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Nurse residency programs

Health Factors: Access to Care
Decision Makers: Educators Healthcare Professionals & Advocates
Evidence Rating: Some Evidence
Population Reach: 100% of WI's population
Impact on Disparities: No impact on disparities likely

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Description

Nurse residency programs are intended to ease the transition from nursing student to practicing nurse, similar to the first year of a physician residency program (Rosenfeld 2016). Programs vary in design and length, but often include an orientation period, a relationship with a more experienced nurse serving as a mentor or preceptor, and guided practice toward independence (Al-Dossary 2014).

Expected Beneficial Outcomes

Increased nurse retention
Increased job satisfaction
Increased job skills
Reduced stress

Evidence of Effectiveness

There is some evidence that nurse residency programs increase retention, job satisfaction (Al-Dossary 2014, Edwards 2015, Letourneau 2015, Rosenfeld 2016, Harrison 2014, IOM-Nursing 2010), and nursing skills among newly licensed nurses (Edwards 2015, Al-Dossary 2014, Letourneau 2015, Bratt 2014). Additional evidence is needed to confirm effects and determine which elements of residency programs are most effective (Anderson 2012).

Residency programs appear to improve retention in pediatric hospitals (Hillman 2011), religiously affiliated hospitals (Pine 2007), and hospitals with Magnet status (Goode 2013). Nurse residency programs may also reduce stress and anxiety for new nurses (Edwards 2015, Letourneau 2015). Programs may increase nursing knowledge and skills in both urban and rural areas (Bratt 2014), though new nurses in rural residency programs report lower levels of stress and greater job satisfaction than peers in urban areas (Bratt 2014). Nurse residency programs may also improve nurses’ organizational commitment (Bratt 2012) and increase participants’ clinical leadership skills over time (Chappell 2015).

Some experts suggest that allocating appropriate resources, creating partnerships, evaluating efforts, and having a sustainability plan contribute to effective residency programs (Bratt 2013). Securing the support of stakeholders such as deans and faculty of nursing schools, chief nursing officers, and government and philanthropic entities (Goode 2016), and appointing a nurse residency coordinator may also contribute to program success (Greene 2016). Mentorship in nurse residency programs may contribute to stress reduction among participants (Rush 2013); new nurses may receive mentor support after program completion (Pasila 2017).

Cost is often cited as a barrier to starting nurse residency programs (Pittman 2013). However, some studies suggest that by increasing retention of new nurses, nurse residency programs avert the costs of hiring replacement nurses (Cochran 2017, Trepanier 2017, Kram 2016).

Implementation

United States

Nurse residency programs are increasingly common across the country; one study estimates that over one-third of US hospitals had programs in place as of 2011 (Pittman 2013). As of 2017, 25 nurse residency programs have been accredited by the Commission on Collegiate Nursing Education (CCNE), including 10 programs at US Department of Veteran Affairs (VA) medical centers (CCNE-ANRP). The University of Colorado Hospital’s Post-Baccalaureate Nurse Residency Program was the first program to receive CCNE accreditation; accreditation was received in 2009 (CCNE-ANRP).

The University HealthSystem Consortium and the American Association of Colleges of Nursing (UHC/AACN) Nurse Residency Program partner to operate yearlong residencies at 187 practice sites in 32 states (UHC-AACN). Hospitals and health systems may develop their own programs or purchase the rights to use established nurse residency training systems such as Versant New Graduate RN Residency (Versant) or the National Council of State Boards of Nursing (NCSBN) Learning Extension’s Transition to Practice program (NCSBN Learning extension-TTP). 

Wisconsin

The University of Wisconsin Hospital and Clinics Nurse Residency Program is CCNE accredited (CCNE-ANRP, UW Health-NRP). Marquette University College of Nursing established the Wisconsin Nurse Residency Program in 2004 in conjunction with 60 hospitals throughout the state; these hospitals currently oversee their individual programs (AHRQ HCIE-Bratt).

Implementation Resources

CNHS-NRP - Children’s National Health System (CNHS). Nursing residency program (NRP). Accessed on May 1, 2017

Citations - Description

Al-Dossary 2014* - AL-Dossary R, Kitsantas P, Maddox PJ. The impact of residency programs on new nurse graduates’ clinical decision-making and leadership skills: A systematic review. Nurse Education Today. 2014;34(6):1024–1028. Accessed on May 1, 2017
Rosenfeld 2016* - Rosenfeld P, Glassman K. The long-term effect of a nurse residency program, 2005-2012: Analysis of former nurse residents. Journal of Nursing Administration. 2016;46(6):336–344. Accessed on May 2, 2017

