Improving Retention, Confidence, and Competence of New Graduate Nurses

by Nursetopia on October 21, 2011

The Article: Ulrich, B., Krozek, C., Early, S., Ashlock, C., Africa, L., & Carman, M. (2010). Improving retention, confidence, and competence of new graduate nurses: Results from a 10-year longitudinal database. Nursing Economics, 28(6): 363-375.

Big Idea: This article discusses Children’s Hospital Los Angeles’ (CHLA) Versant RN residency development, implementation, and 10-year evaluation efforts to reduce costs and churn associated with new graduate nurse turnover. The Versant program consists of an in-depth curriculum, clinical immersion, and mentoring and debriefing.

Survey Says!: Nurse residency is a best practice to transition new graduates from nursing school into complex care. More than 6,000 nurses completed the Versant Residency program, which extends throughout the U.S., within the 10-year time-frame. Statistical analyses showed a decrease in turnover and increases in competency, nurse satisfaction, and confidence. Higher satisfaction scores correlated with lower levels of intent to leave the respective organization.

Quotable: “The readiness of new graduates to function as RNs continues to be in question. Del Bueno (2005), in reviewing 10 years of data for new nurses on the performance-based development system, found that 65%-76% of inexperienced RNs did not meet the expectations for entry-level clinical judgment and the majority had difficulty translating knowledge and theory into practice.”

“Hospitals rely on nurses as a critical component of error prevention. A study by Leape et al. (1995) found nurses intercepted 86% of all medication errors by physicians, pharmacists, and others who are part of the medication delivery system before the errors reached the patients. The application of competence, however, requires self-confidence. Competence without self-confidence is insufficient. As Bandura (2001, p. 10) noted in studies of efficacy, ‘Unless people believe they can produce desired results and forestall detrimental ones by their actions, they have little incentive to act or to persevere in the face of difficulties.’ The acceleration of confidence development in new graduates assures their accelerated competence acquisition is applied.”

So What?: The Versant program is now quite large, extending to healthcare facilities throughout the U.S. RN residency programs – either through Versant or home-grown – are becoming more and more common. If your organization does not have a residency program, one may benefit or impact both human and financial resources. It takes a great deal of coordination and support, and this article is a great place to start learning about best practices and components of a successful RN residency program.


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