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Supplemental Digital Content 1.
Author, Date,
Title, Journal Aim/Purpose Type of
Study/Design Instruments, Reliability &
Validity, Data Collection Methods
Sample, Sample Size,
& How Selected
Results Involving
Turnover/Retention Limitations Quality of Evidence (Max Score=36) Bratt & Felzer.
2012. Predictors of new graduate nurses'
organizational commitment during an NRP.
Journal of Nurses in Staff Development.
To determine whether new grads' personal characteristics, factors
associated with job onboarding, and the work environment influence new nurses' organizational commitment
Longitudinal correlational design
Demographic questionnaire, Nursing Job Satisfaction Scale, Job Stress Scale, Clinical Decision Making in Nursing Scale, & Modified 6-D Scale of Nursing Performance.
Reliability/validity reported for each scale. Standard statistical software used.
16 cohorts (468) of NLRN in a 12 mo.
Residency program in acute care hospitals from 2005-2008
1 year retention rate 81%. Urban vs rural hospital setting, being in desired position, enjoyment element of job satisfaction, & job stress were significant predictors of
organizational commitment
Additional variables should have been tested such as
perceptions of leadership, support, unit culture, and empowerment.
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Chappell, Richards, &
Barnett. 2014.
New graduate nurse transition programs and clinical
leadership skills in novice RNs.
JONA.
To determine predictors of clinical leadership skill for RNs with 24 months of experience or less.
Hierarchical regression modeling to evaluate predictors of CLS among individual characteristics of RNs and characteristics of NGNTPs
Clinical Leadership Survey with reliability score indicated and also global clinical leadership scale to assess concurrent validity. Analysis conducted in PASW Statistics 18.0.
306 NLRNs with less than 24 mo experience in an acute care hospital with residency programs ranging from 4-52 weeks
RNs participating in longer NRPs were significantly more likely to remain in the organization (RNs in NRPs> 24 weeks were 21x more likely to remain at the organization when compared with NRPs
<12 wks
Limited to retrospective, self- report measures of NRP programs.
No ability to evaluate & control for specific characteristics of NRP. Low response rate of 6.6%.
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Fielder, Read, Lane, Hicks, &
Jegier. 2014.
Long-term outcomes of a
To determine what influence a NRP has on LT outcomes including
Descriptive design McCloskey/Mueller Satisfaction Scale, SurveyMonkey through email.
Reliability/validity
51 graduates of the NRP at the medical center (out of all 170 still
5.6% turnover rate during the 1st year, 8.5% after the 1st year, & 13.7% at 3 years
Small sample size.
Selection bias may be present because participation was voluntary from
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post
baccalaureate nurse residency program. JONA.
turnover rates, career
satisfaction, and leadership development.
scores reported.
Analysis using frequency &
descriptive statistics
& nonparametric Kruskal-Wallis tests used.
employed) were voluntary participants
current employees.
Friday, Zoller, Hollerbach, Jones, &
Knofczyynski.
2015. The effects of a prelicensure extern program and nurse residency program on new graduate outcomes and retention. JNPD.
To examine the value of providing both a prelicensure program and postlicensure program on the retention and satisfaction of NLRN
Longitudinal quantitative study with repeated measures
Casey-Fink Graduate Nurse Experience Survey
60 NLRN enrolled in UHC/AACN year long residency program at a 630-bed acute care teaching hospital
95% retention rate at 1 year, and 85%
retention at 2 years.
Small sample size. 29
Goode, Lynn, McElroy, Bednash, &
Murray. 2013.
Lessons learned from 10 years of research on a post-
baccalaureate nurse residency program. JONA.
To examine outcomes from 10 years of research on a post-
baccalaureate NRP and to report lessons learned
Longitudinal
quantitative design Casey-Fink Graduate Nurse Experience Survey
& Graduate NRP Evaluation used over course of entire study. First 3 years, McCloskey Mueller Satisfaction Scale &
Gerber's Control Over Nursing Practice Scale used, but then the Organizational Commitment Questionnaire replaced.
