154 - Building the Future: A Nurse Residency Blueprint for Outpatient Surgery

Description: Description of team:

The ASC Nursing Director, recognizing the need for structured onboarding, led the development of the nurse residency program. The education team included the Nursing Education Coordinators, ASC Nurse Manager, and Clinical Nurse Specialist. The implementation of the program was supported by site nursing managers.

Preparation and planning

The ASC NRP was approved for development by the ambulatory clinic's Chief Nursing Officer (CNO), and the program's framework and tenets were developed by the ASC Nursing Director. The ASCs were granted the opportunity to have Nurse Residents (NR) complete a 52-week program that would allow them to choose their area of practice upon completion- an incentive not offered by most NRPs.

Assessment

Prior to the ASC NRP being developed, no perioperative residency program tailored for staff working in outpatient existed for new nurses. Several new nurses who had previously transitioned to the ASC who did not have the opportunity to complete an ASC NRP, unfortunately transitioned to other positions. After performing a needs assessment, the team identified the need for a program structured specifically. The program's objectives were to enhance clinical competency, provide a more seamless transfer to practice, boost employee retention and work satisfaction, enhance patient outcomes, and foster professional growth. It also aimed to give new nurses the opportunity to begin their careers in their desired area of practice.

Implementation

The team began the process of developing the program in January 2025. Weekly meetings took place to brainstorm and develop the program. The team also consulted with ASC leaders and other nurses who facilitated NRPs in other departments/specialties to get feedback necessary to make a program successful. The ASC Nursing Director provided oversight and guidance to the team. The team worked to develop a 52-week program that included rotations in all ASC areas/departments. Those areas included pre-admission testing, the anesthesia pre-operative clinic, intraop, pre-op, post-anesthesia care unit (PACU), endoscopy and physiatry areas.

Outcome

The program's first cohort shared feedback that is valuable for the program's growth. Surveys were provided to assess the NRP preceptorship. More than thirty preceptors supported the NRP. The residents rated the preceptors as "very good" and shared that the preceptors' timely and constructive feedback, communication and overall support in preparing them for independent practice was very helpful. Positive comments about the preceptorship experience included building confidence and maintaining eagerness to learn. Feedback was provided during the OR rotation. Consecutive OR rotations at one site were requested. The overall ASC Nurse Residency Program was rated excellent by the residents. Survey results showed high general competence and satisfaction with the residency program, with a few areas where extra support or training was identified.

Implications for perioperative nursing

There is a growing need to retain nurses and organizations should take into account transition-to-practice programs that are up to 24 months in duration (Koh et al., 2023). The 52-week NRP has been proven to provide foundation support. Similar programs also provide confidence, competence, improved job satisfaction, and reduced staff burnout. In turn, other outcomes such as improved patient outcomes and a stronger workforce can also be achieved by utilizing NRPs.