Implementation of a Nurse Residency Program for Long-Term Care New Nurses in NJ

Background:

Long Term Care Facilities have a nurse turnover rate of 41% nationally, which results in a replacement cost of up to $88,000/nurse.  Beyond cost, staff instability leads to reduced quality of care; decreased resident and staff satisfaction; and increased hospital readmission.  NJ has one of the highest re-hospitalization rates in the US, ranking 48th among all states for older adults with chronic diseases.

In response to this issue and the 2010 Institute of Medicine Report (The Future of Nursing: Leading Change, Advancing Health) recommendation, the New Jersey Action Coalition (NJAC) organized eight different task forces.  One of its initiatives is to implement Nurse Residency Programs to assist new Registered Nurses in their transition into practice.  In collaboration with Rutgers University School of Nursing (as well as a variety of stakeholding organizations) and supported by $1.6 million in civil monetary penalty monies from the Centers for Medicare and Medicaid Services, NJAC is leading an effort to develop, implement, and evaluate a twelve month Nurse Residency Program in NJ’s Long Term Care Facilities, the first of its kind in the United States. This poster presentation will focus on the implementation and preliminary evaluation of this ongoing project to date.

Method:

LTC Facilities throughout NJ were recruited to participate.  A unique curriculum was developed to educate experienced facility RNs to serve as Preceptors for their new RN (Nurse Residents).  Prior to and following implementation of the educational intervention, data is collected at the individual, unit and organizational level using various standardized tools.  Over 60 days of classroom, observational and simulation-based educational days are then provided to the Nurse Resident, incorporating the Nurse of the Future Core Competencies and the Nurses Improving Care of Healthsystem Elders (NICHE) Geriatric Resource Nurse Competencies, as well as other Evidence-Based Practice frameworks.  Monthly education and support programs bring together the Preceptor and Nurse Resident cohort group.  Each Preceptor/Nurse Resident dyad has a Rutgers Faculty Liaison as a resource and support. Two cohorts with a total of 31 facilities and 71 nurses are part of this study.

Results:

Cohort One will finish in April 2015 and Cohort Two in November 2015.  Data will have been collected for Cohort One by the time of this presentation; and baseline survey results will be available for Cohort Two.

Discussion/Conclusions:

The long range goals for this project are to:

·         increase LTC Facility resident (patient) satisfaction

·         decrease nursing turnover in LTC Facilities

·         develop this model into a sustainable statewide standard

The project will be approximately 90% completed by the time of this presentation, but already there is evidence of successful implementation and continuing interest throughout LTC facilities.  Interest in the program is apparent outside of NJ as well, and plans are in place to share the program content for replication elsewhere.

Available results for Cohort One and Two will be included in the presentation.