As a nursing professional development (NPD) practitioner assigned to a unit, orientation is a large part of what I do. On an average day, I am responsible for 10 to 15 nursing orientees. This large volume of orientees has made traditional documentation and recordkeeping methods challenging and cumbersome.

Enter Microsoft Teams, which serves as a documentation do-it-all, I’ve utilized it to create a digital orientation binder and a secure, private Teams site for each orientee, resulting in a more seamless process. Read on to learn why I developed this new process and how it works day-to-day.

The Challenges of Traditional Recordkeeping

Orientation can be a stressful time for everyone. As a cardiac unit-based NPD, I facilitate orientation for a host of new graduate nurses, experienced nurses, and nurses new to the cardiac specialty. Documentation of orientation is never an NPD's favorite part of the job. In my organization, it was customary for orientees to be handed a large three-ring binder containing tons of information. This includes, but is not limited to, introduction information to the unit, the unit “scavenger hunt,” a skills checklist, unit-based protocols, commonly used medications, and many more essentials. Nurses on orientation are expected to maintain the binder and use it as not only a resource but a housing unit for required documentation and competencies. 

As the nurses on orientation are completing tasks, skills, and demonstrating requirements are met, expectations are that they have their preceptor check off their documentation. Barriers to this process include lack of time, disorganization, and loss of binder. Biweekly, I sit down with the orientee and their preceptor and complete a “progress note” of how things are going. This includes identifying any challenges and accomplishments and setting a plan for the upcoming two weeks. I collect any completed documentation and then the paperwork journeys through the unit manager, myself, human resource personnel, and on occasion, a form has been at risk of being lost. This documentation process is flawed and can lead to major issues, such as missing documentation, noncompliance with regulatory standards, and a bad situation for when accrediting agencies visit. 

Another challenge of traditional recordkeeping is communication between me and the nurse on orientation, the preceptor(s), the leaders, and any other stakeholders involved. While communication is key to the NPD, I often found myself having to communicate about the same point repeatedly when answering questions such as how the orientee is doing, what are the next milestones, who is the assigned preceptor, what is their schedule, etc. Being responsible for making a new hire’s schedule and plan daily and needing to provide that information verbally without access to the schedule causes delays in their assignment and disruption of my own workflow and plan for the day.

Microsoft Teams Offers an Improved Process

Organization and transparency are the keys to a successful orientation. Because of the challenges described, I worked to create a digital orientation binder and private Teams site using Microsoft Teams. This was then utilized for all orientees and has made the process seamless and efficient.

Figure 1: Welcome instructions

To address the documentation challenges, three tabs are embedded in the digital orientation binder. The first tab (Figure 2) contains resources, including presentations on commonly used phone numbers/codes, videos of procedures, high-volume medications and their intended nursing care, protocols, policies, and information on the general population of patients on the floor. Additionally, technology plays a larger role in meeting learner needs, as various modalities such as videos are embedded. This digital binder makes the information accessible from any computer, whether at home, the nurses’ station, or even in a patient’s room. Documents are downloadable and printable all at the learner’s preference. If there are any education or policy changes or updates, these can be replaced easily instead of having to reprint and distribute new information.

Figure 2: A digital orientation binder homepage

The next tab on the Teams page is the orientation skills checklist (Figure 3). In this new format, the preceptor and orientee have access to a digital checklist that they can fill out during the shift. The skills also have hyperlinks to the corresponding hospital policy and learning skills. This has proven to be great, especially for new graduate nurses. I have witnessed a new graduate nurse go into a patient room and access the hyperlink for properly changing a chest tube in the room with a patient as real-time guidance. This is also helpful because as I check in with the orientees bi-weekly, I can review the checklist to ensure progression. For instance, if my orientee tells me that they took care of the patient-controlled analgesia pump today, I can access their checklist to validate documentation is complete.

Figure 3: The orientation skills checklist

The last tab includes their schedule (Figure 4). This has proved extremely helpful for the management team because they are able to access their schedule to see what week of orientation the orientee is in. It also provides information on whether they are in a class, how many hours they are scheduled to work, and who their preceptor is for the day. There is also a folder where all weekly check-ins are loaded so that all parties have access to see how the orientee is progressing. Once the orientee is done with orientation, all files are downloaded into a PDF format, signed, and uploaded into the orientee’s “cloud” folder and then printed to be placed in a physical file. Previous concerns about compliance when an accreditation agency is on site and requests orientation and competency documentation on an employee are now eased.

Figure 4: An orientee's schedule

To address the communication challenge, the private Teams page is the landing site equipped with resources to enhance communication. First, the stakeholders who have access to bidirectional communication are the orientee, manager, director, and unit educator/NPD practitioner. This allows for a confidential space where the orientee is free to ask questions and everyone can be on the same page. It also eliminates “text fatigue.” This is where I or other members of the leadership team receive non-urgent communication via text message or email outside of work hours. Everyone can visualize all conversations and answer questions, during work time.

Good Feedback on the New Process

This labor of love has made the orientation process seamless. The orientees have voiced being happy with the digital process and expressed it as user-friendly. The unit leaders that I cover enjoy being able to go in and access information on the orientees at any time and communicate with the entire team in one message if need be.

Since beginning this project, I have presented it to the nursing directors of my institution and received stakeholder buy-in. I am now in the process of helping other educators/NPD practitioners with building similar digital binders for their units. In the future, I hope this trial will justify a need for financial resource allocation to purchase a true digital platform for the hospital and use it across our hospital system including satellite campuses. My second hope is that this trial can continue to push forth more digital integration in the orientation process and continue to evolve and keep up with a world that is becoming more electronic each day.