1

Retaining Novice Nurses In A Healthcare Organization

Students Name

Institutional Affiliation

Course Name and Number

Professor Name

Assignment Due Date

 2

Retaining Novice Nurses In A Healthcare Organization

Problem/Purpose

Health care of the highest possible standard and safety that is accessible to all Chinese people is a
central goal of the Chinese health care system. Sufficient and efficient personnel is essential for the
provision of care to succeed. Retaining a sufficient number of freshly graduated and qualified employees
is now a vital goal to satisfy current and future healthcare needs as a result of the ever-evolving nature
of healthcare systems and the demographics of their patients. The nursing profession employs more
people than any other in the healthcare industry. Improving patient outcomes and ensuring the
longevity of the nursing workforce depend on retaining nurses in their positions for longer and reducing
the rate at which they leave the field. The study's overarching goal is to aid in the retention of both
‘early career registered nurses’ ECRNs and new nursing graduates by detailing the realities of the early
stages of their careers and the types of resources they need to thrive.

Review of the literature

Internships, residencies, orientation, preceptorships, and mentoring programs are just a few of the
many methods discussed as alternatives to ease the transition from student to nurse and improve the
experience for new nurses (Edwards et al., 2015). Evidence suggests that preceptorship and mentorship
programs improve new nurses' sense of competence, self-confidence, critical thinking, work satisfaction,
and even their stress and anxiety levels (Edwards et al., 2015; Irwin et al., 2018). The success of such
initiatives depends on factors including the training and enthusiasm of their preceptors, the quality of
resources available to them, and the accuracy of the assessments used to evaluate their progress (Irwin
et al., 2018). Studies have shown that program participation may decrease turnover by an average of
11% in preceptorships and 12% in mentoring relationships (Brook et al., 2019). While the execution of
such programs has been studied in some depth, the trend in turnover rates of newly-graduated nurses
has not been thoroughly addressed because of the wide variety in program design and structure (Brook
et al., 2019).

When a whole, the data gathered in this evaluation of the literature is very helpful in demonstrating the
value of preceptorship and mentoring programs for new nurses as they enter the workforce. More study
is needed to evaluate the program's long-term efficacy and the trend in turnover rates once it has been
implemented. The review also highlights the need for standardized program design and structure to
facilitate future replication and improvement of similar initiatives.

Research question/hypothesis

Within three years of starting work in China, what is the turnover rate of new graduate nurses?

How much lower is the turnover rate with a one-on-one mentoring program compared to a basic
preceptorship?

Sample

A tertiary general hospital in the Chinese city of Hangzhou, Zhejiang Province, was the site of a non-
randomized controlled experiment research that lasted for three years. Beginning in August 2013 and
 3

continuing through August 2014, the hospital had a graduate nursing workforce. To work at this facility,
applicants had to have a bachelor's degree in nursing and have passed the NCLEX-RN. Expert RNs were
not included in this research. Students who graduated in August 2013 participated in a standard
preceptorship, whereas those who graduated in 2014 participated in a tailored mentoring program.
Assigning nurses to groups at random would have been impractical and against ethical guidelines for this
study. It was common knowledge that nurses might benefit from formal mentoring programs. By
comparing the groups at different times, any possible contamination was avoided.

Research Design

After a three-week orientation, new graduate nurses were assigned to a unit. All control nurses had one
preceptor. Registered nurses received training in professional competency, education, communication,
collaboration, and management. New graduate nurses worked under a preceptor until they registered,
were examined by a nurse educator, and passed the Evaluation of the Ability to Work Independently
examination. New nurses register in December, and their preceptorship lasts four to six months.
Preceptors educate, supervise, and test proficiency at bedside.

Head nurses suggested one mentor for each experimental nurse. Even though the mentee and graduate
were independent, the mentoring relationship lasted a year. Mentoring programs focused on
instruction, sponsorship, encouragement, counseling, and companionship (AndersonandShannon,1988).
Mentors encourage mentees emotionally and socially and set great examples. Each new nurse gets a
customized professional development plan based on her abilities and experiences. These experienced
nurses were natural mentors as preceptors. These nurses took a 4-hour mentorship training to help
execute the program. Mentors met regularly with the mentoring department to discuss their goals.

Threats to external/internal validity

PASS15.0 calculated the sample size for log-rank testing turnover rate disparities. The hospital's annual
turnover rate of new nurses predicted a 30% three-year turnover rate for the control group and 15% for
the experimental group. Power was 0.80 and Cronbach's alpha 0.05. Each group outflanked 1%. A two-
sided hypothesis requires 120 people per group.

