The United States healthcare system is facing a crisis. Currently there are insufficient numbers of RNs to meet the healthcare needs of the aging population. It is imperative that each nursing student position be filled with a qualified applicant who will complete the program with the capability of passing the National Council Licensure Examination for Registered Nurses. Attrition is a problem in nursing programs. Currently RN programs in the United States have a 50% attrition rate. One reason is academic failure in nursing courses. Nursing students at-risk of failing a nursing course must be supported in the mastery of course content in order to be successful and to progress. Early remediation allows students to master content early in the nursing program and as they progress instead of waiting until the end of the program to begin remediation. The nursing program at which the capstone project took place has an attrition of 25.9% due to failing grades in nursing courses. Faculty and administration share the belief that a 25.9% attrition rate is unacceptable. It is the expectation that more nursing students who begin the nursing program will graduate. A remediation program was made available to all nursing students and attendance was expected for at-risk nursing students. The objectives of the remediation program were to: decrease attrition; help nursing students move from novice and advanced learners to proficient learners; pass each nursing course; pass course examination, the nursing program exit examination, and the NCLEX-RN on the first attempt; and to graduate qualified practitioners. The Johns Hopkins Nursing Evidence-based Practice Model was utilized to guide the development of a remediation program. This model is a three step process utilizing the acronym PET. The “P” represents developing a practice question. The “E” represents finding and evaluating the best evidence from research studies, and “T” represents translating the best evidence into practice. The remediation program implemented as a part of this project was successful in retaining students in the two nursing courses with the highest attrition rates: Fundamentals is taken in the first semester of the nursing program and Medical/Surgical Nursing I in the third semester. The attrition rate decreased from 25.9% to 9.3% in Fundamentals, and from 11.1% to 0% in Medical/Surgical Nursing I. The remediation program will continue in these two nursing courses. Remediation will be added to other courses as students progress in the program which has high attrition rates. Long term objectives will be evaluated to determine if early success in decreasing attrition will result in positive results on the program exit exam and NCLEX-RN pass rates.
