Progressive care orientation: Incorporating a program that supports transition to practice

Abstract

Objective: Progressive care units (PCUs), also sometimes called intermediate care units, improve the utilization of beds within intensive care units while adjusting the workload of the nurse.  PCUs encompass a scope of care between the critically ill patient and the acute care patient. Owing to the advanced skills set needed, nurses with limited experience in this setting may benefit from an orientation course in addition to on-the-job training. The purpose of this project was to develop and evaluate an orientation program for nurses working in progressive care settings at a multi-site hospital system.

Methods: Kolb’s experiential learning theory and adult learning theory were used as a framework to plan and design a 2-day instructional program that addressed the cognitive, psychomotor, and affective aspects of learning needs.

Results: A total of 244 participants completed the 2-day program. The teaching strategies were shown to be effective, as indicated by survey results reporting a mean score of 4.36 on a 1-5 Likert scale (with a score of 1 indicating the presenter did not clearly articulate the subject and 5 indicating that the presenter clearly articulated the subject). The participants stated that they intended to make changes in practice and identified changes to improve the program (e.g., inclusion of high-fidelity manikins, patient-controlled anesthesia).

Conclusions: Incorporating a specialized training program for newly licensed nurses and nurses transitioning to the PCU with less than 2 years’ experience in this setting may improve the nurse’s confidence and performance of patient care skills in this highly acute environment.