Nurse turnover: A literature review – An update Hayes, Laureen J.; O’Brien-Pallas, Linda; Duffield, Christine ...
International journal of nursing studies,
July 2012, 2012-Jul, 2012-7-00, 20120701, Volume:
49, Issue:
7
Journal Article
Peer reviewed
Concerns related to the complex issue of nursing turnover continue to challenge healthcare leaders in every sector of health care. Voluntary nurse turnover is shown to be influenced by a myriad of ...inter-related factors, and there is increasing evidence of its negative effects on nurses, patients and health care organizations.
The objectives were to conduct a comprehensive review of the related literature to examine recent findings related to the issue of nursing turnover and its causes and consequences, and to identify on methodological challenges and the implications of new evidence for future studies.
A comprehensive search of the recent literature related to nursing turnover was undertaken to summarize findings published in the past six years.
Electronic databases: MEDLINE, CINAHL and PubMed, reference lists of journal publications.
Keyword searches were conducted for publications published 2006 or later that examined turnover or turnover intention in employee populations of registered or practical/enrolled or assistant nurses working in the hospital, long-term or community care areas. Literature findings are presented using an integrative approach and a table format to report individual studies.
From about 330 citations or abstracts that were initially scanned for content relevance, 68 studies were included in this summary review. The predominance of studies continues to focus on determinants of nurse turnover in acute care settings. Recent studies offer insight into generational factors that should be considered in strategies to promote stable staffing in healthcare organizations.
Nursing turnover continues to present serious challenges at all levels of health care. Longitudinal research is needed to produce new evidence of the relationships between nurse turnover and related costs, and the impact on patients and the health care team.
Aims
To compare nurse turnover rates and costs from four studies in four countries (US, Canada, Australia, New Zealand) that have used the same costing methodology; the original Nursing Turnover Cost ...Calculation Methodology.
Background
Measuring and comparing the costs and rates of turnover is difficult because of differences in definitions and methodologies.
Design
Comparative review.
Data Sources
Searches were carried out within CINAHL, Business Source Complete and Medline for studies that used the original Nursing Turnover Cost Calculation Methodology and reported on both costs and rates of nurse turnover, published from 2014 and prior.
Methods
A comparative review of turnover data was conducted using four studies that employed the original Nursing Turnover Cost Calculation Methodology. Costing data items were converted to percentages, while total turnover costs were converted to US 2014 dollars and adjusted according to inflation rates, to permit cross‐country comparisons.
Results
Despite using the same methodology, Australia reported significantly higher turnover costs ($48,790) due to higher termination (~50% of indirect costs) and temporary replacement costs (~90% of direct costs). Costs were almost 50% lower in the US ($20,561), Canada ($26,652) and New Zealand ($23,711). Turnover rates also varied significantly across countries with the highest rate reported in New Zealand (44·3%) followed by the US (26·8%), Canada (19·9%) and Australia (15·1%).
Conclusion
A significant proportion of turnover costs are attributed to temporary replacement, highlighting the importance of nurse retention. The authors suggest a minimum dataset is also required to eliminate potential variability across countries, states, hospitals and departments.
Reviewing Employee Turnover Hom, Peter W; Mitchell, Terence R; Lee, Thomas W ...
Psychological bulletin,
09/2012, Volume:
138, Issue:
5
Journal Article
Peer reviewed
We reconceptualize employee turnover to promote researchers' understanding and prediction of why employees quit or stay in employing institutions. A literature review identifies shortcomings with ...prevailing turnover dimensions. In response, we expand the conceptual domain of the turnover criterion to include multiple types of turnover (notably, involuntary quits) and multiple types of staying. Guided by the premise that "everyone eventually leaves; no one stays with an organization forever," we also suggest considering where leavers end up-or post-exit destinations, such as another job, full-time parenting, or educational pursuits. We propose "proximal withdrawal states" that motivate members to participate or withdraw from organizations as an expanded criterion. These motivational states precede turnover and are derived from 2 overarching dimensions: desired employment status (whether employees want to stay or leave) and perceived volitional control (whether quit or stay decisions are completely up to them or at least partially under external regulation). Crossing these dimensions yields 4 prime states: enthusiastic leavers and stayers and reluctant leavers and stayers. We further subdivide these mind-sets into subtypes by differentiating employer from other forms of external control (e.g., family). Focusing on more common subtypes, we explain how they arise from particular motivational forces and profile how they differ by attitudes, behaviors, and turnover speed and destinations. We further discuss ways to measure this expanded criterion and proximal states (and subtypes) and investigate the latter's profiled differences. Finally, we discuss scientific and practical implications and future research directions.
