Nurse Residency Programs and their adaptation to public health

1. Nurse Residency Programsand their adaptation to public health Julie Beth Heiniger, BS RN L. Michele Issel, PhD, RN College of Nursing/School of Public Health University of Illinois-Chicago Presented at the American Public Health Association’s Annual Conference San Francisco, California October 29, 2012 KRISP Project

2. Overview • What is a NRP? • Acute care vs. Community/Public Health (C/PH) • Findings • Application to C/PH • Discussion KRISP Project

3. New Graduate RNs • New RNs have limited experience, yet responsible for a standard patient assignment shortly after completing a standard facility orientation. • Nurse Residency Programs (NRPs) created to promote seamless academic progression (1) KRISP Project

4. NRPs • “A joint partnership between academia and practice that is a learner-focused, postgraduate experience designed to support the development of competency in nursing practice” (2) • Hospital and acute care settings • Shown to: • Decrease recruitment, training costs (3,5,6,7,8,9) • Ease transition of new student nurses (2, 3, 8 10) • Increase nurse retention (3, 5) • Increased job satisfaction (3,4) KRISP Project

5. What about Public Health? KRISP Project

6. PHN Specialty • NRPs absent in Community/Public Health • The public health nursing specialty is distinguished from other nursing specialties through a set of standards and principles focused on population-based healthcare and collaboration with a variety of healthcare disciplines (11) • NRPs ought to be tailored to the uniquely public health nursing specific standards and guidelines! KRISP Project

7. Purpose • Literature review to identify core curriculum components in established nurse residency programs and discuss how they might be applied in a public health model. • PRISMA method of systematic reviews • Part of the KRISP project • http://krispproject.wordpress.com/ KRISP Project

8. Commonalities • Several common core curriculum topics relevant to public health nursing, including: • Critical thinking • Leadership • Evidence-based practice • Time management • Communication • Professionalism • Standards of care • Ethical and Legal Issues • Delegation • Conflict Management KRISP Project

9. Quad Council Competencies • Domain 1: Analytic and Assessment skills • Domain 2: Policy Development/Program Planning • Domain 3: Communication • Domain 4: Cultural competency skills • Domain 5: Community Dimensions of Practice Skills • Domain 6: Public Health Science Skills • Domain 7: Financial Management and Planning Skills • The Public Health Nursing Core Competencies support the scope and standard of practice for public health nursing. • The Public Health Nursing: Scope and Standards of Practice document was used as a reference to ensure continuity and consistency with those standards (11) KRISP Project

10. Deficiencies • Three domains of competencies are not met: • Policy Development and Program Planning • Public Health Science Skills • Financial Management and Planning Skills KRISP Project

11. Discuss… • How can we adapt NRPs to meet specific needs of c/PHNS? How much? Where? Who? How? Students or professionals? KRISP Project

12. Things to Consider Strengths • Existing models • Some categories overlap • Evidence-Based • Undergrad Education • Grants/Funding • AHA Issues • Financing (Isn’t is always...?) • Who would write curriculum? • Time-Frame? • Certification (PHN-C) • Location? • Mentors/Preceptors? KRISP Project

13. Suggestions • Regionalization • Smaller Health Departments combine • Undergraduatetraining • Should there be specialty education in BSN programs? • Interdisciplinary education: • PH policy • Urban Health/Policy • Finance • Business/Administration KRISP Project

14. References • (1) Fink, R., Krugman, M., Casey, K., & Goode, C. (2008). The Graduate nurse experience: Qualitative residency program outcomes. The Journal of Nursing Administration, 38 (7), 341-348. • (2) Hedrich, B. & Llindsay, A. (2006). Nurse Residency Programs: Redesigning transition into practice. Journal for Nurses in Staff Development, 22(2), 55-62. • (3) Altier, M.E., & Kresk, C.A. (2006). Effects of a 1-year Residency Program on Job Satisfaction and Retention of New Graduate Nurses. Journal for Nurses in Staff Development, 22(2), 70-77. • (4) Anderson, T., Lidnen, L., Allen, M., & Gibbs, E. (2009). New graduate RN work satisfaction after completing an interactive nurse residency. Journal of Nursing Administration, 39(4), 165-169. • (5) Meyer-Bratt, M. (2009). Retaining the Next Generation of Nurses: The Wisconsin Nurse Residency Program Provides a Continuum of Support. The Journal of Continuing Education in Nursing, 40(9), 416-425. KRISP Project

15. References, continued • (6) Pine, R., & Tart, K. (2007). Return on investment: Benefits and challenges of a Baccalaureate nurse residency program. Nursing Economics, 25(1): 13-18. • (7) Poynton, M.R., Madden, C., Bowers, R., & Keefe, M. (2007). Nurse Residency Program Implementation: The Utah Experience, Journal of Healthcare Management, 52(6), 385-397. • (8) Hedrich, B. & Llindsay, A. (2006). Nurse Residency Programs: Redesigning transition into practice. Journal for Nurses in Staff Development, 22(2), 55-62. • (9)Goode, C.J., & Williams, C.A. (2004). Post-Bacclaaureate Nurse Residency Program. JONA, 34(2), 71-77. • (10) Krugman, M., Bretschneider, J., Horn, P.B. Krsek, C.A., Moutafis, R.A, & Oare Smith, M. (2006). The National Post- Baccalaureate Graduate Nurse Residency Program. Journal for Nurses in Staff Development, 22(4), 196-205. • (11) American Nursing Association [ANA]. (2007). Public Health Nursing: Score and Standards of Practice. Silver Spring, MD : American Nurses Association. KRISP Project

16. Thank you! • KRISP project • http://krispproject.wordpress.com/ • Funded in part by HRSA Bureau of Health Profession, Division of Nursing,  under the Nurse Education, Practice and Retention Program,  grant number D11HP14605 KRISP Project