Projects
COLLAB-RN Research Projects
Baseline Assessment of Nurse Retention: A Longitudinal Analysis
This retention analysis examines how the work environment and organizational factors may impact nurse turnover in a single academic medical center. The aims include (1) To determine in inpatient units the associations between unit-level nurse-sensitive indicators (NSI), work environment (PES-NWI), and nurse (RN) turnover (TO), (2) Identify factors of the work environment that predict nurse turnover and (3) to understand new graduate RNs’ (NGRN) perceptions of their work environment at the end of their first year of practice and to identify solutions to address their concerns. The retention analyses began with 39 inpatient units at Yale New Haven Hospital and then expanded to include 63+ units of various types across the health system in 2024. Results from these analyses inform leaders in the practice setting and offer insight for the design and implementation of an organizational and system level intervention aimed at mitigating turnover.
Nurse Manager Impact on Turnover (AONL Grant)
About 1 in every 5 registered nurses working in a hospital have left their job in 2021 and 2022 (corresponding to 22-27% turnover). This persistent turnover of acute care presents a substantial threat to the health and well-being of hospitalized patients, families, nurses, and healthcare systems. Job dissatisfaction relating to the work environment is the primary reason nurses consider other jobs or leave the profession. Nurse managers, who provide direct supervision to nurses working inpatient units and have oversight and influence on the work environment, can greatly impact nurse turnover. Our previous work suggests that improvements in nurse manager leadership and ability are significantly associated with less staff nurse turnover, but nurse managers also face increasing pressures in their roles and practice; large and variable spans of control make the work of modern nurse managers untenable. A more detailed understanding of how nurse manager turnover may contribute to staff nurse turnover, nurse satisfaction, and nurse-sensitive indicators is needed, as well as how the relationship between nurse manager turnover and staff nurse turnover may be influenced by nurse staffing, the work environment, or nurse satisfaction. Our work includes a detailed longitudinal assessment of these relationships to inform future interventions to address turnover at all levels and provide guidance for nurse leaders to best support the nursing workforce.
UAP Evaluation
This project evaluates the unlicensed assistive personnel (UAP) apprenticeship program and is supported by a Department of Labor grant that will end June 2026. UAPs hired anywhere in the health system are assigned RN mentors that support transition to practice over 12 months. Data are collected each month and will be used to reflect and describe the success of the program and to evaluate participants’ perceptions of program feasibility, acceptability and appropriateness. Data will also reflect participants’ confidence regarding topics covered within the program’s curriculum. Focus groups with RN mentors and its participants will offer additional insight regarding program impact.
Student Trajectory Quality Improvement Project
Health care systems invest resources in ensuring there is a sustainable and well-prepared nursing workforce to care for patients. Recent nursing workforce dynamics have led to high turnover which potentially threatens the safety and well-being of patients and nurses. To guide strategic resource investment at YNHHS, the team conducted a quality improvement project to examine sociodemographic and employment characteristics of newly licensed nurses who joined the healthcare system as part of the nurse residency program. The purpose is to understand the characteristics of nurse residents to guide future workforce strategies aimed at building the pipeline. Through a brief survey, nurse residents provide various characteristics including demographics, prior work and student experience, hometown and nursing program characteristics. Most importantly, residents identify their top reasons for choosing YNHHS.
Clinical Coach Evaluation
This qualitative study evaluated the clinical nursing coach program. The program offers new graduate nurses coaching resources during off shift times. The programs aim to bolster the support of new nurses in order to support satisfaction and retention at Yale New Haven Hospital. The evaluation process included qualitative engagement via focus groups with off shift nurse administrators, coaches and new graduate nurses.
Evaluating Virtual Nursing
Given the limitations with current evidence surrounding virtual nursing and current health system initiatives and priorities, stakeholders within both the health system and university identified an opportunity to conduct a rigorous evaluation of virtual nursing. This project will begin by identifying what ongoing virtual nursing initiatives exist at YNHHS, identify a virtual nursing conceptual model and summarize existing ongoing virtual nursing initiatives. Aligning with stakeholders and current implementation timeline, the team will develop and design a randomized controlled trial to test virtual nursing models for effectiveness. The use of virtual nursing has exploded over the past few years and COLLAB-RN will aim to structure the use of it within YNHHS, disseminate lessons learned and test and evaluate virtual nursing models in select settings.