The Registered Nurse Exchange Program

Background: In an environment where healthcare delivery continues to evolve, it is imminent that practitioners and administrators remain on the cutting edge of best practices. Institutions must seek opportunities to decrease cost and increase quality. As a response, an initiative was put forth to enter into a nurse exchange collaborative with similar hospitals; the Registered Nurse (RN) Exchange Program (RN Exchange Program) is an innovative program where professional pediatric nurses have the opportunity to learn best practices from other pediatric hospitals through witnessing them in action.  After being invited into the RN Exchange Program, the hospital created a plan to provide structure and processes to ensure its success.

Purpose: This project provides a description of structure, processes, outcomes and benefits of establishing a formalized RN Exchange Program from a professional development perspective. The RN Exchange Program created an opportunity for an organized visit to a similar healthcare institution (i.e. a children’s hospital) for experienced nurses to learn and share best practices; it promotes nursing professional development advancement and enhances opportunities for improvement in professional practice. The program design allows for the inclusion of hospitals across the nation as well as around the world. The Nurse Exchange Program is important for professional growth of the visiting nurse and provides opportunities for nurses at the host organization to engage in dialog to address operational efficiencies and explore approaches or ways to improve care models.

Methods: Structured processes were essential for the success of the RN Exchange Program. A business and education approach was taken to lay the foundation, which included a program plan with financial and marketing projections, timelines for each task and an evaluation mechanism for process improvement. The program plan also included establishing participant criteria, developing the application process, and designing the selection process for participants. The program plan was provided to nursing leadership and approval was received. Upon approval of the plan, a marketing campaign began with sending communication to all nurses using various venues detailing the purpose and providing information about the program. The RN Exchange Program was built specifically for an individual nurse based on his/her interests and occurs over a five day period. To be eligible for the exchange, nurses must meet the following criteria: 1) Direct Care Provider/ Staff Nurse, 2) Two Years of experience, 3) Active participation within nursing committees (unit or system level), and 4) In good standing as verified by unit leadership. The application process requires nurses to declare interest, complete an application, obtain manager approval, undergo a written application review, and complete a panel interview with the home hospital. Within the application, nurses state proposed goals that further provide an outline for learning objectives during the exchange. Applicants with the highest interview scores are chosen to represent the organization. Action learning principles are implemented as participating nurses use the learning objectives to guide their visit and identify best practices. Upon return from the exchange, the nurse is required to provide an overview of the experience to his/her peers and identify a project to implement as a best practice. As a host hospital, evaluations are provided to the visiting nurse and onsite participants at the conclusion of the exchange to receive feedback for program improvement. In addition, the home and host institutions have a continual discourse to address any challenges the nurses may have encountered and for further collaboration in any specific best practice content areas.

Results: During the presentation to peers, nurses exuded with energy as each relayed his/her experience. These nurses also acknowledged a desire to increase participation in hospital affairs and a motivation to share findings: two of the nurses have accepted invitations to become a part of the nurse exchange selection committee; the Neonatal Intensive Care Unit (NICU) has begun laying the foundation for a developmental care committee; and there has been a proposal to review ampicillin administration guidelines with the pharmacy department for potential savings. A status update for each project is ongoing.

Conclusion: Creating a formalized nurse exchange program enhances professional development and permits growth opportunities for the home and host hospitals. Outcomes of nurse experiences with the nurse exchange program have translated into improvements in the nurses’ work environment (or in improved patient outcomes).