Design of a primary care advanced practice nursing fellowship

Abstract

New graduate nurse practitioners (NPs) can find the transition between student and independent practitioner to be difficult. Residency and fellowship programs are becoming a popular option to help support NPs with this transition. The Institute of Medicine has called for support through residency and fellowship programs. These programs have shown positive outcomes including increased job satisfaction, retention, positive patient outcomes, and increased interprofessional collaboration. A hospital located in the northwestern United States is struggling with NP satisfaction and retention. Purpose: A graduate scholarly project was initiated to design a fellowship for NPs in the primary care setting in response to this problem. Methods: The American Nurses Credentialing Center Standards, National Nurse Practitioner Residency and Fellowship Training Consortium Standards, a current program at the Carolinas HealthCare System, and the National Organization of Nurse Practitioner Faculties Competency areas was used as a foundation to the design. Guidance used was Benner's Novice to Expert Theory. Results: A twelve-month program was designed that includes didactic learning sessions, primary care clinical experience, specialty area clinical experience, interprofessional teamwork, and structured evaluation. Intended outcomes of the project for the sponsoring organization are 1) retention of NPs for twelve months after completion of the program and 2) increased employee satisfaction. The graduate nursing student concluded that more input from current programs and increased participation from the sponsoring organization would have made this project more successful. Further research into the best practice for evaluation tools for personnel and participants in these types of programs would also strengthen the design. Foundation based on current accreditation standards helps to strengthen this design.