Effective strategies for nurse retention in acute hospitals: A mixed method study
International Journal of Nursing StudiesPublished 26 December 2011Open access
Koen Van den Heede, Mieke Florquin, Luk Bruyneel, Linda H. Aiken, Luwis Diya, Emmanuel Lesaffre
Citations107
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
This study, together with the international body of evidence, suggests that investing in improved nursing work environments is a key strategy to retain nurses.
Abstract
This study, together with the international body of evidence, suggests that investing in improved nursing work environments is a key strategy to retain nurses.
Keywords
Health ProfessionsNursing
JAMAHospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction
5,188 Citations2002Linda H. Aiken
In hospitals with high patient-to-nurse ratios, surgical patients experience higher risk-adjusted 30-day mortality and failure-to-rescue rates, and nurses are more likely to experience burnout and job dissatisfaction.
The LancetQualitative research: standards, challenges, and guidelines
5,055 Citations2001Kirsti Malterud
CHEST JournalCritical Care Medicine
1,999 Citations1971Peter Šafář, Åke Grenvik
An attempt has been made to direct the evolution of critical care medicine based on the author's personal experiences with the development of emergency care and intensive care programs during the past decade, and on review of the available literature.
Research in Nursing & HealthDevelopment of the practice environment scale of the nursing work index†‡
1,752 Citations2002Eileen T. Lake
Five subscales were derived from the Nursing Work Index to measure the hospital nursing practice environment, using 1985-1986 nurse data from 16 magnet hospitals, and all measures were highly reliable at the nurse and hospital levels.
JAMAEducational Levels of Hospital Nurses and Surgical Patient Mortality
1,721 Citations2003Linda H. Aiken
In hospitals with higher proportions of nurses educated at the baccalaureate level or higher, surgical patients experienced lower mortality and failure-to-rescue rates.
Health AffairsNurses’ Reports On Hospital Care In Five Countries
1,617 Citations2001Linda H. Aiken, Sean P. Clarke +8 more
Reports from 43,000 nurses from more than 700 hospitals in the United States, Canada, England, Scotland, and Germany in 1998-1999 suggest core problems in work design and workforce management threaten the provision of care.
Medical CareThe Association of Registered Nurse Staffing Levels and Patient Outcomes
1,078 Citations2007Robert L Kane, Tatyana Shamliyan +3 more
Increased RN staffing was associated with lower hospital related mortality in intensive care units (ICUs) and lower odds of hospitalrelated mortality and adverse patient events and patient and hospital characteristics, including hospitals’ commitment to quality of medical care, likely contribute to the actual causal pathway.
Nursing ResearchMeasuring Organizational Traits of Hospitals: The Revised Nursing Work Index
864 Citations2000Linda H. Aiken, Patricia A. Patrician
The NWI-R has been found to capture organizational attributes that characterize professional nursing practice environments and its ability to explain differences in nurse burnout is found.
International Journal of Nursing StudiesCombining qualitative and quantitative research within mixed method research designs: A methodological review
706 Citations2010Ulrika Östlund, Lisa Kidd +2 more
The use of the methodological metaphor of triangulation on convergent, complementary, and divergent results from mixed methods studies is exemplified and an example of developing theory from such data is provided.
BiometricsHow to Use Ridit Analysis
638 Citations1958Irwin D. J. Bross
A ridit analysis of data from the Cornell Automotive Crash Injury Research Program (ACIR) will be presented to illustrate the various problems that come up in actual studies, problems ranging from difficulties due to peculiarities and imperfections of the basic data to questions of presentation and interpretation of the results.
International Journal of Nursing StudiesOutcomes of variation in hospital nurse staffing in English hospitals: Cross-sectional analysis of survey data and discharge records
520 Citations2006Anne Marie Rafferty, Sean P. Clarke +5 more
Nurse staffing levels in NHS hospitals appear to have the same impact on patient outcomes and factors influencing nurse retention as have been found in the USA.
International Journal for Quality in Health CareImportance of work environments on hospital outcomes in nine countries
452 Citations2011Linda H. Aiken, Douglas M. Sloane +7 more
Working in a hospital with a better work environment was associated with significantly lower odds of nurse burnout and job dissatisfaction and with better quality-of-care outcomes.
BMC NursingNurse forecasting in Europe (RN4CAST): Rationale, design and methodology
400 Citations2011Walter Sermeus, Linda H. Aiken +13 more
A multi-country, multilevel cross-sectional design is used to obtain important unmeasured factors in forecasting models including how features of hospital work environments impact on nurse recruitment, retention and patient outcomes.
