Transition to Practice Program

Program Overview and Summary of Findings Evidence-Based Transition to Practice Project


The goal of this multi-year project is to ensure that newly licensed nurses are afforded the opportunity to gain confidence and competence as they enter the workforce, thus enhancing patient safety and increasing retention in the workplace.


In 2005, based on the recommendation from the 2004 NC Institute of Medicine Nursing Workforce Report to improve the school-to-work transition for newly licensed nurses in North Carolina, the Foundation for Nursing Excellence (FFNE) launched its Transition-to-Practice initiative with an Agency for Healthcare Research and Quality (AHRQ) grant-supported research conference titled Building an Evidence-Based Transition to Nursing Practice.  This conference identified the core competencies needed by new nurses regardless of practice setting and developed reliable measures to assess competency.

Evidence Bases Transition cover

PHASE I began in 2006 with funding from BlueCross BlueShield of North Carolina Foundation (BCBSNCF).  This Phase determined the significant elements in current transition experiences.  Key findings from Phase I were that the quality of the new nurse/preceptor partnership had a direct relationship with how competent a new RN felt about his/her nursing practice and the higher competency score correlated with fewer reported practice errors at both four and six months.

PHASE II was completed in 2009, with support from BlueCross BlueShield of North Carolina Foundation, The Duke Endowment (TDE), and Kate B. Reynolds Charitable Trust.  A comprehensive literature review of best and promising practices in new nurse transition programs and preceptor preparation, as well as a survey of North Carolina clinical agencies to determine current practices related to preceptor preparation were completed.  In addition, two invitational conferences were convened:  Best and Promising Practices in Preceptor Preparation and Role Development and Simulation and New Nurses:  Promising Practice to Facilitate Transition to Practice.  It became clear from both the Phase I survey findings and Phase II activities that the preceptor was a critical component of the successful transition of a new nurse and that there was no consistent preparation for preceptors.  Thus, the next phase of the initiative focsed on the preparation of preceptors for this essential role.

PHASE III:  With continuing funding support from BCBSNCF and TDE, the focus of Phase III is the testing and evaluation of strategies and tools to prepare preceptors for their critical role in the transition of newly licensed nurses to the practice setting.  In addition to the online modules, face-to-face simulation scenarios were used so preceptors could practice their roles and receive individual feedback on their performance in managing preceptor-preceptee situations.  Interventions were tested in pilot hospital settings across North Carolina beginning late spring 2010 through July 2010.  The piloting of the interventions occurred prior to the employment of newly licensed nurses, with related data collection occuring through the first six months of new nurse employment.

Preliminary results have shown that online learning modules are effective in training preceptors for their critical role! Complete analysis of the effectiveness of the interventions will be completed by Spring 2012.

Preceptor Tool Kit

Preceptor Invitational Conference Powerpoints: