Other Titles
An Innovative Nursing Orientation Program [Poster Title]
Abstract
Background: High turnover rates remain a significant challenge in U.S. healthcare, with hospital turnover rates at 20.7% in 2023, despite a 2% improvement from 2022. Registered nurse (RN) turnover has improved by 4.1%, reaching 18.4%, but is still critical among RNs with less than one year of experience at 34% (Nursing Solution Inc., 2024). The average cost of turnover has increased by 7.5%, reaching $56,300 (Bae, S.H., 2022). Contributing factors include dissatisfaction with care quality, inadequate leadership, poor well-being, staffing shortages, undervaluation, and low salaries (Nightingale Foundation, 2024). At Cook County Health Stroger Hospital, a Comprehensive and Innovative Nursing Orientation Program was implemented in the medical-surgical division to address these challenges, focusing on quality, leadership, clinical competency, well-being, and interprofessional collaboration.
Methods: In 2023 and 2024, each year, there would be 10 new nurses, which was a mix of recent graduates and experienced hires, who voluntarily participated in the program. Participants were divided into small cohorts for a structured orientation that included three weeks of direct training with a nurse manager, followed by an experienced preceptor. Leadership involvement was integrated throughout the training, where nurse leaders provided guidance and feedback, making a significant difference in shaping nursing skills and promoting a culture of excellence. Nurses managed 2-3 patients in their first week, leveraging prior training in policies and charting. The program covered 18 areas, including clinical skills, leadership, quality improvement, patient safety, and emotional intelligence. Training methods included case studies, group discussions, audits, and real-time feedback. Program evaluation was conducted via structured interviews one year post-completion with all 20 nurse participants (cohorts 2023 & 2024) and four nurse managers to assess long-term impact from both frontline and leadership perspectives.
Results:
20% earned promotions as support or charge nurses;
30% planned to earn certifications;
40% implemented their projects and presented at the regional conference;
50% enrolled in advanced nursing programs;
80% expressed leadership aspirations;
100% retention in medical-surgical units, with all participants expressing commitment to the organization.
Notes
References:
1. Nursing Solution Inc. (2024). 2024 NSI National Health Care Retention & RN Staffing Report. NSI_National_Health_Care_Retention_Report.pdf
2. Nightingale Foundation. (2024). Why are Nurses Leaving the Profession? Reasons and Causes for Healthcare Staff Quitting Their Jobs, and What Can Be Done. Why Are Nurses Leaving the Profession? Reasons and Causes for Healthcare Staff Quitting Their Jobs, and What Can Be Done - Nightingale Foundation
3. Bae, S.H. (2022). Noneconomic and economic impacts of nurse turnover in hospitals: A systematic review. International nursing review. 69(3):392-404. doi: 10.1111/inr.12769.
Sigma Membership
Zeta Sigma
Type
Poster
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Translational Research/Evidence-based Practice
Keywords:
Competence, Mentoring and Coaching, Transitional Programs (Education), Employee Orientation, Employee Retention
Recommended Citation
Liu, Linda, "An Innovative and Comprehensive Nursing Orientation Program" (2026). International Nursing Research Congress (INRC). 121.
https://www.sigmarepository.org/inrc/2026/posters_2026/121
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-09-25
An Innovative and Comprehensive Nursing Orientation Program
Toronto, Ontario, Canada
Background: High turnover rates remain a significant challenge in U.S. healthcare, with hospital turnover rates at 20.7% in 2023, despite a 2% improvement from 2022. Registered nurse (RN) turnover has improved by 4.1%, reaching 18.4%, but is still critical among RNs with less than one year of experience at 34% (Nursing Solution Inc., 2024). The average cost of turnover has increased by 7.5%, reaching $56,300 (Bae, S.H., 2022). Contributing factors include dissatisfaction with care quality, inadequate leadership, poor well-being, staffing shortages, undervaluation, and low salaries (Nightingale Foundation, 2024). At Cook County Health Stroger Hospital, a Comprehensive and Innovative Nursing Orientation Program was implemented in the medical-surgical division to address these challenges, focusing on quality, leadership, clinical competency, well-being, and interprofessional collaboration.
Methods: In 2023 and 2024, each year, there would be 10 new nurses, which was a mix of recent graduates and experienced hires, who voluntarily participated in the program. Participants were divided into small cohorts for a structured orientation that included three weeks of direct training with a nurse manager, followed by an experienced preceptor. Leadership involvement was integrated throughout the training, where nurse leaders provided guidance and feedback, making a significant difference in shaping nursing skills and promoting a culture of excellence. Nurses managed 2-3 patients in their first week, leveraging prior training in policies and charting. The program covered 18 areas, including clinical skills, leadership, quality improvement, patient safety, and emotional intelligence. Training methods included case studies, group discussions, audits, and real-time feedback. Program evaluation was conducted via structured interviews one year post-completion with all 20 nurse participants (cohorts 2023 & 2024) and four nurse managers to assess long-term impact from both frontline and leadership perspectives.
Results:
20% earned promotions as support or charge nurses;
30% planned to earn certifications;
40% implemented their projects and presented at the regional conference;
50% enrolled in advanced nursing programs;
80% expressed leadership aspirations;
100% retention in medical-surgical units, with all participants expressing commitment to the organization.
Description
Discover how a leadership-driven nursing orientation program achieved 100% retention. Learn how to use a quality-driven orientation program to transform new hires into empowered, engaged practitioners through standardized training and sustained leadership involvement.