Abstract
Background and Purpose: In 2023, 32.8% of all newly hired RNs leave within the first year, constituting more than a quarter of all RN separations. The average turnover cost for a bedside RN surpasses $52K, and each percentage shift in RN turnover will result in an extra cost/savings of approximately $380K annually for the average hospital. Further, the current national RN vacancy rate stands at a critical 15.7%.
The American Nurses Association (ANA) has called for a greater focus on recruiting and retaining nurses through residency or fellowship programs that transition nurses into new practice settings using evidence-based criteria.
In a longitudinal study, we sought to examine the impact of the ANCC Practice Transition Accreditation Program® (PTAP®) on nurse retention within a 12-hospital system. We hypothesized that a dedicated PTAP® would reduce turnover rates among new hires, yield a positive return on investment (ROI), and decrease reliance on travel nurses.
Methods: Conducting a multi-cohort longitudinal study spanning from January 2022 to May 2023, our team conceptualized and evaluated an evidence-based nurse residency program. This comprehensive initiative encompassed foundational education, focused preceptorship, and a blend of hybrid and simulated learning environments. We then proceeded to compare the retention and turnover outcomes against national averages, while calculating the ROI using a refined tool provided by the Association for Nursing Professional Development® (ANPD).
Results: Out of the 661 nurses in PTAP®, year-over-year retention stood at 90%. A total of 62 NPDs, working at 70% FTE, and three NPDs at 100% FTE collectively offered 800 hours of preceptorship and 60-80 hours of didactic education. These resources supported 578 nurse residents, specializing in ED, mother-baby, critical care, PCU, or behavioral health. Additionally, 500 preceptorship hours and 50 hours of didactic education aided 83 nurse residents specializing in medical-surgical care. Vacancies were minimized due to cohort start dates occurring every 8 weeks, in contrast to the standard national quarterly model start dates. When considering program costs, improved nurse retention, and a 22.8% reduction in turnover, the hospital realized approximately $8.7 million in annual savings, resulting in an overall PTAP® ROI of 39.82%. As of December 2022, the system had successfully reduced job postings for travel nurses by 40%.
Discussion and Conclusion: The transition-to-practice curriculum and preceptorship occur within the initial six months, while the focus shifts to evidence-based practice and mentorship during months 7 to 12 of a nurse's first year in professional practice. PTAP® offers personalized assistance to empower nurses with nursing excellence, rigor through evidence-based practice, shared decision-making, and preceptorship. This model is dedicated to nurturing both the mental and professional well-being of individuals and fostering trust within the team. A substantial investment in professional development has the potential to yield cost savings for hospitals, cultivate nurses who embody scholarly excellence, and maintain a vital workforce.
Notes
Presenter notes available in attached slide deck.
Reference list included in attached slide deck.
Sigma Membership
Non-member
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Investments, Transitional Programs, Nursing Practice, Workforce, Internship and Residency
Recommended Citation
Emery, Jamie; Calabro, Emily; Coleman, Heather; and Peterson, Robin, "A Positive ROI, Healthy Workforce, and Increased Retention Through Transition to Practice" (2026). Creating Healthy Work Environments (CHWE). 52.
https://www.sigmarepository.org/chwe/2024/presentations_2024/52
Conference Name
Creating Healthy Work Environments
Conference Host
Sigma Theta Tau International
Conference Location
Washington, DC, USA
Conference Year
2024
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-02-18
A Positive ROI, Healthy Workforce, and Increased Retention Through Transition to Practice
Washington, DC, USA
Background and Purpose: In 2023, 32.8% of all newly hired RNs leave within the first year, constituting more than a quarter of all RN separations. The average turnover cost for a bedside RN surpasses $52K, and each percentage shift in RN turnover will result in an extra cost/savings of approximately $380K annually for the average hospital. Further, the current national RN vacancy rate stands at a critical 15.7%.
The American Nurses Association (ANA) has called for a greater focus on recruiting and retaining nurses through residency or fellowship programs that transition nurses into new practice settings using evidence-based criteria.
In a longitudinal study, we sought to examine the impact of the ANCC Practice Transition Accreditation Program® (PTAP®) on nurse retention within a 12-hospital system. We hypothesized that a dedicated PTAP® would reduce turnover rates among new hires, yield a positive return on investment (ROI), and decrease reliance on travel nurses.
Methods: Conducting a multi-cohort longitudinal study spanning from January 2022 to May 2023, our team conceptualized and evaluated an evidence-based nurse residency program. This comprehensive initiative encompassed foundational education, focused preceptorship, and a blend of hybrid and simulated learning environments. We then proceeded to compare the retention and turnover outcomes against national averages, while calculating the ROI using a refined tool provided by the Association for Nursing Professional Development® (ANPD).
Results: Out of the 661 nurses in PTAP®, year-over-year retention stood at 90%. A total of 62 NPDs, working at 70% FTE, and three NPDs at 100% FTE collectively offered 800 hours of preceptorship and 60-80 hours of didactic education. These resources supported 578 nurse residents, specializing in ED, mother-baby, critical care, PCU, or behavioral health. Additionally, 500 preceptorship hours and 50 hours of didactic education aided 83 nurse residents specializing in medical-surgical care. Vacancies were minimized due to cohort start dates occurring every 8 weeks, in contrast to the standard national quarterly model start dates. When considering program costs, improved nurse retention, and a 22.8% reduction in turnover, the hospital realized approximately $8.7 million in annual savings, resulting in an overall PTAP® ROI of 39.82%. As of December 2022, the system had successfully reduced job postings for travel nurses by 40%.
Discussion and Conclusion: The transition-to-practice curriculum and preceptorship occur within the initial six months, while the focus shifts to evidence-based practice and mentorship during months 7 to 12 of a nurse's first year in professional practice. PTAP® offers personalized assistance to empower nurses with nursing excellence, rigor through evidence-based practice, shared decision-making, and preceptorship. This model is dedicated to nurturing both the mental and professional well-being of individuals and fostering trust within the team. A substantial investment in professional development has the potential to yield cost savings for hospitals, cultivate nurses who embody scholarly excellence, and maintain a vital workforce.
Description
Our 12-hospital system led a longitudinal study on a comprehensive nurse residency program, yielding substantial results: 90% retention, 22.8% turnover reduction, and $8.7 million annual savings. Explore ANCC Practice Transition Program's role in empowering nurses during the critical 7-12 months of residency, fostering well-being, team unity, and nursing excellence.