Abstract

Abstract Text: Background
An aging population and shortage of providers contribute to shifts in the healthcare landscape and a rapid expansion of Advanced Practice Providers (APPs) in healthcare systems. Effective APP Transition into Practice (TIP) programs are integral to prepare newly practicing APPs for autonomous practice, and the absence of such programs exacerbates role ambiguity and jeopardizes integration and retention of APPs. This gap negatively impacts patient outcomes, disrupts team dynamics, and increases financial strain on healthcare systems.
Purpose
This describes a successful and innovative TIP program. The TIP program aligns with ANCC Magnet® standards, influences patient safety, reduces APP turnover and improves job satisfaction. TIP faculty continue to refine the instructional process to strengthen collaborative debriefing, anticipating a greater return on investment.
Implementation
The inaugural TIP program started in 2019 and has integrated and supported 200 APPs across five hospitals and ambulatory. The program offers a rolling cohort and includes a 4-hour introductory session and six full-day monthly sessions. TIP provides networking with fellow APPs and covers content across three dimensions: Professional Development, Organizational Enculturation, and Clinical Content. A mentorship program, 1:1 support from the TIP manager, and a case study presentation are additional program elements.
Outcomes
The program successfully increased APP graduate throughput and contributed positively to employee retention, with a 94% first-year retention rate. TIP objectively enhanced APP autonomy, as demonstrated by improved scores on the Dempster Scale of Practice Autonomy administered before and after participation. Dempster scores range from 30-150 and higher scores indicate higher autonomy. Scores from the 2024 cohort improved from 122.4 pre-TIP to 130.6 post TIP completion. Post-TIP Demster scores consistently increased since program inception, demonstrating the effectiveness of programmatic changes.
Nursing Implications
A well-designed TIP program significantly enhances APP engagement and retention, leading to associated cost savings. It fosters healthy work environments by providing a foundation that supports improved autonomous practice and peer-to-peer networking. The organization’s TIP program directly impacted over 200 new to practice APPs, and their improved practice autonomy and retention supports the teams they work with and the patients they serve.

Notes

References: Goolsby, M. J., Pierson, C. A., & Sheer, B. (2020). Twenty-eight years of experience measuring autonomy using the Dempster Practice Behavior Scale. Journal of the American Association of Nurse Practitioners, 32 (10), 696-702. https://doi.org/10.1097/JXX.0000000000000408

Hande, K., Jackson, H., & McClure, N. (2023). Nurse practitioner transition to practice: Recommendations and strategies for designing and implementing fellowships. Journal for Nurses in Professional Development, 39 (3), 162–167. https://doi.org/10.1097/NND.0000000000000818

Maylone, M. M., Ranieri, L., Quinn Griffin, M. T., McNulty, R., & Fitzpatrick, J. J. (2011). Collaboration and autonomy: Perceptions among nurse practitioners. Journal of the American Academy of Nurse Practitioners, 23 (1), 51-57. https://doi.org/10.1111/j.1745-7599.2010.00576.x

Speight, C., Firnhaber, G., Scott, E. S., & Wei, H. (2019). Strategies to promote the professional transition of new graduate nurse practitioners: A systematic review. Nursing Forum, 54 (4), 557-564. https://doi.org/10.1111/nuf.12370

Strobehn, P. K., Barnes, H., Bellury, L. M., & Randolph, J. J. (2024). US nurse practitioner voluntary turnover: Development of a framework for analysis. Journal of the American Association of Nurse Practitioners, 36 (4), 210-218. https://doi.org/10.1097/JXX.0000000000000960

Description

The Enhanced Transition into Practice (TIP) program was developed to address the challenges of an aging population and provider shortages, which have driven the expansion of Advanced Practice Providers (APPs). The program focuses on professional development, organizational enculturation, and clinical skills, and successfully supported over 200 APPs since 2019. TIP has improved APP autonomy, job satisfaction, and APP retention leading to associated cost savings and healthier work environments.

Author Details

Kimberly Manning DNP, APRN, FNP-BC, NEA- BC, NPD-BC

Sigma Membership

Non-member

Type

Presentation

Format Type

Text-based Document

Study Design/Type

N/A

Research Approach

N/A

Keywords:

Transition to practice or onboarding, Workforce, Curriculum development

Conference Name

Creating Healthy Work Environments

Conference Host

Sigma Theta Tau International

Conference Location

Phoenix, Arizona, USA

Conference Year

2025

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.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Slides

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Workforce Advocacy: An Enhanced Transition into Practice Program for Advanced Practice Providers

Phoenix, Arizona, USA

Abstract Text: Background
An aging population and shortage of providers contribute to shifts in the healthcare landscape and a rapid expansion of Advanced Practice Providers (APPs) in healthcare systems. Effective APP Transition into Practice (TIP) programs are integral to prepare newly practicing APPs for autonomous practice, and the absence of such programs exacerbates role ambiguity and jeopardizes integration and retention of APPs. This gap negatively impacts patient outcomes, disrupts team dynamics, and increases financial strain on healthcare systems.
Purpose
This describes a successful and innovative TIP program. The TIP program aligns with ANCC Magnet® standards, influences patient safety, reduces APP turnover and improves job satisfaction. TIP faculty continue to refine the instructional process to strengthen collaborative debriefing, anticipating a greater return on investment.
Implementation
The inaugural TIP program started in 2019 and has integrated and supported 200 APPs across five hospitals and ambulatory. The program offers a rolling cohort and includes a 4-hour introductory session and six full-day monthly sessions. TIP provides networking with fellow APPs and covers content across three dimensions: Professional Development, Organizational Enculturation, and Clinical Content. A mentorship program, 1:1 support from the TIP manager, and a case study presentation are additional program elements.
Outcomes
The program successfully increased APP graduate throughput and contributed positively to employee retention, with a 94% first-year retention rate. TIP objectively enhanced APP autonomy, as demonstrated by improved scores on the Dempster Scale of Practice Autonomy administered before and after participation. Dempster scores range from 30-150 and higher scores indicate higher autonomy. Scores from the 2024 cohort improved from 122.4 pre-TIP to 130.6 post TIP completion. Post-TIP Demster scores consistently increased since program inception, demonstrating the effectiveness of programmatic changes.
Nursing Implications
A well-designed TIP program significantly enhances APP engagement and retention, leading to associated cost savings. It fosters healthy work environments by providing a foundation that supports improved autonomous practice and peer-to-peer networking. The organization’s TIP program directly impacted over 200 new to practice APPs, and their improved practice autonomy and retention supports the teams they work with and the patients they serve.