This study addresses the cost to benefit ratio of a healthcare organization’s investment in specialty perioperative residency programs for newly licensed registered nurses and experienced registered nurse orienting into perioperative services. The outcomes for transition to practice residency programs is widely reported however a standardized approach to measuring and reporting cost to benefit ratios and return on investment to these programs as well as specialty residencies remains an opportunity. This study contributes to national standardization and approach by defining the costs of a perioperative residency program and determining the cost to benefit ratio using a return on investment calculator. The organizational first year investment did not show a positive return but by the second year achieve of a consistently positive financial return was achieved. The average savings in reducing traveler salary costs was $40,923 per on-boarding employee with a total savings of $6,343,065.

Document Type


Level of Degree


First Committee Member

P. J. Woods, PhD, MBA, RN

Second Committee Member

Cynthia Nuttall, PhD, RN


adaptive enterprise, COBRAM ©, newly licensed registered nurses, perioperative nursing residency program, return on investment, transition to practice residency program

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Nursing Commons