New residency program strives to improve elderly care, reduce re-hospitalizations and decrease costs

Newark, N.J. – Rutgers is leading an effort to retain nurses working at long-term care facilities in New Jersey, where turnover rates hover at 40 percent.

Rutgers’ College of Nursing and School of Nursing faculty will lead the New Jersey Action Coalition (NJAC) as it develops a yearlong nurse residency program designed to keep newly licensed registered nurses on the job at federally certified, long-term care facilities. The NJAC effort is supported by $1.6 million in funding from the Centers for Medicare and Medicaid Services.

Long-term care is a growing field where nurses can make a difference.

“Staff turnover can create lots of instability and have a negative impact on the quality of care at an institution,” says Edna Cadmus, a clinical professor at the College of Nursing and co-leader of the project.  “When new nurses are well-prepared to work in a specific practice environment and nurtured on the job through programs such as residencies, they are more likely to remain.”

The hope is that increased retention of nurses will improve care, reduce re-hospitalizations and decrease costs. Under the Affordable Care Act, hospitals are penalized if too many patients are readmitted within 30 days of their discharge.

Historically, nurse residency programs have existed in hospitals and other acute care settings, but not in long-term care facilities, notes Susan Salmond, dean of the Rutgers School of Nursing, who is co-leading the project with Cadmus.  “The nurse residency we are planning will strengthen new nurses’ transition from school to the workforce and allow them to develop and demonstrate their competencies.”

Widespread creation of nurse residencies across all practice settings was among the eight major recommendations of the Institute of Medicine’s 2010 report, The Future of Nursing: Leading Change, Advancing Health. The NJAC is a group of volunteers from various health professions working to implement these recommendations.

Nursing faculty will lead the New Jersey Action Coalition in developing a residency program designed to keep registered nurses on the job at long-term care facilities.

The long-term care residency program is being developed to serve as a statewide model to improve geriatric care in such facilities by teaching nurses to employ “best practices.”  Fifty nurses will be selected to train as residents over 30 months, beginning in spring 2014. The Healthcare Association of New Jersey will assist the NJAC in developing partnerships with long-term care facilities seeking to host nurse residents. 

While long-term care facilities are generally not the first choice for employment-seeking RNs, Cadmus and Salmond urge new nurses to take a closer look at such organizations for valuable career opportunities.

“Health care is shifting from a hospital-based model,” notes Salmond, “and long-term care is a growing field where nurses can make an important difference in the lives of patients and their families.”

Rutgers’ Heldrich Center for Workforce Development will analyze data and evaluate the project.