Nurse turnover: A literature review - An update

Background: 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. Objectives: 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. Design: A comprehensive search of the recent literature related to nursing turnover was undertaken to summarize findings published in the past six years. Data sources: Electronic databases: MEDLINE, CINAHL and PubMed, reference lists of journal publications. Review methods: 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. Results: 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. Conclusions: 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. (C) 2011 Elsevier Ltd. All rights reserved.