Scope it Out: A Competency-Based Orientation Bundle for Endoscopy RNs

Purpose: A standardized orientation process, or orientation bundle, is needed to engage new employees and make their transition period most meaningful. Evidence supports that following a competency-based orientation (CBO) and focusing on the employee's introduction to the clinic can lead to increased nurse retention and confidence. Literature suggests that including feedback from nurse mentorship can lead to increased productivity, better safety records, and higher patient satisfaction scores. As addressed in Symmerman et al., (2017), it was important to create an orientation bundle tailored to fit specific needs of a newly opened endoscopy clinic.

Description: In retrospect of previous onboarding orientation experiences, a small group of endoscopy nurses organized and worked on the development of an orientation bundle model for new nurses at the local endoscopy unit. As a result, the orientation bundle was created and implemented into practice in May 2023. Research was also conducted to assess creative and effective ideas to help redesign the current orientation process. Prior to project implementation, endoscopy nurses previously were given a general ambulatory care nursing orientation packet to complete with a preceptor. The new orientation forms include an orientation checklist, an interactive scavenger hunt, physician feedback, and a roadmap that guides new hires from the beginning of orientation to completion. All materials were created using an integrative approach. The bundle was created with the intent to limit the required amount of necessary paperwork material.

Evaluation/outcome: The new orientation bundle is currently being used and evaluated to guide new onboarding nurses and has yielded positive results such as increased confidence and readiness to practice independently. Prior to starting this project, staff were dissatisfied with their orientation onboarding process. After using a multidisciplinary approach to gather physician feedback and re-developing the orientation materials, two nurses were satisfied with their onboarding process.

Since its original implementation, the orientation bundle has been introduced at one additional endoscopy clinic. Upon completion of a new nurses’ journey through the orientation roadmap, orientees from both sites received a post-survey. The survey consisted of nine evaluative questions on a Likert scale from 1-5, four open-ended questions, and two questions assessing education level and nursing experience. Two RNs from the original implementation site completed the survey, and three nurses from the shared site completed surveys after their orientation. 100% of these nurses felt prepared and ready to begin safely on the unit. Survey results from the two clinic sites revealed that new hires can experience similar or varied orientation experiences. Orientation bundles oftentimes have to be changed to meet unit-specific needs.