VA Facilities with More Nurse Training Program Allocations Are More Likely to Fill RN Vacancies Sooner

BACKGROUND:
The U.S. is experiencing a national shortage of nurses. Newly graduated nurses can help mitigate this shortage, but many new nurses encounter difficulties when transitioning from academic programs to clinical practice, and ultimately contribute to the high turnover rates among new and established nurses. VA offers a one-year Post Baccalaureate-Registered Nurse Residency (PB-RNR) program that provides newly licensed registered nurses (RNs) with the opportunity to gain Veteran-specific knowledge and skills. However, the impact of the PB-RNR program on local RN recruitment has been unknown. This study aimed to evaluate the effect of the size of PB-RNR programs at VA facilities on the facilities’ time to fill RN vacancies. Investigators reviewed a sample of 18,187 RN filled vacancies that were posted nationwide between 1/1/2020 and 12/31/2021 from VA facilities that offered the PB-RNR program. The exposure variable was each facility’s number of PB-RNR program allocations, and the outcome was whether the RN vacancy was filled within 90, 60, or 30 days. Covariates related to the workload, support, and interpersonal relationships of RNs were included.

FINDINGS:

• Relative to facilities with lower training program allocations, RN vacancies in facilities with higher PB-RNR training program allocations were more likely to be filled within 90, 60, or 30 days.
• An increase of one training allocation was significantly associated with a 6 percentage point (PP) higher likelihood of filling a vacancy within 90 days, a 7 PP higher likelihood of filling a vacancy within 60 days, and a 5 PP higher likelihood of filling a vacancy within 30 days.
• The impact was significant for 2020 and 2021 positions, and in facilities located in areas with lower social deprivation scores, higher-quality public schools, or with no or partial primary care physician shortages (i.e., higher desirability of the geographic area to potential hires).

IMPLICATIONS:

• Findings provide valuable insights for policymakers considering expansion of the VA RN residency training program to address challenges posed by the RN workforce shortage.

LIMITATIONS:

• Researchers were unable to track the graduates of the program and conclusively attribute the benefits of the PB-RNR program to nurses choosing to remain at the training facility. Nurses who finish their training at one VA facility may end up practicing in a nearby facility with more resources.
• There are other RN residency programs at VA, such as the RN Transition-to-Practice Program, that were not evaluated.
• The results may have been influenced by the COVID-19 pandemic.

AUTHOR/FUNDING INFORMATION:
This study was funded by QUERI. All of the study’s investigators are with QUERI’s Partnered Evidence-based Policy Resource Center (PEPREC).

Li Y, Legler A, Kabdiyeva A, Nguyen P, Garrido M, Pizer S. Impact of Nurse Residency Program on Time to Fill Nurse Vacancies at the Veterans Health Administration. Medical Care. July 3, 2024; online ahead of print.