For healthcare workers, the COVID-19 pandemic created challenging work environments, intensified growing staffing challenges, and increased professional burnout. In 2023, national turnover rates were recorded at 22.5%, with the medical-surgical specialty having a higher turnover rate (NSI Nursing Solutions, Inc., 2023). At a large academic medical center, the need arose to implement creative staffing models that included bringing licensed practical nurses (LPNs) into the acute healthcare setting. As a result, our team of nursing professional development (NPD) practitioners saw the need to create a program to empower and educate LPNs across the inpatient and ambulatory settings. Jones et al. (2021) suggests that by investing in LPNs and addressing their changing needs, organizations improve retention and build a more capable and resilient nursing workforce.
Program Development: The Building Blocks for Success
The NPD practitioners gathered key personnel from both the inpatient and ambulatory settings to define the practice gap of LPNs transitioning into the acute healthcare setting. Gaps identified included emergency response, care of patients with complex and behavioral needs, and an opportunity to increase clinical ladder participation in alignment with organizational goals. After the gap analysis, the NPD practitioners assessed learning needs through direct observation, perspective learner input, and development of an LPN Interest Survey. The results of the survey showed that 54% of the respondents were interested in participating based on the content identified in the gap analysis. Of the individuals who did not want to participate, 43% said it was due to scheduling conflicts, and 19% reported it was related to not finding the proposed content valuable based on their work environment. From this assessment, the foundation and intended outcomes of the course were to increase LPN confidence, improve cardiopulmonary resuscitation response time, and strengthen clinical ladder participation. The program met monthly for a total of nine sessions, and each class included didactic instruction as well as simulation.
NPD practitioners developed curriculum and program content, and secured subject matter experts from departments such as patient experience, diversity office, pastoral care, respiratory therapy, and the stroke and heart failure programs. Content and curriculum were created in the following categories: clinical practice, communication and safety, professional development, and healthy work environment. The didactic portion included topics and activities such as patient experience, incivility, Situation, Background, Assessment, Recommendation (SBAR) communication, cultural diversity, and stress first aid. NPD practitioners collaborated to develop and facilitate simulation scenarios such as emergency response, stroke, hypoglycemia, tracheostomy care, and behavioral de-escalation. During the simulations, learners were separated into ambulatory and inpatient teams to allow engagement in scenarios that best met the needs of their unique practice environments.
Of the 16 participants, five engaged in formal mentorship with the LPN facilitator for 30 minutes prior to each class. These sessions included professional portfolio creation as well as feedback on clinical narrative development. Of the remaining 11, several had already obtained clinical ladder or did not meet current qualifications. Since the program began, 40% of the LPNs who participated in mentoring sessions have achieved clinical ladder.
Did it Make a Difference?
Professional Development and Engagement
The primary goal was to develop a program that increased the skills and confidence of the learners. To evaluate the program goals, learners were asked to complete a post-seminar evaluation at the conclusion of each session via a QR code. Overall evaluation completion across eight seminars was 94%, reflecting strong learner engagement and program credibility. At seminar nine, learners completed an overall program evaluation of the course. Of those who completed the evaluation, 100% valued the content of each session and reported professional growth through participation. Additionally, 93% agreed or strongly agreed that the classroom and simulation experiences were helpful in their professional practice.
Emergency Response
As part of outcome evaluation, the NPD practitioners analyzed the emergency response simulation data comparing the same simulation delivered at seminar one and repeated at seminar eight. Fifty percent of the groups improved their time to initiation of chest compressions. At session eight, 100% of the groups were within the American Heart Association guidelines (2025) for the first shock delivered within two minutes, excluding one group that was unable to be assessed because of an equipment malfunction.
Staffing Impact
The course was implemented after initial onboarding and orientation of LPNs. One of the stakeholder goals was to decrease turnover and use of agency nurses in the acute setting. As a result of supporting staff in this program, and in alignment with other initiatives, one medical-surgical unit was able to decrease not only its vacancy rate but also eliminate its use of travelers. This is relevant to NPD practice showcasing that professional development can impact the financial health of the organization. According to Nursing Solutions Inc. (2023), for every 20 travelers eliminated, it is estimated that a hospital can save $3.1 million, demonstrating the continued impact that professional development can have on retention.
Leading Through Change
NPD practitioners play a pivotal role in assisting organizations with professional development, engagement, and retention by building programs to support staff at a variety of levels. One way that NPD practitioners can commit to creating and maintaining a culture of learning is through the development of additional opportunities, such as an LPN program. NPD practitioners must advocate for the continuation of organizational investment through sharing program outcomes related to patient safety, staff development, and retention.
Acknowledgement
We would like to express our sincere gratitude to Sue Pazuchanics, MSN, RN, CCRN-K, NPD-BC, for her leadership and contributions to the development and operational execution of this program initiative. We would also like to thank Kelly Rotondo, DNP, RN, CTC, and Renee Houser, LPN, for their input through their respective roles in the program.
References
American Heart Association (2025). CPR & first aid emergency cardiovascular care. Retrieved from: https://cpr.heart.org/en/resources/what-is-cpr
Jones CB, McCollum M, Tran AK, Toles M, Knafl GJ. (2021). Supporting the dynamic careers of licensed practical nurses: A strategy to bolster the long-term care nurse workforce. Policy, Politics, & Nursing Practice. 22(4): 297-309. doi: 10.1177/15271544211030268
NSI Nursing Solutions, Inc. (2023). 2023 NSI national health care retention & RN staffing report. https://www.nsinursingsolutions.com
Disclaimer: The views and opinions expressed in this article are solely those of the contributor and do not necessarily reflect the official policy or position of ANPD.
Elizabeth Holbert, MSN, RN
Nurse Residency Program Coordinator and Nursing Professional Development Leader, Penn State Health Milton S. Hershey Medical Center
Liz Holbert is the nursing professional development leader and nurse residency coordinator at Penn State Health Milton S. Hershey Medical Center. She oversees the Graduate Nurse Residency Program and leads a team of five educators within the centralized education department. An alumna of the organization’s 2012 nurse residency cohort, she brings more than 13 years of nursing experience, including eight years in residency program leadership. Holbert holds a BSN from York College of Pennsylvania and an MSN in Nursing Leadership from Walden University. She has led key organizational initiatives such as the development of evidence‑based practice mentorship, professional development pathways, and transition-to-practice programs. She is an active presenter at national conferences and has a peer‑reviewed publication in Critical Care Nursing Quarterly. She serves as chair of the Pennsylvania Nurse Residency Collaborative Steering Council and contributes to national Vizient/AACN committees. Her work has earned multiple honors, including the 2025 Vizient/AACN Nurse Residency Coordinator of the Year.
Sarah Mauldin, MSN, RN
Nursing Professional Development Specialist, Orthopedics Neurosciences & Medicine Specialties
Sarah Mauldin, MSN, RN, is a nursing professional development practitioner in a large academic medical center with more than 13 years of experience in medical-surgical nursing. Mauldin earned both a Bachelor and Master of Science in Nursing from Messiah University. With specialties that include orthopedic joint and trauma, neurosciences, plastics, ENT, and medical specialties, she has eight years of experience simultaneously supporting multiple acute care units. Mauldin is particularly passionate about creating supportive, high-quality onboarding experiences for new staff while fostering ongoing professional development for team members in all roles. She strives to build a positive learning culture grounded in collaboration, competence, and compassion, ensuring that every nurse has the tools and confidence needed to thrive in practice.