Relationship between Participation in Nurse Externship Program and RN Retention and Quality Care

Study Background. Nurse externship programs were initially developed by healthcare institutions as a recruitment tool for new nurses. Literature has demonstrated the positive outcomes of the program on the participants and healthcare institutions but during times of economic difficulties, health care institutions discontinue the program. The studies that demonstrate the value of the program are limited to the recruitment phase and the 2-year retention of the newly graduated nurses. There is a need to demonstrate the value of the program in terms quality of care and long term RN retention. Research Questions. The three research questions this study addressed include: (1) What is the relationship between student nurse externship experience and extension of the new graduate, unit-based orientation? (2) What is the relationship between student nurse externship experience and working full time over the first 5 years of employment? (3) What is the relationship between student nurse externship experience and adherence to select quality care indicators? Study Aims. The aims of this study were: (1) Determine the relationships between nursing student externship, a. extension of new graduate, unit-based orientation and b. working full time over the first 5 years of employment. (2) Determine the relationship between nurse externship and adherence to select quality care indicators: a. Acute myocardial infarction (AMI); b. Heart failure (HF); c. Pneumonia; d. Surgical Care Improvement Project (SCIP); e. Outpatient Department; f. Emergency Department; g. Immunization; h. Stroke; and i. Venous Thrombosis. (3) Develop a ROI formula that can be utilized to explain the cost effectiveness of a nurse externship program. Study Methods. A data collection tool was developed and used to review human resources, education, payroll, and performance improvement files. The data were analyzed using a non-experimental, retrospective, descriptive, correlational, statistical design. Mean square contingency, also known as phi coefficient, was used to test the correlational of the two groups: (1) new grad RNs with nurse externship experience and (2) new grad RNs with no nurse externship experience. Conclusion. The findings were used to develop a ROI formula for the program. The ROI may be used by other institutions to explain both the cost effectiveness of the program and its existence. There is a significant, negative correlation between nurse externship experience and extension of unit-based orientation. No significant correlation was found between nurse externship experience and 5-year full time employment and adherence to quality indicators. Data analysis revealed the average extension length of time for unit-based orientation is 100 hours. The cost benefit of this program for the sample is $211,200 and the computed ROI is 135%.