New graduate nurses make up 10% of an organization's nursing staff (Hopkins & Bromley, 2016). New graduates are faced with the challenge of transitioning to practice from the classroom setting. Nurse residency programs are designed to provide new graduate nurses with a resource in their first year of practice. An integrative review of literature was conducted to analyze components of nurse residency programs associated with their respective outcomes. The implementation of a nurse residency program provides the new graduate nurse with support, education, and clinical skills required of a registered nurse. Proposed analysis of this literature review will be presented. -- Abstract

In this comprehensive resource, nursing staff development expert Jim Hansen, MSN, RN-BC, provides instruction and tools to plan, justify, and structure a nurse residency program that develops and retains new nurses through their first year

The Future of Nursing explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year. Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States. To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles-including limits on nurses' scope of practice-should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care. In this book, the Institute of Medicine makes recommendations for an action-oriented blueprint for the future of nursing.

New graduate registered nurse residency programs are being adopted as best practice by many organizations. The purpose of this thesis was to evaluate the effectiveness of two different types of programs implemented at an organization to see which produced the largest amount of retention. One group was hired directly into a nursing unit or area where orientation began. Another group was hired into a practice area and rotated through three different areas prior to being matched to a unit or area and then completing orientation. Dr. Patricia Benner's Novice to Expert Framework was used to guide this study because successful residency programs should expound onto the new graduate registered nurses educational base and should offer a variety of experiences to assist with moving towards the stage of expert nurse. Retention data was collected retrospectively and included 12 months of retention data for the two cohort groups being compared. Comparison of this data showed a 4.5% increase in retention from one to another. Further comparison of this data showed that the difference in length of service at 12 months between these two cohort groups was not statistically significant (p=.285). Further comparisons of independent hospitals and practice areas also showed no statistically significant differences in overall length of service at 12 months.

"New graduate nurse residency programs' primary function is to provide new graduates with clinical experience and bridge the gap between student and competent registered nurse (Walsh, 2018). While the focus of these programs is on teaching new graduates, a gap in practice has been identified when it comes to the education of the nurses that are training these new graduates. The purpose of this program evaluation was to increase preceptor feelings of preparedness for the precepting role, as well as increase preceptor education attendance rates to at least 50% of eligible nurses. This was a program evaluation with a pre-/post-test design that evaluated the impact of preceptor education in 10 registered nurses. Participants submitted surveys to evaluate their feelings of support and preparedness for their educator roles before and after the educational presentation. There was a statistically significant increase in post-education scores (M=11.2, SD=2.15) when compared to pre-education scores (M=6.6, SD=2.8); t(9) = -5.81, p=0.00025597. Furthermore, 100% of respondents had a higher total score on the post-survey than the pre-survey with a mean difference of +4.6 points +/-2.5 (SD), indicating that they felt more supported and prepared to act as preceptors after the education. By offering a preceptor education curriculum that is easily accessible, organizations will see increased attendance rates and therefore higher feelings of support and preparedness from nurse preceptors. These preceptors will then be able to teach and empower new RNs on their journey to practice, offering a smoother and safer transition to professional independence, and decreasing burnout rates and turnover costs to the healthcare organization (Trepanier et al., 2012)"--Abstract.

Current literature supports the creation and implementation of nurse residency programs to support new graduate nurses as they transition into nursing practice. Additionally, nurse residency programs have been shown to increase nurse satisfaction and retention (Crimlisk et al., 2017; Olson-Sitki et al., 2012). Currently, there are only three nurse residency programs in the state of Alabama. The lack of this important post-licensure resource poses a problem for new graduate nurses who are seeking additional assistance and guidance during the transition to professional practice. This qualitative study examined the decision-making process of hospital leaders in the implementation of the nurse residency program at their facility. This study also explored factors that impacted hospital leaders' decision to implement a nurse residency program. This study found a relationship between the decision to implement a nurse residency program and the desire to increase nursing development in the facilities. The benefits that were identified included building a solid foundation, recruitment and retention, and building relationships. Other factors that influenced the hospital leaders' decision to implement the nurse residency programs were demand and excessive turnover of staff. In addition, multiple barriers such as logistics, manager buy-in, and curriculum development were identified by the hospital leaders as potential barriers to implementation. This study will also be able to help hospital leaders who are struggling with the decision to implement nurse residency programs in their facilities.

The academic-practice gap has been described in the literature for years. Poorly implemented transition to practice can negatively impact patient outcomes, newly graduated nurses, and the nursing profession. Abbreviated prelicensure clinical experiences due to the COVID-19 pandemic have exacerbated the academic-practice gap’s impact on new nurse confidence, competence, safety, and retention. This integrative literature review aimed to identify best practices for developing and implementing a standardized new graduate nurse orientation program in the critical care setting that addresses and supports the transition from student to practitioner in an era of reduced hands-on clinical experiences due to the COVID-19 pandemic. Evidence shows that interventions focused on improving the transition period for newly graduated nurses were beneficial and can positively impact new graduate nurses’ confidence, competence, and retention, as well as patient safety and care quality. A synthesis of the literature revealed common themes in successful transition to practice programs include the presence of a designated resource person/preceptor, structured orientation, nurse residency, clearly defined and routinely measured core competencies, and simulation exercises.