Supporting Transition to Practice in Rural Kentucky

1. DESCRIPTION OF PROPOSAL/MATCH WITH THE ASSOCIATION MISSION What is the purpose of this project? The purposes of this project are to design and pilot a residency program for registered nurses working in rural Kentucky. Although health care institutions in Kentucky's larger cities (e.g., Lexington, Louisville), have implemented residency programs and have experienced positive outcomes, none are located in rural areas of the Commonwealth. The residency program will be focused on new nurses in rural acute care settings. Kentucky has 126 hospitals, including 34% that have 50 beds or less, 25% with 51-1 00 beds and 16% with 101 to 200 beds. The ability for the smaller hospitals to offer a 12-month residency program is limited due to the number of new nurses they hire annually as well as limited fiscal resources. How is it innovative? This project nicely aligns with the RWJF Executive Nurse Fellows Alumni Association vision to impact service at the state level and to leverage a network of nursing leaders to create synergy to support human capital investments through an innovative approach. It is also timely given the National Council of State Boards of Nursing's extensive work on a "Transition to Practice Regulatory Model." The residency will include four components: content, support sessions, local mentors, and a project. a) The content for the 12-month residency program will be delivered via the web. Potential content areas for 6 to 8 web-based modules will be generated from the existing literature on residency programs (e.g., Novice Nurse Leadership Institute in South Florida1, Rural Nurse Internship2, Wisconsin Nurse Residency Program3), project team member's experiences with residency programs, and two stakeholder conference calls with chief nurses, or their designees, from Kentucky hospitals. Assuming the pilot goes well, additional modules will be developed for future cohorts. b) New nurse support sessions will be offered via conference calls on a monthly basis. The project team will determine the structure for these conference calls, based on the literature and experience with new nurses. A facilitator, who is a registered nurse, will be recruited and trained and will be responsible for offering the new nurse support sessions. c) Local mentors, who are registered nurses employed at the same hospitals as the new nurses, will be assigned by the chief nurses or their designees. It is expected that the mentor will contact the new nurse at least monthly. The local mentors will be asked to participate in 3 conference calls during the project to provide them with guidelines for supporting their mentees and to offer support as they implement their roles.