Creating a Statewide Network of RN Residency Programs

Purpose:  The development and implementation of successful, sustainable nurse residency programs, was identified by the Utah Action Coalition as the number one priority for the future of the Utah nursing profession.  All acute care hospital corporations were targeted to begin nurse residency programs by 2014. To implement a statewide program of this size, all acute care corporations were to be included in the initiative.   To accomplish this goal, a broad-based community planning model was needed.  Sensitivity to the unique needs of each hospital in the design of their nurse residency programs while creating some consistency in the nurse residency programs was also a challenge to be addressed. 

Background/Rationale/Best Practices:   Key representatives from the state’s major healthcare providers and academic institutions were selected to be nurse residency sites.   Currently there are seven nurse residency sites operational, with an additional site planned in January 2015. The partnership between each hospital site and an academic program created a seamless transition between the capstone experience and the residency programs which infused the curriculum with educational expertise and tested academic methods.  A steering committee was formed which consisted of representatives from hospitals, the Board of Regents, and other health care providers and nursing leaders.  A neutral community health care convener, HealthInsight, was selected to lead the project.   The nurse residency programs were developed to reduce nursing turnover, increase nurses’ job satisfaction and skill level, and ultimately improve the quality of care given to hospital patients.  Several best practices emerged from the program:  sharing of nurse residency curriculum best practices, collecting data on core indicators, such as nurse satisfaction, demographics, nurse resident competency, evaluation of preceptors, and fostering practical solutions to increase the gender, racial, and ethnic diversity of the nursing workforce. 

Outcomes Achieved:  Although Utah’s nurse residency programs are still in the data collection phase, some positive outcomes are already being documented:  1) reduced nursing turnover with all but one program showing 100% retention, 2) increased  job satisfaction, 3) increased nursing skills competencies, and 4) improved gender, racial, and ethnic diversity of the nursing workforce.  All hospitals corporations are now fully committed to the value of nurse residency programs.

Conclusions/Implications for Clinical and Educational Practices:  To launch nurse residency programs across all state hospital corporations requires a planning model that rewards individual best practices and is sensitive to the unique operational requirements of the individual hospital.  The education-practice model is a sound way to ensure a smooth, seamless transition of the newly graduated nurse to a fully practicing registered nurse.  Utah’s unique model created the environment for sharing of curriculum and data across all hospitals, resulting in significant improvement in all of the nurse residency programs in the state.