Reliability/validity scores reported.
New graduate residents who participated in UHC/AACN residency from 2002- 2012.
88% retention rate in the 1st year of implementation and 94.6% the last year
Voluntary participation, 40%
response rate, which varied greatly across different sites
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Harrison &
Ledbetter. 2014.
Nurse residency programs:
Outcome comparisons to best practices.
JNPD.
In NLRNs, does an RN
residency versus standard orientation increase recruitment and retention? - To compare 3 different NLRN programs within a single health system relative to 1st year turnover and intent to stay.
Cross-sectional descriptive design
Casey-Fink Graduate Nurse Experience Survey
202 NLRNs hired at 3 sites who responded to a mailed survey.
The only site for the NRP had the lowest 1st yr turnover @ 2%, but not statistically significant. It also had significantly
significant higher professional
satisfaction scores &
intent to stay in their current position (although not institution).
Convenience sample, limited responses. All sites in academic medical centers, may not be generalizable to other types of hospitals.
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Hillman &
Foster. 2011.
The impact of a nursing transitions programme on retention and cost savings.
Journal of Nursing Management
To identify the benefits and essential elements of a new graduate residency program
Time-series mixed-methods design
Casey-Fink Graduate Nurse Experience Survey, Areas of Worklife Survey, Conditions of Work-
Effectiveness Questionnaire II, Clinical Decision Making in Nursing Scale
251 new graduate nurses from June 2005- October 2009
90.8% 1-year retention rate averaged over the 9 cohorts
None listed, but economic recession could have potential effects on
retention unrelated to NRP
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Kowalski &
Cross. 2010.
Preliminary outcomes of a local residency programme for new graduate RNs. Journal of Nursing Management.
In a residency program - 1.
Does the level of clinical competency improve? 2.
Does the stress level decrease?
3. Does the level of anxiety decrease? 4. Do they experience
Descriptive design Preceptor Evaluation of Resident form (dev by hospital), Pagana's Clinical Stress
Questionnaire, Speilberger's State- Trait Anxiety Inventory, Casey- Fink Graduate Nurse Experience Survey.
Validity/reliabiliy
55 new graduate residents
1st year cohort retention 78%, 2nd year not completed but 96% at time of research (unclear at what pt in the year).
Stress levels decreased
& clinical competency increased over program. No statistical difference in
professional
Did not list any - but observed was the
reliability/validity of the hospital made tool they used, and
incomplete data of the second year endpoint.
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positive professional transaction? 5.
What % remain employed during a 1 yr program?
reported. SPSS 17.0
& SAS 9.1 used.
satisfaction.
Lynn. 2014.
UHC/AACN Nurse Residency Program: 2014 Outcomes Report.
To examine the impact of the UHC/AACN program on graduates evaluating self- perceptions of competence, confidence, commitment to nursing &
current position
& retention in current organization
Casey-Fink Graduate Nurse Experience Survey
& Graduate NRP Evaluation with validity/reliability noted.
5132 nurse residents hired between 1/12-12/12 in the
UHC/AACN residency program
95% retention.
Professional
satisfaction decreased over time. Greatest significant predictors of commitment to current position were Professional
Satisfaction &
perceived Support.
None listed. 35
Maxwell. 2011.
The
implementation of the
UHC/AACN new graduate nurse residency program in a community hospital.
Nursing Clinics of North America.
To evaluate outcomes of the UHC/AACN residency program implemented at St. Joseph's Hospital of Atlanta, Georgia.
Descriptive, comparative design
Casey-Fink Graduate Nurse Experience Survey
& Graduate NRP Evaluation.
Reliability/validity reported.
29 nurse residents participating in 1st cohort of
UHC/AACN residency program
100% retention in year 1 of NRP compared to previous 40%
retention rate prior to program
Nonrandom and nonexpirimental.
Relies on self reports from employees who may be vunerable to participant response bias
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Medas et al.