This study examined how an ethical work climate influences salespersons' organizational identification, supervisory trust, organizational commitment, turnover intentions, and turnover. Using a sample ...of 393 salespeople, the results found that facets of an ethical work climate are related directly to supervisory trust and organizational identification. One aspect of an ethical work climate, ethical norms, was related directly to turnover. These results indicate that an ethical work climate can directly affect salespersons' job attitudes and outcomes. The results indicate the importance of measuring ethical work climate from a multi-dimensional perspective.
The phenomenon of group turnover has generated substantial yet disconnected scholarly interests. Despite valuable insights gained from the collective turnover literature as well as parallel research ...concerning related or coordinated quitting, a holistic understanding of the unique group turnover phenomenon is needed, both to synthesize existing research across multiple domains and disciplines and to kindle new inquiries regarding its dynamic nature and developmental process. To this end, we begin by conducting an integrative review of research relating to group turnover, reinterpreting it by identifying its common pathways as a function of varying triggers, temporal patterns, and departure destinations. We then leverage the groups literature to explicate group turnover's self-reinforcing and dynamic nature and propose a three-dimensional Interdependence, Temporality, and Emergence (ITE) framework that accounts for its developmental process. Using this framework, we develop an illustrative set of propositions regarding how ITE-related group properties affect the extent to which individual departures might escalate into group turnover of a larger scale and faster speed. Our emphasis on groups as a unique unit of reference thus provides an important conceptual refinement and extension for understanding collective turnover-shifting from a static focus on aggregate exit (rates) to a dynamic focus on the often-coordinated, temporally evolving nature of multiple group member quit events.
•Work attitudes, job strains, and role stressors/interrole conflicts have large effects on turnover intention.•Industry characteristics influence the relationships between antecedents and turnover ...intention.•National cultures and job levels moderate the relationships between the antecedents and turnover intention.
This study meta-analytically examined 35 antecedents of turnover intention in the hospitality industry. Results based on 391 correlations from 144 independent studies indicated that work attitudes, job strains, and role stressors/interrole conflicts showed relatively large effects on turnover intention. Compared to the findings from previous meta-analyses in other industry contexts, burnout, role stressors/interrole conflicts, coworker support had stronger relationships with hospitality employees’ turnover intention. The results also showed some evidence of national cultures and job levels being the potential moderators of the relationships between turnover intention and its antecedents.
The authors conducted a meta-analysis of the relationship between turnover rates and organizational performance to (a) determine the magnitude of the relationship; (b) test organization-, context-, ...and methods-related moderators of the relationship; and (c) suggest future directions for the turnover literature on the basis of the findings. The results from 300 total correlations (N = 309,245) and 110 independent correlations (N = 120,066) show that the relationship between total turnover rates and organizational performance is significant and negative (ρ = -.15). In addition, the relationship is more negative for voluntary (ρ = -.15) and reduction-in-force turnover (ρ = -.17) than for involuntary turnover (ρ = -.01). Moreover, the meta-analytic correlation differs significantly across several organization- and context-related factors (e.g., types of employment system, dimensions of organizational performance, region, and entity size). Finally, in sample-level regressions, the strength of the turnover rates-organizational performance relationship significantly varies across different average levels of total and voluntary turnover rates, which suggests a potential curvilinear relationship. The authors outline the practical magnitude of the findings and discuss implications for future organizational-level turnover research.
