Michelle Michel, MSN ‘99, APRN-CNP, ANP-BC, CVNP-BC, Doctor of Nursing Practice (DNP) student at ɫҹ University College of Nursing, has been instrumental in updating Summa Health System’s nurse residency program by utilizing evidence-based practice methodology. Michel explained that evidence-based practice is the process of translating research into practice.
“If we have the knowledge but don’t do anything with it, nothing changes. The process is an exchange between those who do research and the DNP nurse who analyzes the data and then applies the findings,” said Michel. “By working together, we can improve patient outcomes and provide better care to our patients and families.”
Michel, who is the program coordinator for the Structural Heart Team at Summa Health, recently participated in an evidence-based practice (EBP) skill-building program in partnership with Helene Fuld Trust National Institute for EBP in Nursing and Healthcare from The Ohio State University and Summa Health’s newly developed Center for Clinical Inquiry™. Using an evidence-based methodology to explore process improvements and make informed decisions, participants focused on reducing variation in practice, enhancing quality and improving patient outcomes and reducing cost. During this experience, Michel was asked to think about an area of practice in which she had questions. Recalling conversations with her daughter, who will graduate with her Bachelor of Science in Nursing (BSN) in May 2024, and thinking about her fellow nurses, Michel felt drawn to investigate nurse residency programs and how they impact the working environment for newly licensed nurses. After making her inquiries, Michel learned Summa Health currently offers a five-month-long nurse residency program, however, there was room for improvement.
According to Michel, most newly licensed registered nurses experience a period called transition shock, roughly four to six months after beginning their new role. Nurse Residency Programs support these new nurses by bridging the gap and transition from academia to practice by helping to improve nursing practice, reduce stress and increase the new nurses’ confidence as they acclimate to the nursing environment.
Offered in addition to new-hire orientation, nurse residency programs have become a standard of practice for many organizations. Michel immersed herself in the literature, learning about program outcomes, retention rates of newly licensed nurses, program infrastructure and cost analysis. She found overwhelming evidence that indicated programs lasting one year were best because they supported nurses through the entire transition shock period.
“Newly licensed nurses are working at the bedside, and they are so essential. I wanted to learn how we could improve their work environment to keep them at the facility long-term,” said Michel. “It is expensive to train a new nurse, but it’s also expensive to lose a nurse or employ temporary staff. Literature shows nurse residency programs are cost-effective.”
Michel also realized the importance of having a dedicated clinical coordinator and an advisory board to streamline the nurse residency program, set objectives, measure outcomes and provide continual evaluation leading to improvements that would further foster a sense of belonging for new nurses. Upon synthesizing her findings, Michel partnered with Amanda McComas, MSN, RN, NPD-BC, manager of clinical training and development at Summa Health, who oversees the current nurse residency program.
“Together, we looked at what Summa Health had currently, what the literature recommended and where we could improve our program based on those findings,” said Michel. “We revised our program to reflect the current evidence in the literature.”
Once the revised year-long program rolls out, newly licensed nurses will be divided into cohorts based on hire date, explained Michel. Along with a newly hired clinical coordinator, the program will include trained preceptors and facilitators who will present monthly topics on communication and teamwork, quality improvement, resiliency and stress management, delegation, professionalism, time management and patient safety. Diverse teaching methods will be utilized, and participants will have the option to establish a relationship with a nurse mentor.
“Our mentorship team will be comprised of experienced nurses who are in place to provide newly licensed nurses with emotional support and socialization,” said Michel. “They differ from nurse preceptors whose primary role includes providing guidance and support in a clinical context. Both mentors and preceptors are important in developing successful new nurses.”
For Michel, it has been very exciting to watch this evidence-based practice initiative unfold in front of her, especially because it has aligned with her DNP education.
“Looking at our current nurse residency program from a 1,000-foot view through the lens of evidence-based practice has been a personal highlight for me. This methodology works and I am excited to see our outcomes once the first cohort completes the program,” said Michel. “Developing partnerships and collaborating with others to make a difference at an organizational level has been truly inspiring. It’s so fulfilling to have participated in a project that will positively impact our future Summa Health nurses. I am excited to see their confidence grow and evaluate the program to determine where we excelled and where further improvements are needed.”
A nurse practitioner for more than 20 years specializing in cardiovascular medicine, Michel felt there was more for her to do and achieve in her career. She desired an opportunity that allowed her to make a difference system-wide and reach a broader patient population. Having received her Master of Science in Nursing from ɫҹ University College of Nursing in 1999, in addition to working as an adjunct faculty at the college, Michel said it was an easy decision for her to return to ɫҹ for her DNP program.
Michel shared that her DNP program has been a great learning experience, but she couldn’t have done it without the love and support of her family, colleagues and peers. She also expressed her gratitude to supportive faculty members.
“I am ready to spread my wings and venture into new, interesting opportunities where I can make a bigger impact,” said Michel. “I feel confident about stepping into a leadership role soon.”
Michel’s anticipated graduation is August 2024, and she hopes to continue her involvement in Summa Health’s revised nurse residency program from a leadership perspective.
Image Caption:
(From left) Two-time alumna Karrie Boss, DNP ‘23, RN, APRN, ACCNS-AG, EBP-C, CCRN, System Director, Evidence-Based Practice at Summa Health; Michelle Michel MSN ‘99, APRN- CNP, ANP-BC, CVNP-BC, program coordinator for the Structural Heart Team at Summa Health and ɫҹ University College of Nursing DNP student and Amanda McComas, MSN, RN, NPD-BC, Manager, Clinical Training & Development for Summa Health (Photo by Summa Health).