Text size: Size - small Size - medium Size - large

Transition to Practice has taken off with our innovative study.

Why Transition to Practice (TTP)?

“Authentic leaders are not made nor are they born; they are enabled or disabled by the organizations in which they work.”
— David Leach, MD, Past Executive Director, ACGME

Over the years, NCSBN and boards of nursing (BONs) have looked at the issue of training and retention of new graduate nurses. They have found that the inability of new nurses to properly transition into new practice can have grave consequences.

The Problem

The Impact

New nurses care for sicker patients in increasingly complex health settings.

More than 40% report making
medication errors.

New nurses feel increased stress levels.

Stress is a risk factor for patient
safety and practice errors.

Approximately 25% of new nurses leave a position within their first year of practice.

Increased turnover negatively influences patient safety and health care outcomes.

Health institutions with transition programs have seen a marked drop in attrition, along with improved patient outcomes. There is a need for best practices of training new nurses that can be replicated across the country to ensure consistent quality of care, and drop the alarming turnover rates of new nurses. Additionally, the Institute of Medicine in its Oct. 5, 2010 "Future of Nursing" report calls for the implementation and evaluation of nursing residency programs.

Developing the Model

 In collaboration with more than 35 nursing organizations, a NCSBN committee developed the evidence-based standardized model.

NCSBN collaborated with all stakeholders to work toward a comprehensive solution to assist nurses as they transition from the classroom to practical settings. This TTP model will serve the needs of both large and small, city and rural institutions. The TTP toolkit contains detailed resources on the model.

Conducting the Study

NCSBN is now conducting a longitudinal, multi-institutional, randomized study to investigate the effect of the TTP model on patient safety and quality outcomes. This type of TTP study has not been done before, and is unique for the following reasons:

  • The study is using a control group for comparisons.
  • All levels of nursing education in all settings will be studied.
  • Patient outcome data will be collected.

The study started with a six month design and development phase to develop and test e-learning modules and to develop a web-based data collection system. E-learning modules have been built upon the Transition to Practice Module Outline developed by the committee, with input from BONs and stakeholders.

The modules include:

  • Preceptor Training
  • Patient Centered Care
  • Communication and Teamwork
  • Evidence-based Practice
  • Quality Improvement
  • Informatics

Phase I: Internal Validity

  • July 2011 - December 2012 (18 months)
  • Conducted in three states, and includes a minimum of 250 newly licensed Registered Nurses (RNs)
  • Consists of an intervention group and a control group

Phase II: External Validity

  • April 2012 - October 2013 (18 months)
  • Conducted in the same three states as Phase 1
  • Includes newly licensed RNs and newly licensed practical/vocational nurses (LPN/VNs) in long term care, home health, ambulatory and public health settings
  • Consists of an intervention group and a control group

Participating nurses, preceptors and site coordinators will interact with other participants and NCSBN through a TTP study website. At the end of each phase, data will be organized and analyzed by NCSBN and a third party firm specializing in statistical analysis.

Once Phase II of the study closes in 2013, the results of this study will provide evidence to BONs on whether or not to implement this regulatory model. The results will be shared at the 2014 NCSBN Annual Meeting.

Participating States

Illinois, North Carolina and Ohio have been selected to participate. These three states mounted enormous statewide efforts to identify more than 150 participating sites for Phase I and Phase II of the study. While Phase I consists of hospital settings only, Phase II includes long-term care, home health, ambulatory and public health settings.    

Tags: Research,Transition to Practice,TTP,NCSBN