A comprehensive nurse preceptor program consists of structures and processes that are tied to two types of outcomes. They are structure/process outcomes (sometimes called productivity measurements) and comprehensive program outcomes, which are the bigger outcomes that rely on accomplishing the smaller structure and process outcomes.
There are no specific or prescriptive steps for developing a comprehensive program. Every organization will need to look at its culture, resources, and unique needs to determine the exact steps and content of its program. However, some universal guidelines and steps are helpful to consider when building a program from infancy. I have outlined the basic steps you might want to consider when building a comprehensive nurse preceptor program using the Magnet® language of “Structures, Process, and Outcomes” to define and explain the components of program development. If this language is not familiar to you, a great resource to help you understand how these elements fit within program development is Feel the Pull: Creating a Culture of Nursing Excellence by Gen Guanci, Med, RN-BC, CCRN.
Identify executive sponsors.
Establish who has the decision-making authority to support a system-wide initiative, as well as the ability to delegate responsibility and authority to those who will be carrying out program actions. Initiate their sponsorship as an initial step in program development. Negotiate and articulate their expectations of the program and your expectations of their role in supporting the program. Establish how this group or person will collaborate and provide oversight for a council or committee responsible for identifying, developing, and implementing program processes.
Establish an oversight council or committee.
This will be the group that will identify program needs, develop interventions, and delegate/communicate the work (processes) of the program over time, with input from the point-of-care preceptors, staff, or from whomever else the council/committee feels it is important to get input.
Draft a preceptor policy.
A starting point for the group will be developing a comprehensive preceptor policy. The policy should articulate what items everyone must adhere to and what components may be left up to individual units to decide/implement so as to customize the policy to their unique needs. For example, a policy might state, “All preceptors will be given the time to assess, teach, and evaluate their preceptees when they are not taking care of patients.” The criterion is clear; however, how each unit decides to do this may differ. For instance, one unit may decide to use their charge nurses to watch the preceptor’s patient-care assignment for 20 minutes while the preceptor and preceptee go off the unit to take care of non-clinical needs. Another unit may decide to build it into their overtime and let the preceptor and preceptee come in 15 minutes early. What is measured during program evaluation is whether time was given to teach. The point here is to be clear and specific, but not so prescriptive that units, due to their work environments, could not possibly comply.
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