Almost 30% of new nurse graduates leave the position within the first year of practice, and almost 60% leave within 2 years. When new nurse graduates do not effectively transition into practice, nursing satisfaction is affected, and additional costs are incurred by their organizations through continual hiring of nurses. The purpose of this project was to develop a comprehensive, evidence-based nurse residency program (NRP) for new nurse graduates working in a 16-bed intensive care unit (ICU) of a 160-bed community hospital in the mid-Atlantic region of the United States. Using a team approach, Rosswurm and Larrabee's model of evidence-based practice was used to guide the project design, which included a pretest followed by 10 educational sessions. The plan concluded with a posttest to assess knowledge gained. The curriculum focused on 3 key areas identified by the Commission on Collegiate Nursing Education: leadership, patient outcomes, and the professional role of the nurse. Evaluation of the curriculum was completed by 3 Master of Science in Nursing-prepared content experts using a dichotomous scale. An average score revealed that the content met the objectives of each session. The experts also conducted a content validation index (CVI) of each pretest/posttest item using a Likert scale that ranged from 1 (not relevant) to 4 (highly relevant). The scale-CVI average, or the average CVI of all items, was .99; the universal agreement scale-CVI, or universal agreement of all items was .98, meaning there was high agreement across raters. Nurses who participate in the nurse residency program will be better able to transition into practice in the ICU as they provide care for today's complex patients, thereby positively impacting social change in their role as nurses as well as impacting patient, family, and organizational outcomes.

Graduate nurses beginning their nursing career require a collaborative relationship with an expert nurse mentor to make this transition successful. However, high turnover among these experienced nurse mentors is causing a problematic gap in knowledge transfer, experience, and expertise in the nursing workforce. This project investigated whether nurse mentors who mentored in a Nurse Residency Program (NRP) remained with the organization longer and were more satisfied with their mentoring experience than nurse mentors who mentored outside of a NRP. The diffusion of innovations theory was used to support the project and process of dispersing information on the outcome of the project. Sources of evidence for the project included case-cohort studies, systematic reviews obtained via an exhaustive literature review, and the collection of nurse mentor retention and satisfaction data through the use of a cross-sectional survey. Data were assessed from 214 registered nurses at a hospital in Rapid City, South Dakota and divided into 2 groups: nurse mentor and NRP mentor. When compared to nurse mentors, 10% more NRP mentors reported being employed in their current position with the intent to remain employed for 10 or more years as well as being very satisfied with their mentorship experience, supporting the project question. This project substantiates the need for experienced nurse mentors to prepare new graduate nurses coming into the profession. Contribution to positive social change is as a result of mentorship in nursing that functions as a means of retaining both new graduate and experienced nurses simultaneously.

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Indiana University-Purdue University Indianapolis (IUPUI) / New nurses report feeling unprepared, incompetent, and highly stressed, contributing to first-year turnover rates of 25% in some healthcare organizations. Turnover, combined with a preparation-practice gap, has alerted advocacy organizations and researchers to recommend the development of nurse residency programs. Nurse residency programs are a post-graduate training period where new nurses receive enhanced clinical education in the healthcare setting. While highly variable in structure and attributes, programs usually include educational sessions, clinical immersion, and role socialization opportunities. Evidence supports that new nurses participating in nurse residency programs experience positive outcomes, including increased confidence, competence, and decreased turnover rates. Despite this, only half of the hospitals nationwide have implemented a program with most designed around a single health system mission. This dissertation study aimed to identify the attributes of nurse residency programs influencing the newly licensed registered nurse. An integrative review of the literature and evolutionary concept analysis was completed to examine the state of the science of nurse residency programs. Findings revealed a lack of conceptual and theoretical design and variability among program structures, creating a gap in the literature about the attributes of programs that are most influencing new nurses. Based on the literature's noted gaps, a qualitative description study was conducted. Purposive sampling strategies were used to recruit nurses who recently completed varied program models across the United States. New nurses reported the attributes of programs and described how those positively and negatively influenced the transition to practice experience. The overarching themes revealed that new nurses need a cadre of highly supportive individuals across the clinical and educational continuum who espouse astute interpersonal and communication skills. New nurses desire engaging activities with intra and interprofessional team members for clinical skill application, knowledge advancement, and role socialization. New nurses need the structure of meetings at times and in a sequence conducive to learning; and for preceptorship experiences to be facilitated by trained preceptors, on a unit, and of a length that supports confidence for autonomous practice. Future research will include the development and testing of an evaluation tool based on the findings from this study.