Nurse practitioner orientation is a relatively new but progressive topic and is usually found within the context of APRN models of care, APRN fellowship programs, or departmental orientations within hospital-based organizations. Orientating novice NPs into a hospital-based organization involves transition and are created to integrate the employee within the organization (Meleis, 2010; Meleis, Sawyer, Im, Messias, & Schumacher, 2000). Additionally, orientation is a type of experienced transition that involves finding cohesion within the organization while building clinical proficiency (Bahouth, Blum, et al., 2013; Coble, 2014).
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Transitioning into practice is experienced by all nurse practitioners whether novice or skilled, however it is agreed by several researchers that the transition period of novice NPs tend be more dramatic (Bahouth, Blum, et al., 2013; Brown & Olshansky, 1997; Coble, 2014; Horner, 2017).
In novice nurse practitioners, does a structured nurse practitioner orientation program improve competency outcomes in a 12-month period at the Veteran Affairs North Texas Healthcare System?
Healthcare reform and the Patient Protection and Affordable Care Act (ACA) has led to the evaluation and modifications in health care delivery (Obama, 2016). The objectives of healthcare reform are to provide affordable and quality health care while increasing access to care in the United States (Collins & Saylor, 2018). These objectives have become vastly examined in hospital organizations and nurses will serve as the catalysts to lead in implementing effective solutions (Collins & Saylor, 2018). Nurses are the largest profession within healthcare and because of their adaptability, the nursing profession has the potential to effect a vast amount of necessary changes in the health care system (Institute of Medicine, 2011). There have been numerous studies that have demonstrated the association of nursing and patient outcomes. In 2000, the Institute of Medicine (IOM) reexamined issues of nurse staffing and patient outcomes, thus concluding that health is directly correlated by how well patients are cared for by nurses (Kohn, Corrigan, Donaldson, & Institute of Medicine, 2000). Nurses have the ability to assess strengths and weaknesses within healthcare systems and therefore can provide leadership to improve access, quality, and safety while reducing healthcare costs within organizations (Needleman & Hassmiller, 2009). Furthermore, nurse practitioners (NPs) are the largest advanced practice registered nurses whom are poised to assist with the access to care gaps, coordinating complex care for widespread populations, and serving as primary providers while practicing to their full scope of training and education (Institute of Medicine, 2011). Despite being well matched to serve the needs of Americans, NPs are faced with many challenges (Institute of Medicine, 2011; Kohn et al., 2000). There are more than 248,000 NPs in the U.S., and 49.9% hold hospital privileges (AANP, n.d.). The rapid growth of the hospital-based NP has led to unforeseen challenges,
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