Melinda Swander

University of Central Florida

College of Nursing

 Do

New Nurse Transition Programs Increase

Retention Compared to Standard Orientation?

 New

graduate nurses are faced with many

challenges in the inpatient setting

Electronic documentation requirements

Decrease in hospital length of stays
Higher acuities
Reality shock of the nursing profession

(Trepanier, Early, Ulrich & Cherry, 2012)

 Shortage

of nurses is on the rise

Increase as much as 20% by the year 2020.

Reported turnover rates in 2014 40-60% (Harrison
& Ledbetter (2014).
Cost of new nurse turnover within the first year
of employment is equivalent to a nurses salary
for a whole year (Bratt, 2009).

 In

2010, The Robert Wood Johnson

Foundation and the Institute of Medicine
recommend the implementation of nurse
residency programs to facilitate and support
new nurses transition into clinical practice
(Friedman, Delaney, Schmidt, Quinn, &
Macyk, 2013).

 Review

of the literature was conducted to

evaluate retention rates with a standard
orientation compared to those that initiated
a nurse transition program.

Databases

utilized for search:

One-Search
Cumulative Index to Nursing and Allied Health
Literature (CINAHL)
Cochrane Database of Systematic Review
PubMed

Key search terms included:

Graduate nurse
Nurse residency
Preceptor program
Retention
Employee retention
Orientation program
Residency program
Turnover
Standard orientation
Nurse retention
Traditional orientation
Transition program

Inclusion Criteria

Studies published between

2010 to present.

Written in the English

Language

Compared retention rates

of standard orientation to
retention rates post
implementation of a
transition program.

Exclusion Criteria

Articles that did not

specifically reveal their
retention rates after
implementation

Did not clearly define

components of their
transition program

Written in non-English
languages

Consisting of only literature

reviews.

 Reviewed

a total of 57 Articles
A total of 8 met the inclusion criteria
Total sample size of 1,256 graduate nurses
Level of evidence

4 Level IV
2 Level V
2 Level VI

All

articles met level 3 criteria using Quellys

Tool of Validity

common themes
Retention rates/Decreased turnover rates
Cost savings

Retention Rates

Prior to implementation rates ranged from 50%-57%

Post implementation ranged from 71%-100%

(Berube et al., 2012; Dyess & Parker, 2012; Fiedler et at., 2012; Friedman et al.,
2013; Hillman & Foster, 2011; Oson-Sitki et al., 2012; Setter et al., 2011;
Trepainer et al., 2012)

 Turnover

Rates

12%- 36.8% prior to implementation

5.6% - 11% - post implementation

(Fiedler et al., 2014; Olson-Sitki et al., 2013 & Trepainer et al., 2012)

 Reduction
Decrease

in turnover

in contracted labor

(Berube et al., 2012; Fiedler et al., 2014; Friedman et al., 2013; Hillman
& Foster, 2011; Trepanier et al., 2012)

 Small

sample sizes
Limited participation
No comparison data

 Implement

transition programs
More research to determine effective
components of transition programs
Need for longitudinal studies