Three Reasons Precepting Is More Important Than Ever

A successful preceptorship program offers a supportive environment in which nurses of all skill levels can become clinically competent and emotionally adjusted over a condensed time period. According to the American Association of Critical-Care Nurses (AACN), “Preceptorships are designed to ensure competency: the knowledge, attitudes and skills necessary to function in a specific role.” A well-developed preceptorship helps the new nurse successfully enter his/her unit and make sense of hospital and patient care routines while receiving important training and education. A preceptorship helps the new clinician become acculturated to the organization by introducing him/her to social norms and communicating the unwritten rules that inform every organization. A preceptorship also offers three very significant benefits:

1.    Creates a Strong Learning Base.

Research shows that the majority of new graduate nurses are not prepared for clinical rounds when they start their first job. One study finds that only 10 percent of nurse executives feel that new graduate nurses are sufficiently competent to deliver care. (Trepanier, Early, Ulrich & Cherry, 2012) Preceptorships ensure nurses are competent to function in their role by the end of the onboarding process, and also set reassigned and novice nurses on strong learning tracks. Additionally, preceptorships teach new nurses how to turn on their critical thinking skills by taking them through specific clinical decision-making processes. A study in The Journal of Advanced Nursing found that a preceptor’s use of contextual learning stimulated critical thinking in preceptees when it came to organizing and carrying out tasks, and doing intentional, reflective thinking. (Forneris & Peden-McAlpine, 2009) At the same time, nurse preceptors also benefit from the experience and are more likely to improve their own knowledge and job performance through the unique process of assessing, guiding and evaluating preceptees. (Paton & Binding, 2009)

2.    Moves Quality to Front of Mind.

Preceptorships create an opportunity to educate new nurses on important quality initiatives. In a study of 434 nurse graduates, more than one-third of participants stated that they were “poorly” or “very poorly” trained on quality improvement, or had never heard the term. (Kovner, Brewer, Yingrengreung, & Fairchild, 2010) Preceptorships and specific role modeling can influence performance on important quality measures, which ultimately affect hospital reimbursement. Research shows that when given a role model, new nurses are more apt to follow important behaviors, such as proper hand hygiene, which is critical to reducing nosocomial infections. For instance, when critical care fellows and nurse orientees in a children’s hospital were paired with a supervising physician/ preceptor, respectively, who followed strict hand hygiene guidelines, the new clinicians increased their own hand washing practices by an average of 34 percentage points. (Schneider, et al., 2009) To further support this point on a more general level, the AACN’s preceptor training course, “The preceptor challenge…” encourages preceptors to teach new nurses a detailed and systematic approach to prioritizing their clinical responsibilities in order to reduce the chances of causing a fatal error.

3.    Boosts Employee Satisfaction and Retention.

Preceptorships help bond employees to the organization and set the stage for long-term job satisfaction and increased retention rates. (PricewaterhouseCoopers’ Health Research Institute, 2007) New graduate nurses comprise roughly 10 percent of the nurse workforce in acute care settings. (Trepanier, Early, Ulrich & Cherry, 2012). They are vitally important to maintaining staffing levels, especially given the continuing nursing shortage. At the same time, research shows that between 13 percent and 75 percent of new graduate nurses leave their first jobs within one year for a variety of reasons, including the hospital culture and frustration at not being adequately prepared for their clinical role. (Trepanier, Early, Ulrich & Cherry, 2012)

A well-executed preceptorship can make a dramatic difference in turnover rates. For example, hospitals whose nurses participated in a one-year nurse residency program—developed by the University HealthSystem Consortium and the American Association of Colleges of Nursing—experienced a 96 percent retention rate. Reports show that the program is saving hospitals more than $6 million a year in turnover costs for first-year nurses. (Krsek, 2011) On the other hand, having to continually replace brand-new nursing staff due to satisfaction issues can drive up staffing costs very quickly. Every percentage point increase in nurse turnover costs an average hospital about $300,000 annually.

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References

AACN. (2013). AACN: The preceptor challenge: The AACN Preceptor Development Program.

Kovner, C., Brewer, C., Yingrengreung, S., & Fairchild, S. (2010). New nurses’ views of quality improvement education. The Joint Commission Journal on Quality and Patient Safety, (36)1, 29-35.

Krsek, C. (2011). Investing in nursing retention is a smart move in today’s economy. American Nurse Today, (6)4.

Paton, B., & Binding, L. (2009). Keeping the center of nursing alive: A framework for preceptor discernment and accountability. The Journal of Continuing Education in Nursing, (40)3, 115-120.

PricewaterhouseCoopers’ Health Research Institute. (2007). What works: Healing the healthcare staffing shortage. Accessed August 2013: http://www.pwc.com/us/en/healthcare/publications/what-works-healing-the-healthcare-staffing-shortage.jhtml.

Schneider, J. et al. (2009). Hand hygiene adherence is influenced by the behavior of role models. Pediatric Care Medicine, (10)3, 360-363.

Trepanier, S., Early, S., Ulrich, B., & Cherry, B. (2012). New graduate nurse residency program: A cost-benefit analysis based on turnover and contract labor usage. Nursing Economics, (30)4, 207-214.