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Problem: Many hospitals in the United States as well as Japan have difficulty orienting and retaining new nurse graduates. Hospitals
employing graduates from their own schools of nursing as well as from other schools have been challenged with prolonged periods
of orientation time (up to one year) before the new nurse graduate is able to function autonomously. Furthermore, once through
orientation, hospitals are again having difficulty keeping these new nurses employed at the hospital, costing the hospital system
enormous resources in terms of both money and time.
Purpose: Based on a comprehensive assessment of a Japanese hospital system and its associated School of Nursing in Iizuka, Japan,
a team of nursing education experts from the US worked with the hospital and its school’s nursing leaders to design a customized,
culturally appropriate, Transition to Practice (TTP) model for newly hired registered nurses.
Methods: Through a series of focus groups and nominal group techniques involving all levels of nursing (students to the Chief Nursing
Officer), the experts designed a model for Transition to Practice based on the Japanese principles of Kaizen (quality improvement)
and Wakaba (nurturing the young leaf).
Findings: The newly developed Transition to Practice model encompasses an Academic Service Partnership, a Preceptor Academy,
and Residency for Practice. It also calls for a school of nursing curriculum redesign to emphasize readiness to practice, particularly in
the senior year. QSEN competencies and KSA's serve as the core component for the school of nursing curriculum redesign, preceptor
education, and residency infusion.
Ann M Mitchell is a Professor of Nursing and Psychiatry at the University of Pittsburgh School of Nursing. She has served as Project Director (PI) on three HRSAfunded projects related to screening, brief intervention, and referral to treatment (SBIRT) for alcohol and other drug use and is currently funded by SAMHSA to integrate SBIRT education into the Nurse Practitioner curriculum, addressing substance use across the lifespan. Lastly, she is working with the CDC on two projects to incorporate Alcohol Screening and Brief Intervention (Alcohol SBI) into nursing practice with the ultimate goal of preventing Fetal Alcohol Spectrum Disorders (FASD).