Aim
Using an interactionist perspective to test on‐the‐job embeddedness and off‐the‐job embeddedness as possible moderators for the predictive effects of job satisfaction and job stress on nurses’ ...turnover intentions.
Background
As turnover worsens nurse shortages across the globe, researchers needs to find ways to work out and reduce nurses’ turnover intentions. By exploring contributory factors, namely on‐the‐job and off‐the‐job embeddedness as two distinctive forms that both act as moderators, we add to the literature on effective nurse retention and highlight that incorporating off‐the‐job factors can provide a more realistic understanding of why people consider leaving their organization.
Design
Survey of 361 nurses of the United Kingdom's (UK's) National Health Service, in 2016.
Method
We conducted hierarchical multiple regression and simple slope analyses.
Results
Job satisfaction was negatively associated with turnover intentions, and this negative relationship was stronger when off‐the‐job embeddedness was high (vs. low). Job stress was positively related to turnover intentions, yet high (vs. low) off‐the‐job embeddedness buffered this relationship. In contrast, when on‐the‐job embeddedness was high (vs. low), the relationship between job stress and turnover intentions were even stronger.
Conclusion
Results showed that using an interactionist perspective is useful in predicting nurse turnover. Nursing management should be made aware of the importance of being embedded off‐the‐job to prevent nurse turnover. This paper issues guidelines to form a more comprehensive staff retention programme for the healthcare sector.
目的
采用互动论者观点来测试工作内嵌入和工作外嵌入而作为工作满意度和工作压力对护士离职意愿预测效果的可能调节因素。
背景
随着全球护士离职加剧了护士短缺,研究人员需要找到方法来解决和减少护士的离职意愿。通过探索促成因素,即,作为调节因素的两种不同形式的工作内嵌入和工作外嵌入,我们补充了关于有效护士保留率的文献,并强调,纳入工作外因素能够更现实地理解人们为什么会想要离职。
设计
在2016年,对英国(UK)国家医疗服务体系下的361名护士进行了调查。
方法
我们进行了阶层多元回归分析法和简单斜率分析法。
结果
工作满意度与离职意向呈负相关,当工作外嵌入较高(相对较低)时,这种负相关关系更强。工作压力与离职意向呈正相关,但高(与低)的工作外嵌入缓冲了这种关系。相比之下,当工作外嵌入较高(相对较低)时,工作压力和离职意愿之间的关系更强。
结论
结果表明,采用互动论者观点来预测护士离职是有用的。护理管理人员应该意识到工作外嵌入对防止护士离职的重要性。这篇论文发布了为医疗保健行业制定更全面的员工保留计划的指导方针。
Aim
To assess turnover intention among experienced nurses and explore the effects of work environment, job characteristics and work engagement on turnover intention.
Background
The nursing shortage ...is an urgent concern in China. A high turnover rate of experienced nurses could have serious effects on the quality of care, costs and the efficiency of hospitals. It is crucial to explore the predictors of turnover intention and develop strategies tailored to experienced nurses.
Design
A descriptive, cross‐sectional survey design.
Methods
A total of 778 experienced nurses from seven hospitals was surveyed on their work engagement, job characteristics, work environment and turnover intention in March–May 2017. Structural equation modelling was used to test a theoretical model and the hypotheses.
Results
The results showed that 35.9% of experienced nurses had high‐level turnover intention. The final model explained 50% of the variance in experienced nurses' turnover intention and demonstrated that: (1) work environment was positively associated with higher work engagement and lower turnover intention and work engagement partially mediated the relationship between work environment and turnover intention; and (2) job characteristics were positively related to higher work engagement and lower turnover intention and work engagement fully mediated the relationship between job characteristics and turnover intention.
Conclusions
The study confirms the intrinsic and extrinsic motivators on work engagement posited by job demands‐resources model. Theory‐driven strategies to improve work environment, enhance job characteristics and promote wok engagement are needed to address the nursing shortage and high turnover intention among experienced nurses.
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