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The Pursuit of Nursing Excellence Through Consistent, Standardized Training and Orientation Practices

September 26, 2023
September 26, 2023

This blog is taken from a recent HealthStream webinar entitled “The Pursuit of Nursing Excellence Through Consistent, Standardized Training and Orientation Practices.” The webinar was moderated by HealthStream’s Beth Pfeifer, Senior Product Marketing Manager and featured Julie Miller, BSN, RN, CCRN-K, Clinical Practice Specialist, American Association of Critical-Care Nurses and Sara Grieshop, MHI, BSN, RN, Clinical Practice Specialist, American Association of Critical-Care Nurses.


Nurses Rising Together

Miller began by sharing the American Association of Critical-Care Nurses’ (AACN) theme for the year “Rising Together.” She went on to say “as healthcare continues to emerge from the pandemic, the time is right to evaluate current practices, take control of our practice, create change, and improve ourselves, and through that improve each other and perhaps even our work environments.”

Miller reflected on where nursing is at the moment - , nursing shortages, extraordinary levels of turnover and increasing levels of burnout are the big headlines. However, Miller also pointed out the widening experience versus complexity gap. Nurses leaving the profession in record numbers has left hospitals with less-experienced nurses even as the patients that they are caring for are presenting with more complex needs.

Creating competent, confident nurses is more essential than ever. Standardized training and orientation practices can help instill a sense of excellence among the nursing workforce, but how do health educators accomplish that?


Matching Learner Need to Orientation Content

AACN’s Essentials of Critical Care Orientation (ECCO) helps leaders match learner needs to specific orientation content. There are two tracks: the ICU track which includes 75.45 CE hours, 18 modules and a total of 72 assignments, and the PCU track which includes 67.72 CE hours, 17 modules and 68 assignments. The modular nature of the program means that it can be customized to the unique needs of each learner and that individual modules and the assignments within them can be made available to nurses transferring from other critical care units as well.

ECCO uses a “try then learn” approach in which a learner is presented with a question to answer or a case study to evaluate and then asked a question. After answering, the learner is presented with information to help them understand why their answer is right or wrong along with additional content on the topic. This approach mimics what actually happens on a nursing unit.

AACN recommends that ECCO be implemented using a blended learning approach. The approach can include:

  • Preceptor-guided bedside patient management
  • High or low fidelity simulations
  • Flipped classroom activities
  • Peer-to-peer sharing
  • Case studies
  • Reporting on patient care experiences


The Preceptor Challenge

The industry’s staffing challenges have resulted in a reduced number of preceptors. Preceptors are now taking on two or three orientees at the same time. This means that supporting preceptors is more important than ever. AACN’s Preceptor Challenge has content that will help preceptors better understand their roles in the orientation process. The program helps preceptors with communication skills and provides support for preceptors in the development of learning plans. It can also help ensure that preceptors have a plan to help their orientees develop their critical thinking skills, and also build their own feedback and evaluation skills.


Competence Framework

AACN’s newly-developed Competence Framework helps preceptors answer the most common of questions for preceptors – when is a new nurse ready to transition off of orientation? Grieshop shared that answering that question needs to go beyond a checklist and answer bigger questions about who they are as a provider and whether or not they are seeing patients in a holistic way.

AACN uses a comprehensive approach based on their Synergy Model for Patient Care – a conceptual framework that aligns patient needs with nurse competencies.  It features documentation tools that guide preceptors on how to evaluate critical thinking prioritization as opposed to simply checking off skills from a checklist.