Date of Graduation

Spring 5-18-2023

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions




Executive Leader DNP

First Advisor

Dr. Juli Maxworthy

Second Advisor

Dr. Nicholas Webb



Purpose: Identify and adapt the best evidence for nurse manager orientation and onboarding programs into practice. Assess the program's impact on job satisfaction and retention of new Nurse Managers (NMs) and Assistant Nurse Managers (ANMs).

Background: Constant turnover of ANMs and NMs within local and regional facilities is expensive and negatively impacts nursing leaders' work environment, job satisfaction, and patient outcomes.

Local Problem: The lack of formal orientation and onboarding at the focus facility impacts the retention and job satisfaction of NMs. The sunsetting of a regional hub model of new NM orientation and onboarding led to a just-in-time model that was not developing NM competence or promoting job satisfaction and contributed to extensive ANM/NM turnover.

Methods: CINHAL and PubMed were reviewed and identified seventeen studies discussing nurse manager orientation onboarding, job satisfaction, and retention; single research, systematic reviews, and a meta-analysis were included and limited to 2008-2023 publications and English-only articles, inclusive of reverse reference reviews.

Interventions: Six key themes were identified from these studies: (a) the use of multi-modal interventions to impart knowledge, (b) organizational factors impacting NM effectiveness, (c) mentoring and coaching, (d) individual traits and characteristics, and (e) job satisfaction and retention, and (f) the impacts to organizations and patients.

Results: Pre- and post-interventional surveys using Qualtrics software were analyzed and evaluated for trends to demonstrate the impact of a structured, evidence-based orientation

program on NM job satisfaction and retention. Outputs generated quantitative statistical outcomes using SPSS software: a paired t-test from pre-and post-data sets.

Conclusions: In the targeted hospital, a quality intervention focused on improving new nurse manager orientation and onboarding demonstrated improvements in NM perceived competency and reductions in travelers on assignment.

Included in

Nursing Commons