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Goode, C. J., & Williams, C. A. (2004). Post-baccalaureate nurse residency program.

Journal of Nursing Administration, 34(2), 71-77.

History of the development of the RN residency and outcomes measured. Results to be shared in subsequent publication.

Casey, K., Fink, R., Krugman, M., & Probst, J. (2004). The graduate nurse experience.

Journal of Nursing Administration, 34(6), 303-311.

Developed the evaluation tool: Casey-Fink Graduate Nurse Experience survey.

Altier, M. E., & Krsek, C. A. (2006). Effects of a 1-year residency program on job s atisfaction and retention of new graduate nurses. Journal of Nurses Staff

Development, 22(2), 70-77.

Reported results related to job satisfaction and retention.

Krugman, M., Bretschneider, J., Horn, P. B., Krsek, C. A., Moutafis, R.A., & Smith, M. O. (2006). The national post-baccalaureate graduate nurse residency program: A model for excellence in transition to practice. Journal of Nurses Staff

Development, 22(4), 196-205.

Described components of the program and reported outcomes of the six sites. Used graphs to show how each of the sites compared to the other and the trend notes.

Pine, R., & Tart, K. (2007). Return on investment: Benefits and challenges of a

baccalaureate nurse residency program. Nursing Economics, 25(1), 13-18, 39, 3. Included ROI estimates for one of the six hospitals.

Added six additional sites (2003/2004):

Williams, C. A., Goode, C. J., Krsek, C., Bednash, G. D., & Lynn, M. R. (2007). Post baccalaureate nurse residency 1-year outcomes. Journal of Nursing

Administration, 37(7-8), 357-365.

Data for both cohorts.

Fink, R., Krugman, M., Casey, K., & Goode, C. (2008). The graduate nurse experience: Qualitative residency program outcomes. Journal of Nursing Administration,

38(7-8), 341-348.

Used data from all 12 sites to revise Casey-Fink evaluation tool.

Goode, C. J., Lynn, M. R., Krsek, C., & Bednash, G. D. (2009) Nurse residency

programs: An essential requirement for nursing. Nursing Economics, 27(3), 142- 147, 159.

Appendix C: Institutional IRB Approval

From: IRBe

Sent: Friday, December 09, 2011 1:43 PM To: Harrison, Debra A., R.N.

Subject: 11-007962 - A study has been deemed Exempt by the IRB

Principal Investigator Notification: From:Mayo Clinic IRB

To: Debra A. Harrison CC: Kathryn Clarkson

Debra Harrison Ilana Logvinov Mary Nason

Re: IRB Application #: 11-007962

Title: Comparison of one year outcomes for an RN residency

program to other orientation models within an academic medical center

IRBe Protocol Version: 0.02

IRBe Version Date: 11/21/2011 11:28 AM

IRB Approval Date: 12/9/2011 IRB Expiration Date:

The above referenced application 11-007962 is determined to be exempt in accordance with 45 CFR 46.101, item (b) (2) from IRB review. Continued IRB review of this study is not required as it is currently written. However, any modifications to the study design or procedures must be submitted to the IRB to determine whether the study continues to be exempt.

AS THE PRINCIPAL INVESTIGATOR OF THIS PROJECT, YOU ARE RESPONSIBLE FOR THE FOLLOWING RELATING TO THIS STUDY:

(1) Submission to the IRB of any modifications and supporting documents for review and approval prior to initiation of the changes.

(2) Submission to the IRB of all unanticipated problems involving risks to subjects or others (UPIRTSO).

(3) Compliance with Mayo Clinic Institutional Policies.

Appendix F: Author Permission and Tool Validation

From: Fink, Regina [mailto:[email protected]] Sent: Wednesday, September 24, 2008 3:23 PM To: Hernke, Debra A.

Cc: Kinney, Lisa; [email protected]

Subject: Graduate Nurse Experience Scale Dear Debra:

Per your request, I am sending you some information about the Casey-Fink Graduate Nurse Experience Survey. It was developed in 1999 by Kathy Casey and me and tested in a variety of institutions in Denver. I am attaching the original version with information about its reliability and validity.

The University Health System Consortium (UHC) has used this instrument extensively with their new graduates and have collected data at baseline, 6 months, and 12 months after hire in thousands of nurses. Mary Lynn from UNC did the quantitative analysis. Their reliability and validity information was similar to ours. Five factors accounted for 46% of the variance in total scores using PAF, varimax rotation—

1. Support (.90) (items 19, 9, 6, 7, 18, 10, 4, 13, 23) 2. Organizing/Prioritizing (.79) (items 16, 5, 8, 12, 17) 3. Stress (.71) (items 24, 25)

4. Communication/Leadership (.75) (items 1, 3, 15, 14, 11, 2) 5. Professional Satisfaction (.83) (items 20, 21, 22)

Reliability estimated for the factors ranged from .71-.90 – total .89. This is based on UHC data examining 911 residents. Reliability analysis is ongoing with each new cohort.

