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Why Nurse Residency Accreditation Is Important and a Few of Its Many Benefits

HealthStream recently offered the webinar, “Achieving ANCC Accreditation for Your Nurse Residency Program: The What, Why, and How.” Our multiple presenters included:

  • Dr. Sheryl Cosme, Director of the Practice Transition Accreditation Program and Nursing Skills Competency Program, American Nurses Credentialing Center (ANCC)
  • Michelle Hammerly, Regional Director of Education, CHRISTUS Southeast Texas
  • Kristie Jones, Clinical Educator, CHRISTUS Southeast Texas Hospital
  • Dr. Kim Guthrie, Senior Pathways Engagement Coach, HealthStream
  • Kim Herold, Director of Professional Development Pathways, HealthStream

During this webinar, led by HealthStream experts Guthrie and Herold, the ANCC’s Cosme provided insight on the what, why, and how of ANCC accreditation, while the nurse leaders from CHRISTUS Southeast Texas - St. Elizabeth revealed how they achieved ANCC accreditation after completing their first cohort, using HealthStream's Nurse Residency Pathway. We’ve extracted and condensed a few of their comments below.

Why is nurse residency accreditation important?

Sheryl Cosme is involved in setting national accreditation standards for nurse residency and nurse practitioner fellowships. During the webinar, she shared that “up to 15% of nursing staff in an average hospital are new graduate nurses within their first year of practice. Startlingly, as many as 17% of new graduate nurses leave their jobs within the first year, and 31% within the second year. Nurse leaders believe residency programs can play a huge role in improving retention. Considering that hospitals spend about $85,000 per nurse per turnover, retention of new nurses can mean significant healthcare cost savings.”

The ANCC has chosen to focus on accrediting nurse residency programs, based on the IOM report, The Future of Nursing. Cosme added, “Accreditation is a way for the ANCC to recognize workforce development as well as quality programs that are being run at healthcare organizations across the country and the world.” The ANCC’s Practice Transition Accreditation Program (PTAP) uses evidence-based standards drawn from the empiric literature as a measure against which individual nurse residency programs are compared.

How widespread is this accreditation?

According to Cosme, “Currently there are 34 accredited programs across the country that fall in three different categories—either an RN residency, an RN fellowship or an APRN fellowship. And we have 40 organizations or programs that are currently seeking accreditation from the ANCC.”

What are some of the benefits of accreditation?

Our webinar participants identified several reasons to pursue accreditation:

    1.    The required gap analysis drives program improvements. 

The ANCC accreditation process compares an individual nurse residency program to the ANCC standard and establishes what the former is missing. Cosme offered that, “Some of the biggest gaps that we have had organizations experience is their competency development—that their competencies are truly just skills checklists which do not truly affect the knowledge, skills, and abilities of a nurse in their practice setting. Organizations need to raise up their competencies to really look at those three different areas.” Through this broad gap analysis, organizations may find themselves focusing on their nurse residency programs in terms of leadership accountability, program infrastructure, assessments, resources for nurse residents, and especially outcomes measures.

2.    A program becomes an official commitment when put in writing. 

The accreditation process really helps organizations make their residency programs tangible, institutionalized processes. Cosme shared how “going through PTAP accreditation gives you… ‘the bible of your transition to practice program.’” She also described it as the “living breathing document of how you run and operationalize your program.” This is especially useful in making the program easy to transfer to a new manager when inevitable leadership change occurs.

3.    Support for residency program elements that build nurse confidence.

Kristie Jones, Clinical Educator at CHRISTUS Southeast Texas Hospital, shared experiences from her organization’s successful accreditation journey. She stated, “Confidence is important for the RN so  that they feel able to contribute within their department, that they are being productive, and most of all they're making good choices and being good leaders.” Measuring cohort confidence regularly was important for CHRISTUS. As part of their of their effort, CHRISTUS Southeast Texas used HealthStream’s Nurse Confidence Survey, the proprietary, validated HealthStream survey that is a self-assessment of nursing confidence across five domains of practice. About CHRISTUS’s survey results, Kim Herold, HealthStream’s Director of Professional Development Pathways added, “What we see is a consistent, across-the-board 50% increase in nursing confidence from day one to year one, and that's attributed directly to the program that you guys are delivering.”

4.    Creating an environment where retention is stronger.

CHRISTUS offered a great example of how the principles of an accredited nurse residency program contribute to retention. Michelle Hammerly, Regional Director of Education at CHRISTUS Southeast Texas, pointed out that, “For our first year we're still averaging 98 to 100% retention. And for the second year we're averaging about 85% retention.” She also shared, “We use our residents as ambassadors, telling the other students about our program… for us it's really raised the bar for our competition; we are the only accredited program in our area right now.”

5.    Operationalizing a nurse residency program of development and assessment that meets accreditation standards.

CHRISTUS implemented HealthStream’s Nurse Residency Pathway to support the standards required for their accreditation effort. According to Dr. Kim Guthrie, Senior Pathways Engagement Coach at HealthStream, “CHRISTUS used resources such as clinical-focused courseware needed for the nurse resident to achieve competency and to meet the goal of delivering safe patient care, as well as other tools to ensure the development of critical thinking and clinical judgment skills, knowledge, and confidence of their nurse residents.” Herold summarizes the Nurse Residency Pathway as providing “the content, functionality, workflow, and analytics to support our customers along this journey.”

Access the full webinar recording here.

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