Implementation of a Nursing Transition to Practice program and the Impact on First Year Retention


To evaluate if the implementation of a Transition to Practice (TTP) program improves retention of newly licensed nurses at Wake Forest University Baptist Medical Center.


The TTP program was implemented in November 2019 with newly licensed nurses from five hospitals within the health system participating in monthly workshops. Support to nurses was offered through small group “Tales from the Bedside” groups which served a dual purpose in debriefing workshop content and presenting an evidence- based presentation. Covid -19 resulted in workshops transitioning to virtual. Turnover rates were compared at baseline and at the conclusion of the first cohort completing the program. Because the organization tracks turnover data on a monthly basis, a control chart was utilized to demonstrate the variability month over month. The control chart indicated a downward trend between fiscal years, although not significant. A midpoint and final evaluation was administered to the participants to elicit feedback about the program.


Nurses hired in July and August 2019 began the TTP program in November 2019. The cohorts consisted of 89 and 67 nurses respectively. Nurses completed the program in July 2020. Prior to the implementation of the TTP program in fiscal year 2019, the baseline turnover rate was 22%. At the conclusion of fiscal year 2020, organizational data revealed a 3% decrease in the turnover rate at WFBMC.


Nursing retention is not only a nation-wide issue but a local one as well. The nursing shortage will continue to create burdens for health systems. Development of a TTP program can assist with a reduction in turnover by providing an avenue for socialization for newly licensed nurses and introducing them to resources and best practices. This project was an important first step to re-designing opportunities for newly licensed nurses. Evaluation and implementation of improvements to the TTP program is key for sustainability of the program. During the course of this program, the turnover rate for newly licensed nurses dropped by 3%. Tracking retention and constantly looking for opportunities to enhance the program will be critical for ensuring the organization is promoting optimal learning opportunities for newly licensed nurses while providing the support nurses need and desire.