References

AbuAlRub RF, Omari FH, Al-Zaru IM. Support, satisfaction and retention among Jordanian nurses in private and public hospitals. Int Nurs Rev. 2009; 56:(3)326-332 https://doi.org/10.1111/j.1466-7657.2009.00718.x

Almada P, Carafoli K, Flattery JB, French DA, McNamara M. Improving the retention rate of newly graduated nurses. Journal for Nurses in Staff Development (JNSD). 2004; 20:(6)268-273 https://doi.org/10.1097/00124645-200411000-00006

Arthurs K, Bell-Gordon C, Chalupa B A culture of nursing excellence: A community hospital's journey from Pathway to Excellence® to Magnet® recognition. Journal of Nursing Education and Practice. 2018; 8:(5)26-37 https://doi.org/10.5430/jnep.v8n5p26

Bakker D, Butler L, Fitch M, Green E, Olson K, Cummings G. Canadian cancer nurses' views on recruitment and retention. J Nurs Manag. 2010; 18:(2)205-214 https://doi.org/10.1111/j.1365-2834.2009.01029.x

Barron D, West E, Reeves R. Tied to the job: affective and relational components of nurse retention. J Health Serv Res Policy. 2007; 12 https://doi.org/10.1258/135581907780318419

Closing the gap; key areas for action on the health and care workforce. 2019. https://tinyurl.com/s4jczm7 (accessed 1 March 2021)

Bramley L, Manning JC, Cooper J. Engaging and developing front-line clinical nurses to drive care excellence: Evaluating the Chief Nurse Excellence in Care Junior Fellowship initiative. Journal of Research in Nursing. 2018; 23:(8)678-689 https://doi.org/10.1177/1744987118808843

Brewer CS, Zayas LE, Kahn LS, Sienkiewicz MJ. Nursing recruitment and retention in New York state: a qualitative workforce needs assessment. Policy Polit Nurs Pract. 2006; 7:(1)54-63 https://doi.org/10.1177/1527154406286335

Buffington A, Zwink J, Fink R, DeVine D, Sanders C. Factors affecting nurse retention at an academic Magnet® hospital. JONA: The Journal of Nursing Administration. 2012; 42:(5)273-281 https://doi.org/10.1097/NNA.0b013e3182433812

Bugajski A, Lengerich A, Marchese M, Hall B, Yackzan S, Davies C, Brockopp D. The importance of factors related to nurse retention. JONA: The Journal of Nursing Administration. 2017; 47:(6)308-312 https://doi.org/10.1097/NNA.0000000000000486

Dignity denied: long-term care and Canada's elderly. 2007. https://tinyurl.com/yatjfpa8 (accessed on 20 February 2021)

Draper DA, Felland LE, Liebhader A, Melichar L. The role of nurses in hospital quality improvement. Res Brief. 2008; 3:1-8

Dunham J, Klafehn KA. Transformational leadership and the nurse executive. JONA: The Journal of Nursing Administration. 1990; 20:(4)28-34 https://doi.org/10.1097/00005110-199004000-00007

The Mid Staffordshire NHS Foundation Trust public inquiry. Final report. 2013. https://tinyurl.com/p2ebw82 (accessed 1 March 2021)

Han K, Trinkoff AM, Gurses AP. Work-related factors, job satisfaction and intent to leave the current job among United States nurses. J Clin Nurs. 2015; 24:(21-22)3224-3232 https://doi.org/10.1111/jocn.12987

Hart SM, Warren AM. Understanding nurses' work: exploring the links between changing work, labour relations, workload, stress, retention and recruitment. Economic and Industrial Democracy. 2015; 36:(2)305-329 https://doi.org/10.1177/0143831X13505119

Safe and effective staffing: the real picture. 2017. https://tinyurl.com/ya728mob (accessed 24 February 2021)

Hutchinson M, Jackson D, Wilkes L, Vickers MH. A new model of bullying in the nursing workplace: organizational characteristics as critical antecedents. ANS Adv Nurs Sci. 2008; 31:(2)E60-E71 https://doi.org/10.1097/01.ANS.0000319572.37373.0c

