Nurse residency program receives recognition for consistent, high quality care

The nurse residency program at University of Louisville Hospital, a part of KentuckyOne Health, is one of 12 in the nation to receive recognition for consistent, high quality care. The Commission on Collegiate Nursing Education (CCNE), the leading accrediting body for nurse education and nurse residency programs, has awarded the program a five-year accreditation, the maximum term.

"Accreditation is a testament to the leadership of ULH Chief Nursing Officer Mary Jane Adams, MSN, RN, and demonstrates the level of confidence the CCNE has for the ULH model to achieve competency and effectiveness of the program, including its ability to comply with CCNE standards," said Velinda J. Block, DNP, RN, NEA-BC, chief nursing officer, KentuckyOne Health. "This is considered the industry's 'gold standard,' and provides the metric by which all other residency programs are measured. Over time, it is our goal to expand the success that has been achieved at ULH to additional sites in KentuckyOne."

The aim of the 12-month program is to further develop and transition new baccalaureate-prepared graduate nurses into the workforce, a key recommendation of the Institute of Medicine's landmark report on "The Future of Nursing: Leading Change, Advancing Health." In 2010, the inaugural 14 residents were all graduates of the University of Louisville School of Nursing. Since then, more than 250 nurse residents from nursing schools across the country have completed the nurse residency program.

"Patients have complex health care needs, and it can be very demanding for new graduates," said Marcia Hern, EdD, CNS, RN, dean and professor, UofL School of Nursing. "The ULH nurse residency program is an extension of our senior-level Transitions to Practice course, providing new graduates the additional support they need to be successful."

Hern said the program is similar to the concept of the residency for other health professionals, and is moving the nursing profession to a higher level within its scope of practice. The program shapes new nurses beyond most entry into practice abilities, building upon what they learned in school, she said.

"ULH is proud to be a leader in creating thriving workplace experiences; our nurse residents report improved confidence, competence, ability to organize and prioritize, communication, leadership and a reduction in stress levels," Adams said.

"Nursing educator and theorist Patricia Benner, RN, PhD, FAAN, identified a gap between the end of graduation and competent clinical practice. Benner's application of the Dreyfus model of skill acquisition to the new nurses' experience provides the framework for this successful model. Typically hospitals experience a 50-percent turn-over rate of entry -level nurses in the first six months on the job," said University of Louisville Hospital RN Education Coordinator: Nursing Education & Research, Cathern S. Velasquez, DNP, RN, CPHM. "Through this program we have retained 90-percent of nurse residency graduates at the one-year mark."

Velasquez, who designed the nurse residency program in collaboration with School of Nursing faculty, said the program has saved ULH millions of dollars in retention costs. Since the program began in 2010, she estimates a $25 million savings in recruiting and training costs, including over $9 million for 2013.

As part of their residency experience, nurses are required to develop evidence-based projects, leading to measurable improvements in patient care. One project sought to revise the hospital policy that excluded children under 14 from visiting their loved ones during the lengthy admission and treatment for cancer-related illness in the Oncology ICU setting. This project resulted in health care policy change while improving the patient-and family-centered care experience at ULH. The nurse resident graduates are in the process of publishing an article related to this project in a peer-reviewed nursing journal.

Throughout the program, nurse residents are assessed for competency on their clinical skills, critical thinking, ethics and end of life care, cultural diversity, application of evidence-based nursing practice and leadership, and professional accountability.

"We have enjoyed a strong practice partnership with the UofL School of Nursing; our accreditation interfaces with the school's own CCNE accreditation, and is an extension of the exceptional education they provide to future nurses - the Louisville Metro community is certainly the beneficiary of our joint achievement," Velasquez said.