I did the qualitative data analysis on the five questions at the end of the tool and a manuscript was recently published in July/August 2008 JONA 38(7/8): 341-348 with our revision of the tool so that there is now only one qualitative question to ease in analysis. You are welcome to use that version (2006) in your work. However, psychometrics have not been done on that section. Hope this helps. Let me know if you need anything further. Please note my work email address - please use this one instead of my personal email address which was placed in the article. You are welcome to use either tool without cost; just let us know how it performs. Thanks,

Regina Fink

Regina Fink, RN, PhD, FAAN, AOCN Research Nurse Scientist

University of Colorado Hospital, Department of Professional Resources

Campus Box 901 720-848-6647 Phone

Leprino Office Building 720-848-7377 FAX

12401 East 17th Avenue, 6-028 303-886-8655 Cell

PO Box 6510

Appendix G: Participant Introduction Letter

(Name of participant) (Work location)

Mayo Clinic, (Arizona/Rochester/Florida)

Date

Dear (First name),

Congratulations for completing your first year of employment at Mayo Clinic! As a Chief Nursing Officer at one of the Mayo sites and a current Doctorate of Nursing Practice (DNP) student, I am very interested in your evaluation of this first year of learning. If this is your first employment since passing your NCLEX exam, I will be inviting you to participate in a research project utilizing the Casey-Fink Graduate Nurse Experience Survey. Some of you may have completed this survey during your residency or orientation process. There will also be a question asking your intent to stay. This and the survey results will be for study purposes only and all responses reported as an aggregate, not tracked to individual responses.

You will be receiving an e-mail with a link to the survey. It will take approximately 15 minutes to complete. This study has been approved by nursing

leadership across all sites. I am confident your Nurse Manager would support completion at work. I have enclosed a sample paper copy of the survey to allow you to read the questions ahead of time if preferred. If you were not newly licensed upon hire a year ago, please let me know and I will remove you from the e-mail invitation.

My hope is that this study will provide us with valuable information about how to improve and support new graduate transition into practice across all Mayo sites. Data will be collected through September, 2012, and analyzed in October and November, 2012. Results will be available by the end of the year. Thank you for considering participation!

Sincerely,

Debra A. Harrison MS, RN, NEA-BC Chief Nursing Officer, Mayo Clinic DNP student, University of North Florida e-mail: [email protected]

Appendix H: E-mail Consent

You are being asked to participate in a survey to study the differences between newly licensed RNs at all three Mayo sites conducted by Debra Harrison as part of a Doctorate of Nursing Practice project. The purpose of the project is to study RN residency

outcomes and impact on first year retention and intent to stay.

If you were newly licensed approximately one year ago, please consider completion of the survey. If you are not a newly licensed RN, please notify the sender of this message and your name will be taken off the list. The information will help Mayo Clinic develop an even stronger program to support newly licensed RNs.

The survey contains six sections:

1. Your comfort with specific skills

2. Your confidence, comfort and stress level 3. Job satisfaction

4. Transition issues

5. Demographic information.

6. Two questions regarding intent to stay

The estimated time it will take to complete the survey is less than 20 minutes. Your answers will be confidential and only aggregated responses will be reported. Participation is voluntary and you may choose to withdraw at any time. There are no foreseeable risks or personal benefits to your participation. The results, once tabulated, will be used for reports, publications, and/or presentations. Your participation serves as consent.

To participate in the survey please click the link below:

Hyperlink for survey

Please address any questions regarding the survey to me at any time. The IRB is

responsible for protecting the rights and welfare of research participants. If you have any concerns or questions about your rights as a research participant, you may contact the Mayo Clinic IRB at 507-266-4000. Internal: (77) 6-4000.

Deb Harrison MS, RN, NEA-BC

Chief Nursing Officer, Mayo Clinic, Jacksonville, FL [email protected]

Appendix I: Expense Report

DNP Project Budget:

Secretarial support (9 hours) ($15/hr) $135

Research assistant time (9 hours) ($30/hr) $270

Statistician support $250

Copy costs (project review, memos to participants, etc.) $ 95

Editor for final review $100

Binding costs for final project $150

Total $1000

Note: A grant covering expenses was awarded from the Patricia H. Foster Fellowship at

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