Document Type

Doctoral Project

Publication Date



The transition to practice (TTP) of new registered nurses has long been a concept of interest within the nursing profession as unsuccessful transition to practice impacts individual nurses, healthcare organizations, the nursing profession, and the quality of patient care. There has been a renewed focus on transition to practice as changes in the healthcare delivery system and nursing profession have highlighted the importance of successful TTP in ensuring quality patient care in all settings. With an increasing geriatric population and healthcare delivery shifting away from acute care settings, greater numbers of new registered nurse graduates are transitioning to practice in extended care facilities where there are fewer resources to support successful transition to practice. According to the American Health Care Association, the 2012 mean turnover rate for registered nurses in skilled nursing care centers was 50%, which was an 11% increase from the prior year. This evidenced-based practice change project developed a new registered nurse graduate nurse TTP program in the extended care setting using the TTP program developed by the National Council of State Board of Nursing (NCSBN). Implementation of the program was piloted in two facilities within a large multisite healthcare system that provides extended care, skilled nursing, and home health care services. The intent of the project was to support the TTP of new registered nurse graduates who have been employed for less than 12 months in this setting and to determine the feasibility and sustainability of the v TTP program throughout the organization. Preceptors were identified at each pilot site to work with the new registered nurse graduates for completion of the program. Each new registered nurse graduate completed five online modules over the course of 10 weeks and met with a preceptor after each module. Following completion of the program, the new registered nurse graduates were invited to complete a survey to evaluate the program and provide feedback. They were also invited to complete the Casey-Fink Graduate Nurse Experience Survey© both pre and post completion of the program to measure any differences in their confidence levels following the intervention. The Iowa Model of Evidence-Based Practice to Promote Quality Care (Iowa Model) was used to guide implementation of the project. Although there was a small sample size and findings from the Casey- Fink Graduate Nurse Experience Survey© showed no significant statistical findings for the outcome of confidence, feedback about the program was positive with anecdotal evidence that the program was valuable to the organization. Following completion of the pilot project, the stakeholders decided to create a task force to implement the program across the organization as it was viewed as a positive, sustainable approach to help new registered nurse graduates experience a successful transition to professional practice.

Included in

Nursing Commons