Transcript Document

Deidre Dennison RN
NUR 444 – Nursing Leadership
SUNYIT
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Purpose: To investigate the efficacy of nurse
residency programs (NRPs) on new graduate
nurse retention in general by performing
literature reviews as well as comparing the
overall trends to the outcomes of Albany
Medical Center’s NRP
Audience: New graduate registered nurses
(RNs & GNs) employed at AMC & other
institutions nationwide
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I worked with a staff member at the Center
for Learning & Development at Albany
Medical Center – a separate off-site center
dedicated to continued education and
extensive orientation/course offerings
My experience included multiple NRP
sessions, hospital critical care nursing
leadership meetings, education &
resuscitation committee meetings, follow-up
with NRP ‘cohort group’(ICU & cardiovascular)
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According to Rhodes et. al. (2013), newly
licensed registered nurses (NLRNs) make up
approximately 10% of the clinical staff in
hospitals
Turnover rates of NLRNs within the first year
averages from 35% to 61%
Contributes to increased hospital costs,
staffing shortages, and quality of care
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Factors that have been shown to add to new
graduate nurse turnover include:
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Stress
Ineffective orientation
Working ‘short’
Scare resources
Group cohesion/support
Feelings of being unprepared for the multiple roles
associated with nursing
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Focus of NRPs include clinical skills, but the
focus is more on professional skills:
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Critical thinking
Time management/organization
Prioritization
Appropriate delegation
Professional/Interdisciplinary communication
Effective patient teaching/health literacy
Dealing with difficult patients and families
Stress management
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Provides a ‘cohort group’ to new registered
nurses which meets socialization needs & which
the new grad can express their successes &
frustrations
Promotes leadership skills
Reduces newly graduated registered nurse
turnover from the 30% range into the single
digits in some cases (Trepanier, Early, Ulrich, & Cherry
2012)
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Reduces hospital costs - for every nurse that
leaves a position, it costs the hospital between
$40,000 - $64,000 (Baggot, et. al. 2013)
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Based on the changes of practice as nurses
progress in their field, gain more experience,
and develop more effective
clinical/professional skills
Evolves in five stages throughout the nurse’s
career
“Movement from reliance on abstract
principles to use of past concrete examples
as paradigms” (Hood, 2010, p.13)
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The organization has been using NRPs for almost
three years as mandatory orientation for new
graduate registered nurses
12 month program
Requires research Power Point presentation to
nursing leadership at the end of the program by
smaller groups based on specialty
Improved new grad retention rates beginning the
first year and beyond
My agreement with Albany Med prohibits me
from releasing specific figures as the findings are
being prepared for publication in the future
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NRPs can be an effective way to reduce new
graduate registered nurse turnover along with
the associated expenses & other negative
results of turnover
Cost analysis shows that although NRPs
require financial and time investments, they
are still less costly than high turnover
expenses
Provides a more level playing field in regards
to practice by nurses with various levels of
education/preparation
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Hood, L. J. (2010). Leddy & pepper's conceptual bases of
professional nursing. Philadelphia, PA: Wolters Kluwer Health.
Theisen, J. L., & Sandau, K. E. (2013). Competency of New
Graduate Nurses: A Review of Their Weaknesses and
Strategies for Success. Journal Of Continuing Education In
Nursing, 44(9), 406-414.
Trepanier, S., Early, S., Ulrich, B., & Cherry, B. (2012). New
Graduate Nurse Residency Program: A Cost-Benefit Analysis
Based On Turnover and Contract Labor Usage. Nursing
Economic$, 30(4), 207-214.
Rhodes, C., Radziewicz, R., Amato, S., Bowden, V., Hazel, C., McClendon,
S., & ... McNett, M. (2013). Registered Nurse Perceptions After
Implementation of a Nurse Residency Program. Journal Of Nursing
Administration, 43(10), 524-529.