Abstract: This project was conducted to examine learning needs, satisfaction, and turnover intention before and after completion of the Nurse Residency Program for new graduate nurses hired at the University of California (UC) San Diego Medical Center. Research has shown the necessity and importance of the implementation of a nurse residency program, not only for new graduate nurses, but for the healthcare institution as well. A convenience sample of new graduate nurses participating in the Cohort Eight Nurse Residency Program were surveyed before the start and following a 6 month program. The data suggests that after participating in the 6 month long Nurse Residency Program, new graduate nurses were apt to be more knowledgeable on skill acquisition, more satisfied in UC San Diego Medical Center with fewer uncertainties in their professional practice, and their turnover intention had decreased from the presurvey results.

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 nurses encounter "transition shock" when they enter the workplace, especially in acute care settings such as hospitals. New graduate nurses have a difficult time transitioning into the work environment because they are unprepared by their academic training for the realities they will face and they often don't have the proper support in place to guide them through the transition. This leads to a high attrition rate of up to 30% within the first 18 months of employment which costs hospitals and health care facilities. High nurse turnover of new graduate nurses who aren't prepared for the complexities of clinical practice affect the quality of care provided. Patient outcomes are negatively affected because it often leaves hospitals dealing with a shortage of experienced nurses, which they compensate for by having high patient to nurse ratios. New graduate nurses must develop the necessary critical thinking skills to handle higher acuity patients and difficult situations, develop confidence in their clinical skills, and adapt to peer relationships. One solution to the "transition shock" that new graduate nurses face is the implementation of nurse residency programs. Nurse residency programs are shown to help new graduates have a better transition into the workplace and increase nurse retention. This paper discusses the problem of new graduate nurse turnover, the benefits of nurse residency programs, and the numerous research studies which have been done showing the success of nurse residency programs on new nurse graduate retention and job satisfaction. It also discusses how to implement a nurse residency program and monitor and evaluate its success.

Poor retention is a critical issue among healthcare workers throughout the country. Decreased job satisfaction directly impacts nursing retention rates, particularly among new nurses transitioning from school to clinical practice. This MSN project introduces an enhancement to the current nurse residency program that includes clinical rotations in its educational foundation to solve job satisfaction issues among new graduate nurses. Evidence-based research indicates that clinical rotations benefit nurses early in their careers. These benefits include increased involvement in work, acquired additional skills, and enhanced job satisfaction in the workplace. This MSN project provides a clear path for implementing this unique type of residency program in nursing to be piloted at the University of Utah Hospital system in Salt Lake City. The new residency program format will be eight months and be implemented in a twenty-week timeline. The project implementation includes a project proposal, a PowerPoint presentation for staff and administration, and a lesson and assignment plan for educators in the program. Additionally, the project will provide pre- and post-surveys to test the understanding and success of project implementation and allow for future improvements and changes based on trends. The project also identifies ways to disseminate significant results and learned information to the university's stakeholders and other organizations nationwide. Providing clinical rotations to train and support new nurses can significantly impact the long-standing nurse retention crisis.

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.

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 problem addressed in this project pertains to new graduate nurses and their transition to practice needs as well as the costs facilities must endure when these new nurses leave their job prematurely. According to the Arizona Nurses Association, more than 50% of all new graduate nurses leave their first job and sometimes nursing altogether because of decreased orientation time and the shock that exists when they transition from student to professional nurse (AzNA, 2009). New graduate nurse turnover costs facilities $49,000 to $92,000 per nurse (Trepanier, Early, Ulrich, and Cherry, 2012). This impacts patient care as it interferes with staffing on units, continuity of care, and loss of staff productivity. The solution presented in the project is to institute nurse residency or internship programs in most facilities which will help to transition new nurses from student to competent and confident professional nurses who can provide safe, evidence-based care. This solution is based on results seen in extensive research from both quantitative and qualitative research studies. This solution will decrease the costs related to nursing turnover. This project details what needs to happen to implement a nurse residency program as well as how it will be evaluated and how the information will be disseminated to key stakeholders and other healthcare professionals.