This evidence-based practice project assessed the impact of integrating mindfulness training into an existing nurse residency program. BACKGROUND: Stress and burnout are endemic in healthcare. The transition to practice is associated with stress and anxiety for newly graduated nurses. Evidence supports mindfulness-based interventions to mitigate stress and burnout and improve the workplace environment and patient outcomes. METHODS: This project employed a pre/post design to measure burnout, stress, and mindfulness, comparing means and standard deviations between intervention and comparison nurse residency cohorts. Mindfulness training was integrated at 4 points within the 1st 6 months of the residency program. RESULTS: The intervention cohort reported significantly less burnout and stress and more mindfulness at 6 months than the comparison group. CONCLUSIONS: Mindfulness training can be feasibly integrated into an existing nurse residency program to decrease stress and burnout for new graduate nurses during the transition to practice.

Newly licensed nurses gain knowledge and skills at the academic level to enter the profession as novice nurses. A nurse residency program is crucial in the successful transition of new nurses to their professional role. In addition, supportive structures are essential for new nurses to acquire the skills, knowledge, and decision-making abilities appropriate for their specific area of practice. At Houston Methodist, an additional element of the nurse residency program includes transition to practice classes that are designed to increase new nurses’ knowledge and understanding of relevant skills. The classes provide practice in specific environments and improve self-confidence with elements identified through Casey-Fink surveys. In addition to the initial classes developed to support these areas, feedback showed the need to incorporate specific classes for specialized environments. As a result, the coordinators of the nurse residency program, experts, and leaders from specialty areas explored and developed specific learning opportunities. The aim of this article is to showcase the strategies used to develop customized approaches to ensure successful transitions to practice for newly licensed nurses.

The transition of new graduate nurses (GNs) to professional practice has its challenges, thus providing an established program to facilitate this journey can lessen some of these challenges. Various approaches exist to help GNs transition into their practice environment. This article describes the Houston Methodist Nurse Residency Program (HMNRP), a successful transition program for GNs within a mutli-facility health care system. Houston Methodist (HM) moved from independent practices to a unified system approach to provide a combination of centralized and decentralized nurse residency program sessions to meet the needs of the GNs. This innovative approach has ensured the success of the program. Multiple strategies are important for an effective systematic approach. Some of these strategies include (1) identifying the ideal players, including coordinators, facilitators, stakeholders, and content experts and (2) providing the resources needed to achieve the desired results. Establishing a unified approach to ensure that outcomes are met is essential to success. Defining goals and desired outcomes will guarantee that the purpose of the program is achieved. A multi-faceted approach can be used to teach and facilitate the sessions, continuous assessment and program evaluation help to identify opportunities for improvement. Including all key stakeholders in the evaluation and future planning allows for the program to evolve to meet the outcomes and needs of all involved. Planning is a vital component to ensure a smooth transition. Program success truly lies in the planning.

Objective: Progressive care units (PCUs), also sometimes called intermediate care units, improve the utilization of beds within intensive care units while adjusting the workload of the nurse.  PCUs encompass a scope of care between the critically ill patient and the acute care patient. Owing to the advanced skills set needed, nurses with limited experience in this setting may benefit from an orientation course in addition to on-the-job training. The purpose of this project was to develop and evaluate an orientation program for nurses working in progressive care settings at a multi-site hospital system.Methods: Kolb’s experiential learning theory and adult learning theory were used as a framework to plan and design a 2-day instructional program that addressed the cognitive, psychomotor, and affective aspects of learning needs.Results: A total of 244 participants completed the 2-day program. The teaching strategies were shown to be effective, as indicated by survey results reporting a mean score of 4.36 on a 1-5 Likert scale (with a score of 1 indicating the presenter did not clearly articulate the subject and 5 indicating that the presenter clearly articulated the subject). The participants stated that they intended to make changes in practice and identified changes to improve the program (e.g., inclusion of high-fidelity manikins, patient-controlled anesthesia).Conclusions: Incorporating a specialized training program for newly licensed nurses and nurses transitioning to the PCU with less than 2 years’ experience in this setting may improve the nurse’s confidence and performance of patient care skills in this highly acute environment.