Transition to practice nurse residency programs have published many positive findings including an increased first year nursing retention rate and enhanced support for the novice nurse. One commonly used survey to measure the new nurses’ progress is the Casey Fink Survey that focuses on the new nurses’ perception of support, organization and prioritization, communication and leadership, and professional satisfaction, and stress (Casey, Fink, Krugman, & Propst, 2014).
Similar to nurse residency programs, the literature also supports formalized nursing research programs. Latimer & Kimbell (2010) , McLaughlin, Speroni, Killy, Guxzetta & Desale (2013) , and Patterson, Turner, Speroni, McLaughlin & Guzzetta (2013) stress the importance of a dedicated leader or mentor and a strong infrastructure for the success of a formalized program. In addition, outcomes of these research programs reveal an increase in nurses’ research knowledge and ability, and an impact on evidence based practice dissemination (Black, Balneaves, Garossino, Puyat & Qian, 2015; McLaughlin et al., 2013; Duffy, Culp, Sand-Jecklin, Stroupe, & Lucke-Wold, 2016; Hatfield, Kutney-Lee, Hallowell, Guidice, Ellis, Verica & Aiken, 2016).
In contrast to the nurse residency programs and research fellowships, there is a gap in extensive literature reflective of the impact of palliative care fellowships within the acute care setting. General palliative care education has been shown to have a positive impact on staff confidence when supporting patient and family decision making during this difficult time (Beattie, Brady, & Tobias, 2013; Milic et al., 2015; Nakazawa et al., 2013). Survey results from Milic et al. indicate that nurses reported greater skill and confidence on 14 survey items after completing an educational workshop. Similarly, Nakazawa et al. (2013) conclude that confidence scores of practitioners significantly increased after education was provided.
A review of the Nurse Residency Program, Nursing Research Fellowship and Palliative Care Fellowship at one organization will be shared. The presenters from this organization, consisting of four acute care hospitals, an acute care rehabilitation hospital, home care and a drug and alcohol rehabilitation center, will share the structure and outcomes of each program while aligning each program with the organization’s mission and strategic plan. Each program/fellowship requires an evidence based or research project. In this organization’s experience, these projects contribute significantly to improving and impacting nursing practice both at the campus and system level.
The nurse residency program is a commercially available program that runs over one year. Data specific to recruitment, retention and the first year transition will be shared. The research fellowship at this organization is aimed at enhancing participant knowledge related to research and it utilizes structured, formalized education and mentoring specific to the participants’ identified topics from start through implementation. Projects that have been implemented throughout the health system will be shared as results. The Palliative Care Fellowship at this organization is a one year program that was created by the organization based on the eight domains of practice for quality patient care identified by the National Consensus Project (National Consensus Project, 2013). Data from a one year longitudinal study using the Powazki et al. survey that concluded in 2017 reflects enhanced nurses’ knowledge and comfort level when caring for palliative care patients after completing the fellowship. This fellowship has graduated over 30 nurses and has led to significant professional growth, advancement and supports succession planning.
These outcome oriented programs have been implemented as a strategy to address the universal challenges of patient safety, patient experience, quality outcomes and cost. The authors believe that the most important commonalities leading to the success of the three programs within their organization include: a supportive environment with clear expectations from leadership, designated leaders, and the expectation of successful dissemination of evidence based practice and research throughout the healthcare system.
To support the resource investments of time and finances, the impact of continuing education for patients, nurses and the organization must be measured. The purpose of this presentation is to share the impact of these formally structured programs, the instruments used to measure success and examples of evidence based practice and research that has resulted from these programs. This model for staff nurse engagement results in short and long term goal achievement that directly supports the safety, quality, and patient experience outcomes in the organizational strategic plan.