Retention Benefits of a Clinical Nurse Residency Program in ED
Robin MacPherson-Dias, MS, BSN, RN, CEN, TCRN, CCRN
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Session G presented Saturday, September 16, 2017
Purpose: Emergency Departments RNs experience an annual turnover rate of approximately 22% which is higher than national average. New Graduate Residency programs have been shown to increase nurse retention. The objective of this study was to examine the retention benefits of a Clinical Nurse Residency (CNR) program in the Emergency Department and examine the perceived benefits, challenges, and effectiveness of an ED CNR program.
Design: Descriptive statistics were used to describe retention rates. Focus groups were utilized for qualitative analysis to obtain major themes regarding the Emergency Department CNR program.
Setting: Level 2 trauma center, STEMI recieving center, primary stroke center, annual volume > 82,000.
Participants/ Subjects: All ED CNRs between 2005 and through 2016 were included in the retention data. The comparison group included all ED RNs hired between 2005 through 2016. Focus groups included 23 prior ED CNRs.
Methods: Hire date and end date (if applicable) for all Emergency Department RN’s who started between 2005 and present was provided by Human Resources. The group separated into CNR’s and non-CNR’s. Retention rates at 1 year, 2 years, 3 years, and 5 years were calculated for ED CNR RN’s and ED non-CNR RN’s from 2005 through 2016. Frequency distribution was utilized and displayed as a percentage. For the focus groups, 4 separate focus groups were executed utilizing purposive sampling of past and present CNR’s. Open-ended questions were employed, notes were taken by the moderator, and notes were summarized for analysis.
Results/Outcomes: Retention rates for RNs who completed the ED CNR program exceeded the retention rate of non-CNR RNs by approximately 20% in all categories (1yr, 2yrs, 3yrs, and 5yrs). Themes from focus group questions: - What were the major factors that contributed to your success in the ED CNR program? Support, Education, Program length, Camaraderie; - What were the most challenging aspects of the ED CNR program? Learning to manage time and priorities, Pace and critical nature of ED, Volume of knowledge to gain; - What factors have contributed to your retention in the ED following the CNR program? Teamwork & camaraderie, coworkers "ED family", Education, Support.
A Clinical Nurse Residency program in the ED is a cost-effective effective strategy to address nursing turnover and retention in the ED. Retention rates for ED new grad CNRs exceed the retention rates of non-CNR RN’s in ED. Participants of a structured ED CNR program feel supported and prepared for their role as an ED RN.
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