RNTTP Residency Program Directive and Program Guide: The

RNTTP Residency Program Directive and Program Guide: The Foundation Mary Pat Couig, PhD, MPH, RN, FAAN Office of Nursing Services Workforce/Leadership Workstream

PROCESS New process managed by Office of Regulatory and Administrative Affairs (ORAA) – Is policy still necessary? – Policy only—attachments as a separate document – Review by program offices before official concurrence process 2

NEW TITLE VHA Registered Nurse Transition-to-Practice Residency Program 3

MAJOR CHANGE Included responsibilities for the Deputy Under Secretary for Health for Operations & Management – Responsible for providing support to the VISN Directors for implementing the program 4

PURPOSE Use of “employed” to differentiate between PBNR program Included all new RN graduate degrees (associate, diploma, baccalaureate, & master’s entry to practice State it is a residency program for VA employed nurses 5

BACKGROUND Strengthened this section with use of statistics and workforce projections of need for RNs Included language from the GAO report 15-794, VA Health Care: Oversight Improvements Needed for Nurse Recruitment & Retention Initiatives Included findings from the Ann Arbor evaluation; factors affecting implementation of the program 6

DEFINITIONS RN Transition-to-Practice Resident: a new graduate RN, employed by VHA, who is participating in the RNTTP Residency Program 7

POLICY It is VHA policy that every VA medical facility that hires new graduate RNs, in their first licensed RN role or RNs with less than one year of professional experience, establish or collaborate with, an established, structured, one-year RNTTP Residency Program based on the CCNE Standards for Accreditation of Entry-to-Practice Nurse Residency Programs. 8

RESPONSIBILITIES VA Medical Facility Director and all members of the VA Medical Facility Leadership Team – Responsible for providing support, including fiscal support, to implement the program – Not sure if this language will remain (fiscal support) 9

RESPONSIBILITIES-ADPCS Designating a program director Overseeing the following recommended staffing ratios depending on VAMC VA medical facility program status: – (a) Allocating 1.0 Full-Time Employment Equivalent (FTEE) to the RNTTP Residency Program Director in order to initiate a program for the first year, regardless of the number of RNTTP residents. – (b) Allocating a minimum of, a 1.0 FTEE to the RNTTP Residency Program Director to manage the various aspects of the program, if no other personnel are assigned to administer the program. – (c) Allocating 0.5 FTEE to the RNTTP Residency Program Director 1-5 RNTTP residents. – (d) Allocating 1.0 FTEE to the RNTTP Residency Program Director for 6-15 RNTTP residents. – (e) Allocating 1.0 FTEE to the RNTTP Residency Program Director for 15-25 RNTTP residents and 0.5 FTEE clinical support, 0.25 FTEE administrational support for programs with large numbers of RNTTP Residents. – Determining if an additional role of coordinator or the need for an administrative assistant is necessary, dependent upon the FTEE allocation of each individual involved and the program or the VA medical facility size. 10

GRAPH OF FTEE ALLOCATION FTEE Allocation for Residency Program Director 1.0 If in first year of program of any size, or FTEE Allocation for Clinical Support FTEE Allocation for Administrative Support 0.5 If no other personnel are available to assist with program administration, or If there are 6-15 residents, or If there are 15-25 residents 0.5 0.25 If the RNTTP program is established or there are a small number of residents (1-5). 11

STAFFING RECOMMENDATIONS 0 FTEE for months 1-3, 0.5 FTEE for months 4-6, 0. 8 FTEE for months 7-9, 0.9 FTEE for months 10-12. 12

PROGRAM EVALUATION Process to determine program effectiveness Ensure completion of evaluations forms – Casey-Fink – A resident competency assessment – End of program evaluation Annual report to ADPCS at end of each FY 13

NEXT STEPS Review by Labor Management Relations To USH for signature Program guide revisions Once directive signed communicate to ADPCSs & others 14