Health AffairsNursing: A Key To Patient Satisfaction
397 Citations2009Ann Kutney‐Lee, Matthew D. McHugh +5 more
The nurse work environment was significantly related to all HCAHPS patient satisfaction measures and patient-to-nurse workloads were significantly associated with patients' ratings and recommendation of the hospital to others, and with their satisfaction with the receipt of discharge information.
Journal of Advanced NursingNurse intention to remain employed: understanding and strengthening determinants
349 Citations2006Ann E. Tourangeau, Lisa Cranley
Possible strategies to strengthen predictors of intention to remain employed include employment practices that reflect moral integrity, incorporate clear communication systems, maximize employee involvement in decision-making, promote praise and recognition, and establish a shared vision and goals.
Nursing ResearchVariations in Nursing Practice Environments
337 Citations2006Eileen T. Lake, Christopher R. Friese
Considerable variation exists in the quality of hospital nursing practice environments across hospitals and to examine their associations to hospital bed size, community size, teaching intensity, and nurse staffing levels.
Journal of Nursing ManagementImpact and determinants of nurse turnover: a pan-Canadian study
336 Citations2010Linda O’Brien‐Pallas, Gail Tomblin Murphy +3 more
Managing turnover within nursing units is critical to high-quality patient care and a supportive practice setting in which role responsibilities are understood by all members of the caregiver team would promote nurse retention.
Journal of Advanced NursingNurses’ intention to leave the profession: integrative review
321 Citations2010Mervi Flinkman, Helena Leino‐Kilpi +1 more
More in-depth research is needed to give nurses opportunities to explain in their own words the reasons for their intentions to leave the profession, using sound measurement instruments, consistent measures of leaving intention and more rigorous sampling.
JONA The Journal of Nursing AdministrationNurse Outcomes in Magnet® and Non-Magnet Hospitals
289 Citations2011Lesly A. Kelly, Matthew D. McHugh +1 more
The better work environments of Magnet hospitals are associated with lower levels of nurse job dissatisfaction and burnout, and Magnet hospitals have significantly betterWork environments than non-Magnet hospitals.
Journal of Nursing ScholarshipHospital Ethical Climates and Registered Nurses' Turnover Intentions
257 Citations2005Sara Hart
Of the variables included in this analysis, the hospital ethical climate was most important in explaining nurses' positional and professional turnover intentions.
Nursing ResearchGlobal Use of the Practice Environment Scale of the Nursing Work Index
246 Citations2010Nora E. Warshawsky, Donna Sullivan Havens
Recommendations for future research use include reducing scale length, using consistent scoring methods, considering the impact of various modifications on the basis of cultural and clinical setting nuances, and using the measure in longitudinal and intervention research designs.
Medical CareThe Impact of Social Work Environment, Teamwork Characteristics, Burnout, and Personal Factors Upon Intent to Leave Among European Nurses
242 Citations2007Madeleine Estryn‐Béhar, B.I.J.M. van der Heijden +6 more
To prevent premature leaving, it is important to expand nurses' expertise, to improve working processes through collaboration and multidisciplinary teamwork, and to develop team training approaches and ward design facilitating teamwork.
Orthopaedic NursingWorkplace Violence
238 Citations2003Laura Sofield, Susan Salmond
The physician was the most frequent source of verbal abuse, followed by patients, patient families, peers, supervisors, and subordinates, and the relationship of verbal abuse with intent to leave the organization was determined.
BMC NursingFactors influencing nurses' compliance with Standard Precautions in order to avoid occupational exposure to microorganisms: A focus group study
228 Citations2011Georgios Efstathiou, Evridiki Papastavrou +2 more
Changing current behavior requires knowledge of the factors that may influence nurses' compliance with Standard Precautions, which will facilitate in the implementation of programs and preventive actions that contribute in avoiding of occupational exposure.
AORN JournalMagnet Hospitals: Attraction and Retention of Professional Nurses
220 Citations1983Martha Hoffman
Applied Nursing ResearchNew graduate nurse transitioning: Necessary or nice?
219 Citations2008Elaine S. Scott, Martha Keehner Engelke +1 more
The findings indicate that orientation programs are essential to the retention and satisfaction of new graduate nurses and supports nurse executives' ability to advocate for and receive funding for transition-to-work programs as well as the placement ofnew graduate nurses in well-staffed units.
OECD health working papersTackling Nurse Shortages in OECD Countries
216 Citations2005Steven Simoens, Mike Villeneuve +1 more
Journal of Nursing ManagementAddressing the turnover issue among new nurses from a generational viewpoint
178 Citations2008Mélanie Lavoie‐Tremblay, Linda O’Brien‐Pallas +3 more
The balance between the level of effort expended and reward received plays an important role in young nurses' intent to leave.
