Transition to Practice in Nonhospital Settings

Abstract

A survey conducted in 2001, and replicated in 2003 with the same results, found that fewer than 50% of employers thought newly licensed nurses were safe and effective in practice.These findings caused concern for boards of nursing, so in 2002 the National Council of State Boards of Nursing (NCSBN) began to examine transition to practice (TTP) in nursing, developing an evidence-based model program and studying its effectiveness in hospital and nonhospital settings. After completion of the TTP study in hospitals with registered nurses (RNs) published earlier in 2015, a study was conducted in nonhospital facilities with RNs and licensed practical nurses to determine if NCSBN's TTP program could be used effectively across settings. Sites volunteering to participate, however, faced many challenges while the study was underway. This article presents the TTP program, study design, challenges faced by nonhospital sites trying to implement a TTP program, and limited findings. These results are important because they highlight what was learned and set the groundwork for future TTP programs and studies involving nonhospital sites. The study examines factors faced by new graduates, such as work-related stress and job retention. This study included 34 nonhospital settings in three states. The sites that volunteered were nursing homes and public health and home health settings. Twenty-three facilities hired 48 new nurses who were enrolled in the study between April 1, 2012, and October 31, 2012. Each site was randomized to either the study group (TTP group), which adopted the NCSBN's TTP program or the control group, which used its existing onboarding orientation program. Results are presented on competency assessment, reports of errors and safety practices, work stress, job satisfaction, and retention.