Kleinman C. The relationship between managerial leadership behaviors and staff nurse retention. Hosp Top. 2004; 82:(4)2-9 https://doi.org/10.3200/HTPS.82.4.2-9

Lavoie-Tremblay M, Fernet C, Lavigne GL, Austin S. Transformational and abusive leadership practices: impacts on novice nurses, quality of care and intention to leave. J Adv Nurs. 2016; 72:(3)582-592 https://doi.org/10.1111/jan.12860

Leurer MD, Donnelly G, Domm E. Nurse retention strategies: advice from experienced registered nurses. J Health Organ Manag. 2007; 21:(3)307-319 https://doi.org/10.1108/14777260710751762

Li Y, Jones CB. A literature review of nursing turnover costs. J Nurs Manag. 2013; 21:(3)405-418 https://doi.org/10.1111/j.1365-2834.2012.01411.x

McDaniel C, Wolf GA. Transformational leadership in nursing service. A test of theory. JONA: The Journal of Nursing Administration. 1992; 22:(2)60-65 https://doi.org/10.1097/00005110-199202000-00027

McGillis Hall L, Lalonde M, Dales L, Peterson J, Cripps L. Strategies for retaining midcareer nurses. JONA: The Journal of Nursing Administration. 2011; 41:(12)531-537 https://doi.org/10.1097/NNA.0b013e3182378d6c

McLemore MR, Levi A, James EA. Recruitment and retention strategies for expert nurses in abortion care provision. Contraception. 2015; 91:(6)474-479 https://doi.org/10.1016/j.contraception.2015.02.007

Nursing Times (NT) workforce summit 2018: HEE leader highlights focus on nurse retention amid rising demand. 2018. https://www.nursingtimes.net/news/workforce/hee-leader-highlights-focus-on-nurse-retention-amid-rising-demand/7026269.article (accessed 1 March 2021)

Moher D, Shamseer L, Clarke M Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015; 4:(1) https://doi.org/10.1186/2046-4053-4-1

National Heart Lung and Blood Institute. Study Quality Assessment Tools. 2018. https://tinyurl.com/yalfrtlp (accessed 24 February 2021)

Newman K, Maylor U, Chansarkar B. The nurse satisfaction, service quality and nurse retention chain. J Manag Med. 2002; 16:(4)271-291 https://doi.org/10.1108/02689230210445095

NHS England, NHS Improvement. Interim NHS people plan. 2019. https://tinyurl.com/y2w9pbm4 (accessed 24 February 2021)

NSI Nursing Solutions Inc. 2020 NSI national health care retention & RN staffing report. 2020. https://tinyurl.com/y5d66x9h (accessed 24 February 2021)

Perreira TA, Berta W, Herbert M. The employee retention triad in health care: exploring relationships amongst organisational justice, affective commitment and turnover intention. J Clin Nurs. 2018; 27:(7-8)e1451-e1461 https://doi.org/10.1111/jocn.14263

Philippou J. Employers' and employees' views on responsibilities for career management in nursing: a cross-sectional survey. J Adv Nurs. 2015; 71:(1)78-89 https://doi.org/10.1111/jan.12473

Ramoo V, Abdullah KL, Piaw CY. The relationship between job satisfaction and intention to leave current employment among registered nurses in a teaching hospital. J Clin Nurs. 2013; 22:(21-22)3141-3152 https://doi.org/10.1111/jocn.12260

Royal College of Nursing. The UK nursing labour market review 2019. 2020. https://tinyurl.com/4dhk6c96 (accessed 24 February 2021)

Royal College of Nursing Northern Ireland. Safe and effective care campaign in Northern Ireland. 2020. https://tinyurl.com/ybx3bnco (accessed 1 March 2021)

Royal College of Nursing Wales. The Nursing Workforce in Wales 2020. 2020. https://tinyurl.com/y8vv7bm6 (accessed 1 March 2021)

Schmiedeknecht K, Perera M, Schell E, Jere J, Geoffroy E, Rankin S. Predictors of workforce retention among Malawian nurse graduates of a scholarship program: a mixed-methods study. Glob Health Sci Pract. 2015; 3:(1)85-96 https://doi.org/10.9745/GHSP-D-14-00170