Citations - Evidence

Al-Dossary 2014* - AL-Dossary R, Kitsantas P, Maddox PJ. The impact of residency programs on new nurse graduates’ clinical decision-making and leadership skills: A systematic review. Nurse Education Today. 2014;34(6):1024–1028. Accessed on May 1, 2017
Anderson 2012* - Anderson G, Hair C, Todero C. Nurse residency programs: An evidence-based review of theory, process, and outcomes. Journal of Professional Nursing. 2012;28(4):203-12. Accessed on May 1, 2017
Bratt 2012* - Bratt MM, Felzer HM. Predictors of new graduate nurses’ organizational commitment during a nurse residency program. Journal for Nurses in Staff Development. 2012;28(3):108-119. Accessed on May 11, 2017
Bratt 2013* - Bratt MM. Nurse residency program: Best practices for optimizing organizational success. Journal for Nurses in Professional Development. 2013;29(3):102–110. Accessed on May 1, 2017
Bratt 2014* - Bratt MM, Baernholdt M, Pruszynski J. Are rural and urban newly licensed nurses different? A longitudinal study of a nurse residency programme. Journal of Nursing Management. 2014;22(6):779–791. Accessed on May 1, 2017
Chappell 2015* - Chappell KB, Richards KC. New graduate nurses, new graduate nurse transition programs, and clinical leadership skill: A systematic review. Journal for Nurses in Professional Development. 2015;31(3):128–137. Accessed on May 1, 2017
Cochran 2017* - Cochran C. Effectiveness and best practice of nurse residency programs: A literature review. MEDSURG Nursing. 2017;26(1):53-63. Accessed on May 11, 2017
Edwards 2015* - Edwards D, Hawker C, Carrier J, Rees C. A systematic review of the effectiveness of strategies and interventions to improve the transition from student to newly qualified nurse. International Journal of Nursing Studies. 2015;52(7):1254–1268. Accessed on May 1, 2017
Goode 2013* - Goode CJ, Lynn MR, McElroy D, Bednash GD, Murray B. Lessons learned from 10 Years of research on a post-baccalaureate nurse residency program. Journal of Nursing Administration. 2013;43(2):73–79. Accessed on May 1, 2017
Goode 2016* - Goode CJ, Reid Ponte P, Sullivan Havens D. Residency for transition into practice: An essential requirement for new graduates from basic RN programs. JONA: The Journal of Nursing Administration. 2016;46(2):82-86. Accessed on May 11, 2017
Greene 2016* - Greene MA, Warren JI, Perkins S. Transforming nursing organizations through implementation of nurse residency programs. Journal for Nurses in Professional Development. 2016;32(5):267-268. Accessed on May 11, 2017
Harrison 2014* - Harrison D, Ledbetter C. Nurse residency programs: Outcome comparisons to best practices. Journal for Nurses in Professional Development. 2014;30(2):76–82. Accessed on May 1, 2017
Hillman 2011* - Hillman L, Foster RR. The impact of a nursing transitions programme on retention and cost savings. Journal of Nursing Management. 2011;19(1):50–6. Accessed on May 1, 2017
IOM-Nursing 2010 - Institute of Medicine (IOM). The future of nursing: Leading change, advancing health. Washington, DC: National Academies Press; 2010. Accessed on May 1, 2017
Kram 2016* - Kram SL, Wilson J. Nurse residency program attracts and retains novice nurses. Nursing. 2016;46(2):15-16. Accessed on May 11, 2017
Letourneau 2015* - Letourneau RM, Fater KH. Nurse residency programs: An integrative review of the literature. Nursing Education Perspectives. 2015;36(2):96–101. Accessed on May 1, 2017
Pasila 2017* - Pasila K, Elo S, Kääriäinen M. Newly graduated nurses’ orientation experiences: A systematic review of qualitative studies. International Journal of Nursing Studies. 2017;71:17-27. Accessed on May 11, 2017
Pine 2007 - Pine R, Tart K. Return on investment: Benefits and challenges of baccalaureate nurse residency program. Nursing Economics. 2007;25(1):13-8, 39. Accessed on May 2, 2017
Pittman 2013* - Pittman P, Herrera C, Bass E, Thompson P. Residency programs for new nurse graduates: How widespread are they and what are the primary obstacles to further adoption? The Journal of Nursing Administration. 2013;43(11):597–602. Accessed on May 2, 2017
Rosenfeld 2016* - Rosenfeld P, Glassman K. The long-term effect of a nurse residency program, 2005-2012: Analysis of former nurse residents. Journal of Nursing Administration. 2016;46(6):336–344. Accessed on May 2, 2017
Rush 2013* - Rush KL, Adamack M, Gordon J, Lilly M, Janke R. Best practices of formal new graduate nurse transition programs: An integrative review. International Journal of Nursing Studies. 2013;50(3):345–356. Accessed on May 12, 2017
Trepanier 2017* - Trepanier S, Mainous R, Africa L, Shinners J. Nursing academic-practice partnership: The effectiveness of implementing an early residency program for nursing students. Nurse Leader. 2017;15(1):35-39. Accessed on May 11, 2017

Citations - Implementation

AHRQ HCIE-Bratt - Bratt MM. Residency program for first-year nurses eases entry into profession, producing well-above average retention rates. Rockville: AHRQ Health Care Innovations Exchange. Accessed on May 1, 2017
CCNE-ANRP - American Association of Colleges of Nursing (AACN). CCNE accredited nurse residency programs. Accessed on May 1, 2017
NCSBN Learning extension-TTP - National Council of State Boards of Nursing (NCSBN) Learning Extension. Transition to practice (TTP) program. Accessed on May 11, 2017
Pittman 2013* - Pittman P, Herrera C, Bass E, Thompson P. Residency programs for new nurse graduates: How widespread are they and what are the primary obstacles to further adoption? The Journal of Nursing Administration. 2013;43(11):597–602. Accessed on May 2, 2017
UHC-AACN - American Association of Colleges of Nursing. The University HealthSystem Consortium and the American Association of Colleges of Nursing (UHC/AACN) Nurse Residency Program. Accessed on May 2, 2017
UW Health-NRP - University of Wisconsin Health System (UW Health). Residencies, fellowships and internships: Nurse residency program (NRP) (Post-Baccalaureate). Accessed on May 11, 2017
Versant - Versant. Versant new graduate RN residency. Accessed on May 12, 2017

Page Last Updated

May 11, 2017

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