAM pilot.

Identifier

SC 11.MAN.2024.Kollman.J

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