The determinants and consequences of adult nursing staff turnover: a systematic review of systematic reviews

Abstract

BackgroundNurses leaving their jobs and the profession are an issue of international concern, with supply-demand gaps for nurses reported to be widening. There is a large body of existing literature, much of which is already in review form. In order to advance the usefulness of the literature for nurse and human resource managers, we undertook an overview (review of systematic reviews). The aim of the overview was to identify high quality evidence of the determinants and consequences of turnover in adult nursing.MethodsReviews were identified which were published between 1990 and January 2015 in English using electronic databases (the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Applied Social Sciences Index and Abstracts, CINAHL plus and SCOPUS) and forward searching. All stages of the review were conducted in parallel by two reviewers. Reviews were quality appraised using the Assessment of Multiple Systematic Reviews and their findings narratively synthesised.ResultsNine reviews were included. We found that the current evidence is incomplete and has a number of important limitations. However, a body of moderate quality review evidence does exist giving a picture of multiple determinants of turnover in adult nursing, with - at the individual level - nurse stress and dissatisfaction being important factors and -at the organisational level - managerial style and supervisory support factors holding most weight. The consequences of turnover are only described in economic terms, but are considered significant.ConclusionsIn making a quality assessment of the review as well as considering the quality of the included primary studies and specificity in the outcomes they measure, the overview found that the evidence is not as definitive as previously presented from individual reviews. Further research is required, of rigorous research design, whether quantitative or qualitative, particularly against the outcome of actual turnover as opposed to intention to leave.Trial registrationPROSPERO Registration 17 March 2015: CRD42015017613.Electronic supplementary materialThe online version of this article (10.1186/s12913-017-2707-0) contains supplementary material, which is available to authorized users.

Nurses' intention to stay: The impact of perceived organizational support, job control and job satisfaction

“…This finding was consistent with Cowden and Cummings' theory. Additionally, a systematic review about the determinants and consequences of nursing staff turnover revealed that job satisfaction/dissatisfaction was the decisive factor affecting the ITS/leave (Halter et al, ). In this study, similar conclusions were reached.…”

Occupational stress, quality of working life and turnover intention amongst nurses

“…However, despite this, the sense of altruism found amongst nurses can serve to satisfy them (Nasrabadi et al , ). It remains the case, however, that without adequate support and attention from the hospital authorities, nurses can experience decreased levels of job satisfaction, which can then lead to increased levels in intention to leave their employment (Halter et al , ).…”

“…Although many factors contribute to nursing shortages, high nurse turnover is considered to be one of the major contributors (Sokhanvar et al , ; Tourani et al , ). Turnover is not consistently defined in the literature (Halter et al , ), with descriptions ranging from the actual leaving of the organization to an intent to leave in the near future (Mazurenko et al , ). It has been defined as any career move, whether that move is external, such as when nurses leave the profession or an organization entirely, or internal, when nurses move between nursing units in the same hospital (Duffield et al , ).…”

Authentic leadership, job satisfaction and organizational commitment: The moderating effect of nurse tenure

“…In turnover research, work attitudes have been frequently investigated; for example, job satisfaction and organizational commitment have been reported to be connected to quality nursing performance and job retention (Ahmad, Ahmad, & Shah, ; Halter et al, ). Nurses who are satisfied with their tasks, their work environments and the ways they are treated by their organizations are likely to feel a deeper connection to their organizations and accordingly increase their organizational commitment (Benevene et al, ; Chang, ).…”