Transition to Practice: Designing, Implementing, and Evaluating an Evidence-based Nurse Residency

Monday, 18 November 2013: 1:45 PM

Jean S. Shinners, PhD, RN-BC
Versant, Ithaca, NY

Learning Objective 1: Examine evidence-based components of an RN residency needed to support new graduate transition to practice.

Learning Objective 2: Describe expected outcomes of a residency based on recent research.

Initiation into nursing practice can be difficult for new graduates with turnover rates reaching as high as 60% (IOM, 2010). High turnover leads to nursing “churn” which is both costly and detrimental to staff morale and patient safety (Ulrich, B. et al., 2010).  Much of the turnover is contributed to a lack of confidence and support during the graduate RNs transition from an academic to professional practice environment (NCSBN, 2009). A designated time for transition has become so critical that the Institute for Medicine (IOM) Future of Nursing Report (2010) recommends all graduates participate in a residency to support them during their initiation to professional practice and development.

 This presentation describes the key components of a 1 year, precepted RN residency that includes 18 weeks of clinical immersion with curricula support followed by 34 weeks of clinical experience with supportive components (mentoring & debriefing). It identifies national standards and evidence-based strategies that provide the foundation for a successful residency.

A ten year research project is presented with data collected from over 6,000 new graduates. Validated measurement instruments are described and analysis methods used. Results showed a decrease in turnover rates, an average competency observed rating equal to or higher than comparison groups, and a correlational increase in self-confidence and organizational commitment.

 A successful graduate residency program is needed to develop and sustain new RNs. A residency that supports the development of new graduate competence and confidence using classroom instruction, guided opportunities to develop hands-on mastery of nursing skills, professional guidance, and engagement of all stakeholders is critical (Ulrich, B., 2010).