Methodology

In this study, researchers examined hospital nurse turnover. When the nurses left or the study ended,
the observation period terminated. Employment information included hometown, unit, and internship
hospital. The nursing and HR divisions updated each nurse's electronic file and recorded the data in an
Excel sheet. The annual turnover rate was computed by dividing the number of nurses who quit in a year
by the total number of nurses at the start. For three years, the study calculated the turnover rate for
nurses.

The level in the evidence hierarchy

This study meets level III reliability and validity requirements. Non-randomized research provide third-
level evidence. This study examined the attrition rates of freshly graduating nurses in a Hangzhou
tertiary general hospital's conventional preceptorship program with a customized mentorship program.
PASS15.0's sample size was sufficient with power of 0.80 and Cronbach's alpha of 0.05. The researchers
averaged the nurses' annual turnover rate over three years. This non-randomized study can show if
 4

mentoring programs retain new grad nurses. More randomized controlled research is needed to confirm
these findings and establish causality. Descriptive observational studies like this one are typically ranked
low in the strength of the evidence presented.

Instruments

This study recorded nurse turnover statistics using Excel sheets and electronic files. Nurses' hometowns,
units, internship hospitals, and statuses were provided. Nursing and HR updated and recorded each
nurse's electronic file. The annual turnover rate was obtained by dividing the number of nurses who quit
by the total number at the start of the year. Over three years, this data calculated nurse turnover.
PASS15.0 and a two-sided hypothesis determined the sample size.

Legal/ethical issues handling

Managing the case study "Retaining Novice Nurses in a Healthcare Organization" poses complex legal
and ethical issues. Human subject ethics require individuals to consent after obtaining all study
information. Privacy, discretion, objectivity in data analysis, precision in results reporting, and legal
compliance should be prioritized. The study must respect all healthcare, research, and data protection
laws. The General Data Protection Regulation requires participants' data to be protected. Addressing all
legal and ethical issues is essential to ensure the study is conducted ethically.

Data analysis

This study compared a mentorship program to a preceptorship program in terms of their ability to keep
new nurses from leaving their positions. Age, sex, place of residence, and employer information were all
part of the dataset used in the SPSS 22.0 analysis. Propensity score matching was utilized to account for
confounding variables that may have affected the turnover rate. Factors that increased the likelihood of
employee turnover were examined using a survival analysis, with results presented as hazard ratios, 95%
confidence intervals, and p-values. In addition, we ran a Cox proportional hazard regression analysis to
isolate additional factors that may have played a role in the high turnover rate we observed. As a whole,
the turnover rate was significantly lower in the mentorship group than in the preceptorship group.
When comparing the two groups' demographics before and after the matching process, however, there
was little difference.

Conclusions/recommendations

The study concluded that mentorship programs can help healthcare organizations retain inexperienced
nurses. A regular preceptorship program and a customized mentorship program were evaluated for
turnover rates of new graduate nurses. The mentorship program reduced turnover by 15% compared to
the control group's expected 30%. The study emphasizes the necessity for uniform program design and
structure to replicate and improve similar projects. The program's long-term efficacy and turnover rates
need further study. Mentorship programs help inexperienced nurses transition from student to
professional.

Implications for EBP

Using the latest and most credible research in an evidence-based practice (EBP) framework improves
clinical decision-making and patient outcomes. EBP has been gaining ground in healthcare to ensure
 5

high-quality care, and better patient outcomes. EBP can prevent new nurses attrition rate, as evident in
this case study.

Evidence-based practice (EBP) could be used to identify new nurses' turnover issues and find remedies.
Workplace stress and burnout can be measured, as can the incidence of a lack of mentorship and
support and the effectiveness of poor orientation and training programs. This information might be
utilized to implement evidence-based therapies in the organization, such as ongoing training and
mentorship programs, workload and scheduling changes, and an extensive orientation program for new
hires. EBP can also assess the effectiveness of these strategies. These data could be used to track and
compare new nurses' satisfaction and turnover rates. Such data would show whether the programs have
retained new nurses and improved their workplace comfort.

In conclusion, using evidence-based practice to solve healthcare issues like nurse retention is a
systematic and planned approach. EBP can improve patient outcomes and new nurse satisfaction by
collecting and analyzing data, developing evidence-based treatments, and assessing their effectiveness.