2015. Outcomes of a
comprehensive nurse residency
To evaluate the effectiveness of a year-long comprehensive NRP on NLRN
Prospective cohort
study design McCloskey/Mueller Satisfaction Scale, Casey-Fink Graduate Nurse Experience Survey
24 nurse residents participating in NRP in 2010.
90-94% since implementation. Intent to leave was highest at 12 months (out of 6, 12, 18 month
Response rate decreased at every endpoint, which could have impacted results.
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program.
Nursing Management.
satisfaction, confidence and role transition, retention rates, and intent to leave
and an investigator- developed Intent to Leave Survey.
Reliability/validity of tools listed.
endpoints).Significant predictors linked to satisfaction included weekends off/month, recognition from supervisors, opportunity for day shift, flexibility for scheduling weekends off, control over work setting, opportunities for interdisciplinary interaction,
recognition from peers, & control over work conditions
Single-site study, limited
generalizability.
Olson-Sitki, Wendler, &
Forbes. 2012.
Evaluating the impact of a NRP for newly graduated RNs.
JNSD.
1.What is the overall new graduate experience that includes a NRP? 2. What is the impact, if any, of the NRP on new nurse employee satisfaction? 3.
What is the impact, if any, of the NRP on new graduate nurse retention?
Nonexperimental, repeated measures, time series mixed- methods design.
Casey-Fink Tool (validity/reliability listed) &
investigator- developed tool.
SPSS software used for analysis.
31 new graduates who
volunteered to participate hired in 2006
& 2007.
Turnover prior to program was 12-15%, and after was 7-11%.
Economic recession &
temporary regional surplus of NLRNs could have artificially supported retention
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Phillips & Hall.
2014. Graduate nurse internship program. JNPD.
To evaluate a NRP created to improve retention rates of graduate nurses within their 1st year of hire and to
Comparative descriptive design
Casey-Fink Graduate Nurse Survey
(validity/reliability reported). SPSS used for analysis.
20 new graduates compared from 2010- 2011
No significant increase in retention post implementation.
Small sample limits
generalizability
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improve their perception of their role trasntion and socialization.
Rosenfield, Glassman
&Capobianco.
2015.
Evaluating the short and long term outcomes of a post-BSN residency program. JONA.
To evaluate short and long term outcomes of the
UHC/AACN NRP at NYU Langone Medical Center
Retrospective
descriptive design. Online survey &
Intent to Stay Survey. No reliability/validity data given or analysis method.
425 nurse residents from 2005-2012
90.6% 1 yr retention rate. Of all hired between 05-12 65.5%
remained employed (48.9% from 05, 95.6% from 12)
Single center, limits
generalizability
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Trepanier, Early, Ulrich, &
Cherry. 2012.
NGNRP: A cost-benefit analysis based on turnover and contract labor usage. Nursing Economic$.
To conduct a cost-benefit analysis of a nursing residency program utitlizing turnover rate and contract labor usage.
Stepwise
regression analysis Stepwise regression analysis and cost- benefit analysis done with secondary data collected by national provider of
residency program and a multi-site health care corporation
524 nurse residents from a multi-site healthcare corporation (15 hospitals)
(15 hospitals in study) had pre-residency retention rates of 63.2%. Now have 93.6% retention @ 1 year.
Not applicable to non-hospital settings. State of economy 2008- 2010.
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Ulrich et. al.
2010. Improving retention, confidence, and competence of NGN: Results from a 10-Year Longitudinal Database.
Nursing Economic$.
To evaluate development of a RN residency program
Longitudinal mixed-methods design.
"Reliable and validated measurement instruments"
6000+ nurse residents from 1999-2009
Retention @ 12 mo=92.9%, 24 mo=80.4%, 36 mo=71.4%, 48 mo=65.8%, 60 mo=60.2%. (Pre- residency retention @ 12 mo=73% & 24 mo=51%)
"Data only included in database if they meet the established criteria" -which is never specified.
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