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RN transition to practice programs (RNTTPs) that have been piloted and implemented in recent years deserve more rigorous evaluation to answer critical questions about their implementation and sustainment. Because RNTTPs are touted as potentially alleviating critical RN staffing shortages and supporting the development of the nursing workforce's future, the benefits of these programs should be documented, and best practices should be ascertained so they can be scaled and sustained.
First-year registered nurses (RNs) have the highest turnover rate of all hospital-based RNs, and often face a myriad of challenges, despite having completed rigorous academic programs and extensive clinical experience. Comprehensive, multi-component RNTTPs can assist with becoming acquainted with the RN role and gaining an identity as a professional RN, which may help improve retention among new RNs. We conducted a systematic review of published evidence syntheses on RNTTPs, focusing on 2 key questions related to RNTTP effectiveness and characteristics of effective RNTTPs.
The systematic review literature search identified 140 potentially relevant reviews on RNTTPS. Nineteen were included in the final narrative synthesis. There was no seminal study or set of studies that all reviews included, and no single review that included the majority of identified original research studies. Most reviews were appraised as low or critically low overall confidence in the review results. Two reviews that were high or moderate confidence emphasized the methodological issues in the available evidence, and found that the best quality evidence, which used a mix of methodological approaches, indicated a connection between RNTTPs and increased critical thinking, competency, and retention. The evidence for program length was inconclusive, with published evidence syntheses suggesting similar lengths around 6-12 months.
Registered Nurse Transition to Practice Programs: A Systematic Review (Management Brief)
Miake-Lye IM, Schlak AE, Thies J, Higgins P, Couig MP. A Landscape of Evidence on RN Transition to Practice Programs: A Systematic Review of Reviews. Medical Care. 2026; 64(1S). DOI: https://doi.org/10.1097/MLR.0000000000002230.
