The Impact of a Clinical Ladder Program: A Quality Improvement Initiative

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Date

2025-05

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The Ohio State University

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Abstract

Nurse clinical ladder programs (CLP) serve as structured professional development pathways. Evidence suggests the use of CLPs may improve retention and recruitment efforts and perpetuate organization leadership’s efforts to develop nurse professionals. The intent of this quality improvement initiative was to employ evidence to redevelop and implement a self-sustaining CLP, incorporating organization culture and preferences, and to evaluate the impact on program participation, staff satisfaction, and workplace engagement. Beginning with an evidence-based rewrite of the program, the new CLP was incrementally rolled out for 11 weeks among chair and co-chairs of the organization’s Shared Leadership Council. Prior to implementation, CLP enrollment was less than 1%. After implementation, program participation rose to 44% among the target population. The Utrecht Work Engagement Scale – 9 (UWES-9) and Minnesota Satisfaction Questionnaire Short Form (MSQ) measured impact to work engagement and staff satisfaction (n = 3). Results were not consistent with improved outcomes and were not considered meaningful due to limited sample size and evaluation period. A longer implementation period and assessment of nursing staff’s perception is needed to illustrate a greater impact on the effectiveness of an evidence-based CLP at the organization.

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clinical ladder program, quality improvement, professional development, job satisfaction, workplace engagement

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