Interventions to Reduce Adult Nursing Turnover: A Systematic Review of Systematic Reviews

Abstract

Background:Nurse turnover is an issue of concern in health care systems internationally. Understanding which interventions are effective to reduce turnover rates is important to managers and health care organisations. Despite a plethora of reviews of such interventions, strength of evidence is hard to determine.Objective:We aimed to review literature on interventions to reduce turnover in nurses working in the adult health care services in developed economies.Method:We conducted an overview (systematic review of systematic reviews) using the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Applied Social Sciences Index and Abstracts, CINAHL plus and SCOPUS and forward searching. We included reviews published between 1990 and January 2015 in English. We carried out parallel blinded selection, extraction of data and assessment of bias, using the Assessment of Multiple Systematic Reviews. We carried out a narrative synthesis.Results:Despite the large body of published reviews, only seven reviews met the inclusion criteria. These provide moderate quality review evidence, albeit from poorly controlled primary studies. They provide evidence of effect of a small number of interventions which decrease turnover or increase retention of nurses, these being preceptorship of new graduates and leadership for group cohesion.Conclusion:We highlight that a large body of reviews does not equate with a large body of high quality evidence. Agreement as to the measures and terminology to be used together with well-designed, funded primary research to provide robust evidence for nurse and human resource managers to base their nurse retention strategies on is urgently required.

Retaining nurses in metropolitan areas: insights from senior nurse and human resource managers

“…at the micro‐organisational level) in developed economies (Halter et al . ). Against this paucity of empirical evidence, there is a need to draw on the evidence from experience, i.e.…”

“…at the individual level) and for leadership that creates group cohesion (i.e. at the micro-organisational level) in developed economies (Halter et al 2016b). Against this paucity of empirical evidence, there is a need to draw on the evidence from experience, i.e.…”

Factors influencing the recruitment and retention of registered nurses in adult community nursing services: an integrative literature review

“…Some of these factors have already been identified as influencing factors towards the retention of community nurses as shown above. However, drawing from the wider literature, a number of studies have considered why hospital nurses leave employment and many of these studies cite job satisfaction (Lu et al, 2012), effectiveness of nurse managers (Halter et al, 2017), staffing levels (Hairr et al, 2014), work autonomy and collegial relationships (Duffield et al, 2014) as influencing factors. No doubt, some of these factors mirror those highlighted above.…”

“…However, it is unknown how many community nurses and how many hospital nurses have taken this approach or have identified opportunities elsewhere. Overall, literature shows the absence of effective and efficient models considering organisational, professional and personal factors, impinging the development of interventions capable of improving the retention of nursing workforce (Halter et al, 2017).…”

The Management and Administrative Practices Resulting in the Exit of Nurses from the Irish Healthcare System – a Review

“…Research done previously has shown that retention is proven to be a better solution to recruitment when dealing with staffing shortages (Halter et al, 2017). Doran suggests that it is time for the concerned authorities to work on keeping Irish nurses in Ireland and in the public sector.…”