Date of Graduation

Summer 8-1-2020

Document Type


Degree Name

Master of Science in Nursing (MSN)


School of Nursing and Health Professions

First Advisor

Liesel Buchner


Problem: Staff nurse retention is an ongoing problem for this intensive care unit (ICU). Through exit interviews from staff who left, inadequate onboarding and education made them feel unprepared for their job and not part of the team. The preceptors on the unit have never been trained on the roles and responsibilities of being a preceptor. The current onboarding process consists of pairing new hires with a preceptor who either happens to be willing to do it that day or someone who has been there the longest. There is no consistency or personalizing the orientation information to the new hire. Teaching preceptors on the roles, responsibilities, and different teaching methods would help to provide consistency to the process of orientation, and preceptors would be able to personalize the education for the student with the new teaching methods learned. Consistent onboarding helps new hires feel supported and confident by having preceptors who know their role and can adapt their teaching method to each new hire’s learning style.

Context: This ICU has 75 staff nurses split among three shifts. Critical care experience can range from one year to 25 years. This ICU has recently encountered major vacancies, amounting to seven full-time equivalents needing to be filled. The skill mix due to vacancies can vary from shift to shift. Last year, a new critical care training program was implemented for six nurses, five of whom left the unit after finishing the training for various reasons. None of the nurses who were precepting had any experience in precepting or were formally trained as a preceptor.

Measures: A family of measures was developed for the implementation of this project. The overall outcome measure is to train all selected preceptors. The process measures for the project are the pre- and post-course surveys evaluating the course effectiveness. Weekly debriefing huddles would measure the effectiveness of the preceptor to implement what they learned in the class. The balancing measure for this would be the weekly debriefings, and any negative findings would guide the orientation process.

Results: Prior to this project, there were no preceptors trained on the roles and responsibilities of being a preceptor. Due to the COVID-19 pandemic, we were only able to facilitate training two staff nurses. The post-course surveys showed improvement in knowledge of preceptor expectations.

Conclusions: Common themes in exit interviews, sporadic spikes in harm events, no formal preceptor roles and responsibilities, and decreasing retention rates, identified a need for consistent and formal education. Due to the COVID-19 pandemic, the interventions to test and to address these issues will have to be postponed until alternative ways are identified to conduct a preceptor educational class. Based on other process improvement projects in other facilities, we expect that once these interventions are carried out, we should see a decrease in harm events and an increase in retention.