This multisite study of transition to practice included 105 hospitals in three states. Hospitals volunteered to participate and
were randomly assigned to either the study group or the control group, and all new graduate registered nurses hired between
July 1 and September 30, 2011, were invited to participate. The study hospitals adopted the National Council of State Boards
of Nursing’s Transition to Practice model program; control hospitals continued using their existing onboarding programs, which
ranged from simple orientation procedures to structured transition programs with preceptorships.
The new graduate nurses who volunteered for the transition to practice study (n = 1,088) filled out surveys at baseline,
6, 9, and 12 months after beginning their first nursing position. Competence was reported by both the new nurses and their
preceptors. New nurse self-reported data included the number of errors, safety practices, work stress, and job satisfaction.
The hospitals provided retention data on the all the new graduates hired during the study period. Though the results showed
few statistically significant differences between the two groups, when the hospitals in the control group were categorized as
having established or limited programs, differences were detected. Hospitals using established programs had higher retention
rates, and the nurses in these programs reported fewer patient care errors, employed fewer negative safety practices,
and had higher competency levels, lower stress levels, and better job satisfaction. Structured transition programs that included
at least six of the following elements were found to provide better support for newly graduated RNs: patient-centered
care, communication and teamwork, quality improvement, evidence-based practice, informatics, safety, clinical reasoning,
feedback, reflection, and specialty knowledge in an area of practice.
Nancy Spector, PhD, RN, FAAN, Mary A. Blegen, PhD, RN, FAAN, Josephine Silvestre, MSN, RN, Jane Barnsteiner, PhD, RN, FAAN, Mary R. Lynn, PhD, RN, FAAN, Beth Ulrich, EdD, RN, FACHE, FAAN, Lou Fogg, PhD, and Maryann Alexander, PhD, RN, FAAN
Spector, N., Blegen, M.A., Silvestre, J., Barnsteiner, J., Lynn, M.R., Ulrich, B., Fogg, L., & Alexander, M. (2015). Transition to practice in hospital settings. Journal of Nursing Regulation, 5(4), 24-38.
- Publish Date
- Practice, Research