Date of Conferral
10-5-2026
Date of Award
October 2026
Degree
Doctor of Nursing Practice (DNP)
School
Nursing
Advisor
M. Terese Verklan
Abstract
Background: The transition from student nurse to practicing registered nurse is a challenging period marked by role overload, emotional stress, and inconsistent preparation. In healthcare organizations, varied onboarding pathways create a critical practice gap that can compromise clinical confidence, lower job satisfaction, and trigger nurse turnover. Purpose & Methods: The purpose of this doctoral quality improvement project was to evaluate whether participation in a structured nurse residency program (NRP) improves transition-to-practice outcomes compared to direct-hire onboarding at a tertiary care center in West Tennessee. Utilizing a retrospective matched cohort design, de-identified data from new graduate nurses hired between August 2024 and August 2025 were analyzed using Microsoft Excel. Descriptive statistics summarized clinical competence via an adapted Clinical Performance Evaluation Tool (CPET), job satisfaction using an adapted Nurse Job Satisfaction Scale (NJSS), and workforce stability via 12-month human resources retention records. Results: Findings revealed that NRP participants reported higher satisfaction with supervisor support compared to their direct-hire peers. However, clinical competence scores and 12-month retention rates remained comparable between the two groups. Conclusion: The outcomes support the continuation of the structured NRP while highlighting targeted operational adjustments. Recommendations include implementing standardized preceptor education, incorporating objective competency and satisfaction assessments, and establishing an ongoing evaluation framework for long-term retention. This project advances nursing practice by offering evidence-based transition strategies that promote workforce stability and support positive social change through optimized patient outcomes.
Recommended Citation
Hiscox, Courtney Cole, "Impact of Nurse Residency Programs Compared to Direct Hire Models on Competence, Retention, and Job Satisfaction in New Graduate Nurses" (2026). Walden Dissertations and Doctoral Studies. 20884.
https://scholarworks.waldenu.edu/dissertations/20884
