A description of U.S. post-graduation nurse residency programs

Area of Science:

• Nursing Education
• Healthcare Workforce Development
• Quality Improvement in Healthcare

Background:

• Increasing complexity of patient care necessitates support for newly licensed registered nurses.
• Nurse residency programs (NRPs) are a common response, but their implementation varies.
• Understanding implementation fidelity is crucial for assessing NRP effectiveness.

Purpose of the Study:

• To describe Nurse Residency Programs (NRPs) in the U.S.
• To identify the extent of treatment fidelity across different NRP models.
• To inform future research on NRP impact.

Main Methods:

• A 24-item survey based on the outcomes production conceptual framework was used.
• Survey distributed to directors/chief nursing officers at 1,011 U.S. hospitals (≥250 beds).
• Achieved a 20% response rate with 203 surveys returned.

Main Results:

• 48% of surveyed hospitals operate a Nurse Residency Program (NRP).
• NRP models identified: University HealthSystems Consortium (22%), facility-based (54%), and other (24%).
• Significant differences (p < .01) found in career planning, projects, and mentoring within and across models.

Conclusions:

• Lack of treatment fidelity across NRPs limits objective determination of their impact on patient outcomes.
• Variability in program elements hinders the assessment of NRPs as a discrete intervention.
• Hospital size may influence the feasibility of supporting comprehensive NRPs.