Paper
Thursday, July 14, 2005
This presentation is part of : A Scientific Approach to Educational Assessment: Using Computerized Testing to Measure Learning Outcomes in Nursing
Predicting Employment Success of New RNs in Acute Care Settings
Peg Reiter, MS, RN-C, St. Luke's Episcopal Hospital, Houston, TX, USA, Ainslie Nibert, RN, PhD, Health Education Systems, Inc. (HESI), Houston, TX, USA, and Anne Young, EdD, RN, College of Nursing, Texas Woman's University, Houston, TX, USA.

Objective: To describe relationships between predictors of employment success for new graduates in adult acute care settings. This study expands a pilot study of new RNs employed in critical care. The Health Education Systems Inc. (HESI) Exit Exam (E2) was evaluated for usefulness in predicting NCLEX-RN success and achievement of clinical performance goals assessed throughout the first year of employment.

Design: Descriptive, correlational design comparing employment success indicators.

Population, Sample, Setting, Years: 80 newly-licensed RNs employed in adult medical/surgical and critical care staff nurse units at a large hospital in southwestern USA. Orientation began within three months of graduation beginning June 1999 to June 2003.

Concept or Variables Studied Together: E2, competency assessment exam scores, clinical performance evaluation scores, and NCLEX-RN outcomes.

Method: Relationships among E2 scores, NCLEX-RN outcomes, and clinical performance evaluations were studied, and the E2's predictive accuracy with NCLEX-RN success was calculated. Predictors of orientation goal achievement were compared for RNs employed in adult medical/surgical units and RNs employed in critical care units. Significant correlations (p < .05) were found among E2 and initial competency assessment scores, and between ninety-day performance evaluation scores and retention rates at one year.

Findings: Unlike the critical care RNs, who predominantly scored above the minimally-acceptable level of 85 on E2 on a first attempt, 25% of those in adult medical/surgical units scored below 85, and 30% had HESI scores below 88. Findings indicated the E2 was a highly accurate predictor of NCLEX-RN success for new graduates employed in entry-level RN positions in two different clinical areas within the same hospital.

Conclusions: Results confirmed the E2's accuracy in predicting employment success for newly-graduated nurses within their first year in critical care or adult medical/surgical nursing practice.

Implications: The E2 was useful in assessing initial RN competency in units experiencing high staff turnover.