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Vizient/AACN Nurse Residency ProgramTM

Leadership Presentation

Program Development

Vizient Presentation │ Feb 2016 │ Confidential Information2

University HealthSystem Consortium and AACN partner to address the nursing

shortage

NRP begins demonstration project and multi-site research study

NRP made available to hospitals nationally outside of Vizient membership

Hawaii adopts NRP and becomes the first to implement a state collaborative

• 10 year celebrations

• Conclusion of multi-site study

• New evaluation tools

• Dashboards

• Maryland state collaborative

• Implementation in ambulatory, long term care, other alternative settings

• Continued research to establish the ROI

• Continued growth

• YOUR IDEAS

1999

2002

2008

2011

2012

2013

Future

IOM Report on the Future of Nursing2010

Vizient/AACN Nurse Residency Program™

Vizient Presentation │ 2016 │ Confidential Information3

ID

MT

WA

OR

SDWY

ME

IANE

NV UTCO WV

MOKS

AZ NMOK

TNNC

VAKY

AR SC

ALMSGA

CA

LA

FL

ND

TX

MN

INIL

WI

MI

PA

OH

NY

AK

AK & HI not to scale

Participating

Not participating

HI

VTNH

MA

RICT

NJ

DEMD

DC

A Transition to Competency and Professionalism


Program is designed to support the

new graduate nurse to:

•Use effective decision-making skills

•Provide clinical nursing leadership at

the point of care

• Incorporate research-based evidence

into practice

•Strengthen professional commitment

to nursing

•Formulate an individual development

plan

What is Unique About the Vizient/AACN Nurse Residency ProgramTM?


• Has become the gold standard, well published, cited by IOM

• Only nurse residency program to be adopted as a state model

– Hawaii

– Maryland

• 1-year curriculum

• Requires an academic partner

• Designed as monthly seminar sessions, the residency experience is a

complement to nursing orientation and specialty training, but with a

different focus

• Can be customized to hospitals, systems, other care delivery settings

• Demonstrated consistently positive results since the initial

demonstration project in 2002

* Goode, C.J., Lynn, M.R., McElroy, D., Bednash, G.D., & Murray, B. (2013) Lessons Learned From 10 Years of Research on a Post-

Baccalaureate Nurse Residency Program. Journal of Nursing Administration, 43(2), 73-79.

The Journey


High Expectations

At 6 Months

At 12 Months

Competent

Practitioner

Vizient/AACN Nurse Residency ProgramTM


CurriculumFocus on

Professional Practice

MandatoryParticipation

of NewGrad Hires

Participationin an

Evidence-basedPractice Project

Interactivewith Experts in the

Organization

SupportDevelopment

of Professional Portfolio or Plan

Requirementfor an

AcademicPartnership

Evaluationand

Benchmarking

Organizational Impact


Retention is a Signature Outcome


82.0

84.0

86.0

88.0

90.0

92.0

94.0

96.0

98.0

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Mean = 93.1SD = 2.89

National Average for Nurse

Turnover in First Year 20-27%

Benefits As Reported by Program Participants and Supported by Data

Increased:

• Retention

• Commitment

• Confidence

• Skill

• Clinical Leadership

• Professionalism

• Interprofessional Team Building

• Evidence-based Practice


Greatest Strengths Reported by Nurse Managers


•Support system/cohort concept/

safe place for students

•Confidence/growth/ knowledge

residents gain

•Collaboration/networking

•Evidence-based practice project

•Recruitment and retention

Program Implementation


Key Features of NRP Implementation


• Most often implemented in Nursing Education or Professional

Development

• Applied across all practice settings

• Used to assist hospitals meeting the Institute of Medicine goal of 80%

BSN by 2020

• Supports higher level of professionalism and development of future

leadership

• Cited by Magnet reviewers as a critical component of nursing

excellence

CNO

Coordinator

Facilitator

Preceptor

Unit Nurse Mgr

Content Expert

Academic Partner


Resident

Supporting Roles

Curriculum and Program Emphasis


Evidence-Based Practice Project

Leadership

Patient care delivery, care coordination, resource management, delegation, inter-professional communication and conflict

resolution

Quality Outcomes

Safety and quality focus, pain, skin and wounds, falls, medications, infection control, patient teaching and changing patient

condition

Professional Role

Ethical decision making, end of life care,

cultural competence, stress management,

evidence based practice and professional

development

Evidence-based Practice Project

• Group or individual project

• Identify a practice problem

– Nurse manager

– Unit based council

– Staff meeting

– Observation

• Literature review of research on the subject

• Formulate a change in practice

• Implement the change

• Evaluate the results


Power of the Evidence-based Practice Project (March 2016)

Influencing Nursing Practice and Policy: Podium presentations

• Utilizing Modern Music Therapy to Promote Patient-Centered Care and

Increased Satisfaction in the Intensive Care Unit

• Cell Phone Application Increasing RN Confidence and Compliance with Policies

• The Formation of the Nurse Residency Program Alumni Association

• Quantitative Blood Loss in the Post-Partum Period

Influencing Nursing Practice and Policy: Poster presentations

• First Place: Intrinsic Configuration of Alarm Parameters: A Quality Improvement

Project to Attenuate Non-Actionable Alarms in a Neurosciences Critical Care

Unit

• Second Place: The Use of Premedications for Blood Product Transfusions in

the Pediatric Hematology/Oncology Population

• Third Place: Skin Risk Assessment in Neonates


Communicating Expectations


• Mandatory for all new graduate

hires

• Attends and participates in all

NRP events

• Accountable for scheduling

• Actively participates in evidence-

based project

• Completes all surveysCNO

Coordinator

Facilitator

Preceptor

Unit Nurse Mgr

Content Expert

Academic Partner

Resident

NRP Professional Resident Networking


Residency Program Evaluation and Reporting


Vizient Evaluation Tools


Evaluation Outcomes Timing

Casey Fink Graduate

Nurse Experience

Survey

Stress

Support

Organizing and prioritizing

Communication/leadership

Professional satisfaction

Program start (within 10 weeks)

6 months

12 months

24 months (Optional)

36 months (Optional)

Resident Progression

Survey

Autonomy

Collaboration

Unit engagement

Unit leadership

Satisfaction and commitment

Patient safety

Advocacy

Program start (within 10 weeks)

6 months

12 months

End of Program

Evaluation

Feedback re: preceptors, facilitators,

sessions12 months

Post-Residency

SurveyIncluding career progression

24 months

36 months

Institution Specific Evaluation Tools


Evaluation Outcomes Timing

Recruitment of high quality

applicants

Increase in numbers of high quality

applicantsBased on hiring

practices

Retention

Increase in retention of new graduates

(Determine benchmark) Annually

Evaluation of seminars and

content experts

Satisfactory evaluations of seminars and

content experts (Determine benchmark) Monthly

Evaluation of resident

facilitators

Satisfactory evaluation of resident

facilitators (Determine benchmark) Annually

Evaluation of NRP coordinators

Satisfactory evaluation of NRP

coordinator(s) (Determine benchmark) Annually

Insights Learned by Experience

• Advisory group is critical

• Unit manager involvement is a key to success

• Recruiter/HR involvement positions expectations

• Marketing of the program is important internally and externally

– Managers, preceptors, staff nurses

– Colleges of Nursing

– Web site for new graduate applications

• Incentives and motivation for the program leaders

– Visibility at national meetings

–Supports Magnet and Pathways to Excellence

– Accreditation


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