Exploring the Structure and Content of Hospital-Based Pediatric Nurse Residency Programs

• The Future of Nursing recommended establishing nurse residency programs (NRPs) to facilitate transition to practice.
• A survey was carried out to describe orientation programs and NRPs in children’s hospitals and pediatric units.
• Characteristics of the programs (structure, faculty, preceptors, content, educational strategies, and outcomes) are described.
• Benefits of NRPs include improved confidence, peer support networks, increased safe practices, and a decrease in nursing turnover.
• Challenges of NRPs include adequate funding and program implementation.

PurposeThis paper presents the results of a national survey of pediatric nurse residency programs (NRP).Design and MethodsThe Pediatric Nursing Certification Board (PNCB) database was used to identify 316 hospitals with pediatric units, including children’s hospitals and community hospitals with pediatric services. The Residency Task Force of the Institute of Pediatric Nursing (IPN) developed the survey, Exploring Pediatric Nurse Residency Programs. Survey items addressed structure, content, outcomes, benefits and challenges of NRPs, including a comparison with orientation programs and use of preceptors.ResultsOf the 316 hospitals contacted, 65 provided usable information and 45 reported having an NRP. Most (94%) of the hospitals have an orientation program, and 70% had an NRP. The NRPs were typically internally developed (60%) and a year in length (46.5%). Most common content (> 80%) included critical thinking, stress management, small group support, professional role transition, pediatric resuscitation, and evidence based practice. Evaluation of the NRPs included measures of satisfaction, turnover rates, and standardized measures, primarily the Casey–Fink Graduate Nurse Experience Survey (48.7%). Challenges include obtaining financial support from the organization, developing content relevant across units, providing time away from clinical units, and maintaining preceptors. Benefits noted included development of professional role confidence and peer support networks, increased safe nursing practices, and a decrease in nursing turnover.Conclusions and Practice ImplicationsIn the ongoing development of NRPs in children’s hospitals, issues such as appropriate content, optimal length, standardization across settings, impact on nurse retention, safe practice and patient outcomes all need to be addressed.