Global Collaboration to Improve Patient Outcomes?

While the number of graduates from schools of nursing is increasing, there is a national trend that shows they are leaving the profession at alarming rates. Studies suggest that "supply is not sufficient for demand and, to exacerbate the problem, newly licensed nurses are leaving their first positions at an estimated rate of 35%-61% (Cochran, 2017, p. 53). Another report states that "18% of new graduates will leave their first job within the first year, and 34% will leave within 2 years" (NLN, 2013). This problem could potentially contribute to decreased patient outcomes and increased costs to facilities as they are continuously recruiting and training new nurses. Furthermore, research suggests that the transition to practice is a stressful period, and new graduates who receive support and guidance through nurse-residency programs tend to have higher satisfaction rates, deliver better patient care, and have lower turnover rates. While interventions have been put into place to increase nursing-student capacity, it can be assumed that the effectiveness of maintaining new graduates in practice is lagging.Therefore, the purpose of this project was to evaluate the nurse-residency program in a local, level-two trauma center in a rural setting that can serve up to 34,000 patients a year. A convenience sample of 13 registered nurses who completed the nurse-residency program or who were currently enrolled in the program and graduated within a year of beginning the residency program were surveyed using the Casey-Fink Graduate Nurse Experience Survey (New Graduate Survey). Also, a convenience sample of 41 staff members of the local emergency department, which included registered nursing staff who didn’t participate in the nurse-residency program, operations specialists, physicians, and paramedics, were given an adapted Casey-Fink Graduate Nurse Experience Survey to evaluate their perception of the new graduates’ readiness to practice. Project results indicate that new graduates who participated in the program tend to be more confident, the nurse-residency program is meeting the needs of the new graduates, and retention rates of the new graduates has increased since the inception of the program. Facilities and management can incorporate these findings into developing and maintaining nurse-residency programs in order to improve patient outcomes and new-graduate satisfaction and retention rates.

Research has supported that transition-to-practice programs can help improve new-graduate retention rates and quality of care at the bedside, while decreasing costs to facilities associated with registered-nursing-turnover rates. However, even with this information, many facilities are still reluctant to implement any sort of evidence-based transition-to-practice program, and continue with the three-to six-month general floor orientations.