Efficient strategies for testing large numbers of patients must be developed to limit the spread of COVID-19. We demonstrate that our drive-through model is an efficient method of testing large numbers of patients during a pandemic. In the drive-through, cost per patient and PPE use were significantly less than three brick and mortar clinics providing testing. We provide an example of effective nurse practitioner leadership in a drive-through testing site and demonstrate that NPs are ideally suited to provide leadership given their adaptability, ability to function in a variety of settings and extensive experience with care coordination and logistics.

New graduate nurses (NGNs) in the intensive care unit have trouble learning standards of care essential to patient safety and outcomes. Two checklists were developed to help NGNs learn to consistently practice to the unit standards of care during orientation. NGNs were more consistently able to practice to the standards of care compared to a control group that had not utilized the checklists. Preceptors noticed modest improvements in the abilities of NGNs to practice to the standards of care. It is essential that nursing care be held to the highest standard to maintain patient safety and achieve positive outcomes. This includes regular assessment and care of intravenous (IV) drips and IV access, vital signs monitoring and emergency equipment, invasive devices, and hemodynamic monitoring systems as well as preparation for shift change to ensure a smooth handoff. In the transplant/ surgical intensive care unit (ICU) in a large academic medical center, the new graduate nurses (NGNs) are expected to master difficult medical concepts and operate multiple complex devices after 12 weeks of orientation. Based on staff feedback, preceptor evaluation, and direct observation, it became clear that recent cohorts of NGNs were not consistently practicing to the unit standards of care. For example, NGNs would often fail to change expired central line dressings and IV tubing, which would put patients at risk for serious infectious complications. This was observed to be an issue across multiple NGN cohorts, and so it was determined that there was opportunity to reexamine the unit-based NGN orientation program.Discussion with unit leadership, preceptors, and former cohorts of NGNs revealed that although NGNs were trained how to complete the tasks necessary to practice to the unit standard of care, they were not provided with any standardized method with which to reliably remember to complete these tasks. Experienced nurses complete these tasks from memory gained through years of repetition; however, it is not reasonable to expect the same of NGNs being oriented to the ICU environment. RationaleAccording to Patricia Benner's novice to expert theory, NGNs are classified as "novices" and are by nature task-oriented and rely on rules to guide their actions. They lack the ability to prioritize tasks to focus the overall clinical picture of the patient (Benner, 1982). NGNs often become entirely focused on remembering to complete tasks and consequently forget to pay attention to more important external demands, such as subtle changes in vital signs. Their ability to think critically is extremely limited, and they are unable to develop these skills until they master routine tasks (Benner, 1982).The use of checklists in an ICU NGN orientation program is an ideal way to provide a standardized tool for NGNs to help them learn to practice to the standards of care. The tasks that must be completed to meet these standards, though seemingly mundane, are critical to maintaining patient safety, high-quality care, and patient/family satisfaction. I...