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ATI, graduate nurses, hospital administration, NCLEX



  1. Wray, Karen MSN, RN, BC
  2. Whitehead, Tanya PhD
  3. Setter, Robyn MS, RN, BC
  4. Treas, Leslie MS, RN


This article describes outcomes from the first year of a hospital orientation program for graduate nurses that was expanded to systematize and enrich preparation of graduate nurses for success on the NCLEX-RN licensure examination. The study protocol provided the Assessment Technologies Institute predictor examination to assess risk for licensure examination failure, review materials, and a meeting with an education specialist to identify and prioritize study needs. Those at highest risk for failure were also provided an in-depth written study plan and ongoing follow-up and support until the licensure examination was taken. The study sample consisted of 90 graduate nurses who were hired from May through August of 2005 at the University of Kansas Hospital. The pass rate for participants was 86.7% on the first attempt in year 1 of the program. At-risk graduates who reported that the predictor results impacted their study habits and followed the study recommendations were more likely to pass the licensure examination. Graduate nurses reported a high level of satisfaction with the support provided. Specific challenges faced by hospital nurse administrators in recruitment and retention and return on investment over a 3-year improvement plan are described.