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Nurse residency programs

Health Factors: Access to Care
Decision Makers: Educators State Government 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, 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 increase participants’ clinical leadership skills over time (Chappell 2015).

Some experts suggest that securing the support of stakeholders, allocating appropriate resources, creating partnerships, training preceptors or mentors to provide long-term support, evaluating efforts, and having a sustainability plan contribute to effective residency programs (Bratt 2013).

 Cost is often cited as a barrier to starting nurse residency programs (Pittman 2013).

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). The University HealthSystem Consortium and the American Association of Colleges of Nursing (UHC/AACN) Nurse Residency Program, for example, partner to operate yearlong residencies at 187 practice sites in 32 states (UHC-AACN).

The University of Colorado Hospital’s Post-Baccalaureate Nurse Residency Program is the first program to receive Commission on Collegiate Nursing Education (CCNE) accreditation; accreditation was received in 2009 (CCNE-ANRP).

Wisconsin

The University of Wisconsin Hospital and Clinics Nurse Residency Program is CCNE accredited (CCNE-ANRP). 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 the program (Marquette-WNPR, AHRQ HCIE-Bratt).

Implementation Resources

CNHS-NRP - Children’s National Health System (CNHS). Nursing residency program (NRP). Accessed on June 29, 2016

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 June 29, 2016
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 June 29, 2016

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 June 29, 2016
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 June 24, 2016
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 June 29, 2016
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 June 29, 2016
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 June 29, 2016
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 June 20, 2016
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 June 29, 2016
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 June 29, 2016
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 June 24, 2016
IOM-Nursing 2010 - Institute of Medicine (IOM). The future of nursing: Leading change, advancing health. Washington, DC: National Academies Press; 2010. Accessed on March 13, 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 June 29, 2016
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 June 24, 2016
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 June 24, 2016
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 June 29, 2016

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 June 24, 2016
CCNE-ANRP - American Association of Colleges of Nursing (AACN). CCNE accredited nurse residency programs. Accessed on June 24, 2016
Marquette-WNPR - Marquette University. College of Nursing. Wisconsin Nurse Residency Program (WNPR). Accessed on June 20, 2016
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 June 24, 2016
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 June 29, 2016

Page Last Updated

June 29, 2016

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