Conceptual Plurality in Transition Programmes for Newly Hired Nurses: An Umbrella Review

Background/Objectives: Nurse transition programmes are widely implemented to support newly hired nurses and promote workforce retention. Despite the growing number of pub- lished reviews, conceptual inconsistency and methodological heterogeneity limit the inter- pretability and cumulative value of the evidence. This umbrella review aimed to synthesise and critically examine review-level evidence on nurse transition programmes, clarifying programme typologies, contexts, methodological approaches, reported outcomes, and the- matic patterns. Methods: An umbrella review was conducted in accordance with PRISMA 2020 guidance. Systematic searches were performed in CINAHL, PubMed, Scopus, Web of Science, and Google Scholar, supplemented by citation tracking. Results: Fourteen reviews published between 2010 and 2025 were included: 12 reviews of primary studies and two reviews of secondary evidence (one umbrella review and one meta-review). Programme models and outcome measures were highly heterogeneous, and primary study overlap was slight (CCA = 2.55), indicating that reviews in the corpus drew on largely non-overlapping sets of primary studies. Transition programmes for new nurses commonly use one-on- one preceptorships with supernumerary practice, simulation-based learning, and active methods like case studies and reflective journaling to build competence and confidence. Their duration varies from a few days to 12 months, aligning with the progressive learning curve of new graduates. Professional outcomes, particularly competence and confidence, were consistently reported, whereas organisational outcomes, such as retention, showed mixed, methodologically constrained evidence. Patient-level outcomes were rarely exam- ined. Thematic analysis revealed a shift over time from individual professional readiness towards implementation and organisational considerations. Conclusions: Given this con- ceptual plurality, there is an urgent need to standardise key indicators for evaluating the effectiveness of nurse transition programmes across healthcare settings globally.