"How Can We Do Better?": A Case Study of a Pre-Implementation Analysis of a Residency Program for New Graduate Nurses in Canada.

Abstract

BackgroundUp to 33% of newly graduated nurses leave the profession within the first two years. This high turnover rate can burden care teams, negatively impacting the quality of care provided. To alleviate this problem, transition programs are offered to new nurses; however, they vary considerably in type and duration. Despite this heterogeneity, many researchers conclude that transition programs have a positive overall effect on new nurses' competencies, self-confidence, satisfaction, stress, and retention, especially when they are longer than six months and have an explicit framework and structure, such as residency programs.PurposeTo conduct a pre-implementation analysis of a residency program in the Canadian context.MethodsUsing a case study methodology, two sequential steps were performed to model the already implemented transition program and its components that needed to be upgraded to a residency program. Data were collected through 1) document analysis (n = 1,601) with selected interviews of stakeholders (n = 5) and 2) a survey with new graduate nurses (n = 29) and preceptors (n = 11).ResultsA preliminary logic model of the program was developed, depicting the structure of the proposed activities in terms of organizational orientation, unit integration, autonomous practice, and additional support measures. The operationalization of some program components was variable and sometimes missing, thereby affecting its quality.ConclusionThis study showed how transition programs already implemented in clinical settings can be enhanced into residency programs by conducting a pre-implementation analysis. This can positively impact the transition of newly graduated nurses, including their retention.