Posted: March 12th, 2023

Investigating the Impact of Nurse Residency Programs on New Graduate Nurse Retention

Investigating the Impact of Nurse Residency Programs on New Graduate Nurse Retention

Nurse residency programs (NRPs) are structured educational and mentoring interventions that aim to facilitate the transition of new graduate nurses (NGNs) from academic settings to clinical practice. NRPs have been widely implemented in various health care settings as a strategy to improve NGN retention, satisfaction, and competence. However, the evidence on the effectiveness and cost-benefit of NRPs is still limited and inconclusive. This blog post will review some of the recent literature on NRPs and their impact on NGN retention, as well as discuss some of the challenges and recommendations for future research and practice.

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What are NRPs and why are they important?

NRPs are defined as "a formalized, structured program that provides support, education, and mentorship to newly licensed registered nurses during their first year of practice" (American Association of Colleges of Nursing [AACN], 2015, p. 1). NRPs are designed to address the gap between academic preparation and clinical reality that many NGNs face when they enter the workforce. NGNs often experience stress, anxiety, role ambiguity, lack of confidence, and high turnover rates during their first year of practice, which can compromise their quality of care and patient safety (Rush et al., 2019). NRPs aim to provide NGNs with the necessary knowledge, skills, and support to overcome these challenges and enhance their professional development and retention.

What are the benefits of NRPs for NGNs and health care organizations?

Several studies have reported positive outcomes of NRPs for NGNs and health care organizations. For example, a systematic review by Rush et al. (2019) found that NRPs were associated with improved NGN retention, competence, confidence, satisfaction, leadership skills, and patient outcomes. A meta-analysis by Anderson et al. (2018) also found that NRPs reduced NGN turnover rates by 12% compared to usual orientation programs. Moreover, a cost-benefit analysis by Goode et al. (2016) estimated that NRPs could save health care organizations $67.3 million per year by reducing NGN turnover and vacancy costs.

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What are the challenges and limitations of NRPs?

Despite the promising results of NRPs, there are also some challenges and limitations that need to be addressed. First, there is a lack of standardization and consistency in the definition, design, implementation, and evaluation of NRPs across different settings and countries. This makes it difficult to compare and synthesize the results of different studies and to identify the best practices and components of effective NRPs (Rush et al., 2019). Second, there is a need for more rigorous and long-term research on the impact of NRPs on NGN retention and other outcomes. Most of the existing studies are observational, cross-sectional, or quasi-experimental, with small sample sizes, short follow-up periods, and potential confounding factors. There is also a lack of data on the cost-effectiveness and return on investment of NRPs from different perspectives (e.g., NGNs, employers, patients) (Anderson et al., 2018). Third, there is a need for more stakeholder involvement and collaboration in the development, implementation, and evaluation of NRPs. This includes engaging NGNs, preceptors, mentors, educators, managers, administrators, policy makers, researchers, and professional associations in identifying the needs, goals, expectations, resources, barriers, and facilitators of NRPs in different contexts (AACN, 2015).

What are some recommendations for future research and practice?

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Based on the current literature and best practices guidelines, some recommendations for future research and practice on NRPs are:

- Develop a clear and consistent definition and framework for NRPs that reflects the core elements and competencies of NGN transition to practice.
- Conduct more randomized controlled trials and longitudinal studies with large and diverse samples to examine the impact of NRPs on NGN retention and other outcomes over time.
- Use standardized and valid instruments to measure the outcomes of NRPs at multiple levels (e.g., individual, organizational, patient).
- Assess the cost-benefit and return on investment of NRPs from different perspectives (e.g., NGNs, employers, patients) using economic evaluation methods.
- Involve multiple stakeholders in the planning, implementation, and evaluation of NRPs to ensure their relevance, feasibility, sustainability,
and scalability.
- Disseminate and share the results and best practices of NRPs through publications,
conferences,
and networks.

Conclusion

NRPs are valuable interventions that can facilitate the transition of NGNs from academic settings to clinical practice
and improve their retention
and performance.
However
there is still a need for more research
and collaboration
to enhance
the quality
and effectiveness
of NRPs
in different settings
and contexts.

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References

AACN. (2015). AACN standards for establishing
and sustaining healthy work environments: A journey to excellence (2nd ed.). American Association of Colleges of Nursing.

Anderson, G., Hair, C., & Todero, C. (2018). Nurse residency programs: An evidence-based review of theory, process, and outcomes. Journal of Professional Nursing, 34(4), 326-337. https://doi.org/10.1016/j.profnurs.2017.12.008

Goode, C. J., Lynn, M. R., Krsek, C., & Bednash, G. D. (2016). Nurse residency programs: An essential requirement for nursing. Nursing Economics, 34(3), 142-159.

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Rush, K. L., Adamack, M., Gordon, J., Lilly, M., & Janke, R. (2013). Best practices of formal new graduate nurse transition programs: An integrative review. International Journal of Nursing Studies, 50(3), 345-356. https://doi.org/10.1016/j.ijnurstu.2012.06.009

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