Facilitators of Nurse Practitioners’ Transition to Practice: An Integrative Review

Abstract

Aim: To review the literature and identify the facilitators that help new graduate nurse practitioners (NP) transition to practice. Background: The NP profession originated in the United States in the 1960s and followed in the same decade by Canada. Although the NP profession has existed for more than 50 years, struggles still exist in their full implementation to the health care system. These challenges include recruitment and retention, healthcare setting support, role clarity, public awareness, legislation and regulation, and funding. Focusing on retention, NPs have double the amount of turnover in comparison to their physician counterparts. This high turnover rate is often attributed to the challenges NPs face during their transition to practice as new graduates. Methods: An integrative literature review guided by the framework proposed by Whittemore and Knafl. Data sources included: CINAHL, Medline, and Web of Science. Twenty-seven studies met the inclusion criteria and were assessed using the Mixed Method Appraisal Tool. Findings from the studies were obtained and analyzed using themes. Findings: Five themes were identified: (1) fellowship or orientation/onboarding programs, (2) mentorship, (3) prior registered nurse experience, (4) autonomous practice, and (5) communities of practice. This review revealed the complexity and interconnection of facilitators to transition. Conclusion: The NP role continues to expand globally; it is imperative that facilitators to transition are implemented to improve NP retention and address the education to practice gap.