Spence Laschinger HK, Leiter M, Day A, Gilin D. Workplace empowerment, incivility, and burnout: impact on staff nurse recruitment and retention outcomes. J Nurs Manag. 2009; 17:(3)302-311 https://doi.org/10.1111/j.1365-2834.2009.00999.x

Takase M, Teraoka S, Yabase K. Retaining the nursing workforce: factors contributing to the reduction of nurses' turnover intention in Japan. J Nurs Manag. 2016; 24:(1)21-29 https://doi.org/10.1111/jonm.12266

Universities and Colleges Admissions Service. Nursing applications soar as UCAS publishes latest undergraduate applicant analysis. 2021. https://tinyurl.com/y8a2ect9 (accessed 1 March 2021)

Unruh L, Zhang NJ. The role of work environment in keeping newly licensed RNs in nursing: A questionnaire survey. Int J Nurs Stud. 2013; 50:(12)1678-1688 https://doi.org/10.1016/j.ijnurstu.2013.04.002

Valizadeh L, Zamanzadeh V, Habibzadeh H, Alilu L, Gillespie M, Shakibi A. Threats to nurses' dignity and intent to leave the profession. Nurs Ethics. 2018; 25:(4)520-531 https://doi.org/10.1177/0969733016654318

Van Osch M, Scarborough K, Crowe S, Wolff AC, Reimer-Kirkham S. Understanding the factors which promote registered nurses' intent to stay in emergency and critical care areas. J Clin Nurs. 2018; 27:(5-6)1209-1215 https://doi.org/10.1111/jocn.14167

Wong FKY, Liu H, Wang H, Anderson D, Seib C, Molasiotis A. Global nursing issues and development: analysis of World Health Organization documents. J Nurs Scholarsh. 2015; 47:(6)574-583 https://doi.org/10.1111/jnu.12174

Factors influencing retention among hospital nurses: systematic review

11 March 2021
15 min read
Volume 30 · Issue 5

Abstract

Background:

Recruitment and retention of nursing staff is the biggest workforce challenge faced by healthcare institutions. Across the UK, there are currently around 50 000 nursing vacancies, and the number of people leaving the Nursing and Midwifery Council register is increasing.

Objective:

This review comprehensively compiled an update on factors affecting retention among hospital nursing staff.

Methods:

Five online databases; EMBASE, MEDLINE, SCOPUS, CINAHL and NICE Evidence were searched for relevant primary studies published until 31 December 2018 on retention among nurses in hospitals.

Results:

Forty-seven studies met the inclusion criteria. Nine domains influencing staff turnover were found: nursing leadership and management, education and career advancement, organisational (work) environment, staffing levels, professional issues, support at work, personal influences, demographic influences, and financial remuneration.

Conclusion:

Identified turnover factors are long-standing. To mitigate the impact of these factors, evaluation of current workforce strategies should be high priority.

Nurses are fundamental in ensuring the delivery of high-quality care in healthcare institutions. Globally, there are an estimated 29 million nurses and midwives (Wong et al, 2015), who constitute the largest group of health professionals within healthcare organisations. However, over the past decades, nursing shortages have become a global challenge. Across the UK, there are around 50 000 nursing vacancies in total: 43 615 in England, 3060 in Scotland, 1612 in Wales and 1671 in Northern Ireland (Royal College of Nursing (RCN), 2020; RCN Northern Ireland, 2020; RCN Wales, 2020).

In 2019, the total number of registrants who left the Nursing and Midwifery (NMC) register was 27 589, which included both UK-trained and non-UK trained nurses, a figure that was 23% higher than in 2013 (RCN, 2020). Such a reduction in nurse numbers inevitably puts patient safety at risk, as well as the quality of the care provided, it also decreases efficiency. In addition, reduced staff numbers affect staff morale, the health of individual nurses, and increase costs for organisations, which have to continually recruit and train new employees to replace those who have left (AbuAlRub et al, 2009; Perreira et al, 2018).

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