Journal of Advanced NursingOrganizational configuration of hospitals succeeding in attracting and retaining nurses
177 Citations2006Sabine Stordeur, William D’Hoore +1 more
Organizational characteristics are key factors in nurse attraction and retention and the concept of attractive institutions could serve as a catalyst for improvement in nurses' work environments in Europe.
JONA The Journal of Nursing AdministrationFaces of the Nursing Shortage
171 Citations2005Mary R. Lynn, Richard W. Redman
Examination of the relationship between organizational commitment, job satisfaction, and nurses' intention to leave their current position or nursing found aspects of work and professional satisfaction predict both the intention to left current position and nursing.
International Journal of Nursing StudiesFront-line management, staffing and nurse–doctor relationships as predictors of nurse and patient outcomes. A survey of Icelandic hospital nurses
167 Citations2007Sigrún Gunnarsdóttir, Sean P. Clarke +2 more
Efforts to improve and maintain nurses' relations with nurse managers and doctors, as well as their perceptions of staffing adequacy, will likely improve nurse job satisfaction and employee retention, and may improve the quality of patient care.
Journal of Organizational BehaviorPredictors of intentions to leave the ward, the hospital, and the nursing profession: A longitudinal study
167 Citations1995Moshe Krausz, Meni Koslowsky +2 more
The findings supported a progression model of withdrawal intention, according to which a nurse first decides to leave the ward, then the hospital, and, finally, the profession, which is supported by data collected at two time periods.
Choice Reviews OnlineThe future of the nursing workforce in the United States: data, trends, and implications
166 Citations2009
This paper will refer to choosing the future of the nursing workforce in the united states data trends and implications as the reading material to break the boredom in reading.
International Journal of Nursing StudiesThe relationship between inpatient cardiac surgery mortality and nurse numbers and educational level: Analysis of administrative data
163 Citations2009Koen Van den Heede, Emmanuel Lesaffre +5 more
It is suggested that nurse staffing is one of several variables influencing patient safety and the need to study the impact of nurse-staffing levels on in-hospital mortality using nursing-unit-level specific data is suggested.
Critical Care MedicineOrganizational climate and intensive care unit nurses’ intention to leave*
159 Citations2006Patricia W. Stone, Elaine Larson +4 more
Improving professional practice in the work environment and clinical competence of the nurses as well as supporting new hires may reduce turnover and help ensure a stable and qualified workforce.
Health Services ResearchNurse Working Conditions, Organizational Climate, and Intent to Leave in ICUs: An Instrumental Variable Approach
138 Citations2006Patricia W. Stone, Cathy Mooney‐Kane +4 more
Journal of Clinical NursingTransformative impact of Magnet designation: England case study
110 Citations2008Linda H. Aiken, James Buchan +2 more
Implementation of the Magnet hospital intervention was associated with a significantly improved nursing work environment as well as improved job-related outcomes for nurses and markers for quality of patient care.
International Journal of Nursing StudiesNurse staffing and patient outcomes in Belgian acute hospitals: Cross-sectional analysis of administrative data
98 Citations2008Koen Van den Heede, Walter Sermeus +5 more
No significant association was found between the acuity-adjusted Nursing Hours per Patient Day, proportion of registered nurses with a Bachelor's degree and the selected patient outcomes, which should not be inferred as implying that nurse staffing does not have an impact on patient outcomes in Belgian hospitals.
Implementation ScienceInterventions aimed at improving the nursing work environment: a systematic review
94 Citations2010Donna MJ Schalk, Marloes LP Bijl +3 more
It is recommended that investigators use controlled studies with pre/post measures to evaluate interventions that are aimed at improving the NWE and that more evidence-based knowledge about the implementation of interventions will become available for healthcare leaders to use in rebuilding nursing work environments.
Nursing Administration QuarterlyAmerican Nurses Credentialing Center Magnet Recognition Program Application Manual, 2008 Edition
74 Citations2009Deborah Martin
Journal of Clinical NursingAn international hospital outcomes research agenda focused on nursing: lessons from a decade of collaboration
57 Citations2008Sean P. Clarke, Linda H. Aiken
The international collaborations discussed in this article have found remarkable similarities in the experiences of hospital nurses across countries in terms of positive and negative aspects of their work, sizeable differences across hospitals within countries in working conditions and investments in high-quality practice environments.
Journal of Nursing EducationPredictors of Turnover Intention in Nurse Faculty
50 Citations2011Denise K. Gormley, Susan M. Kennerly
Organizational climate intimacy and disengagement, affective and continuance organizational commitment, and role ambiguity were shown to predict turnover intention in nurse faculty.
JAMAThe Future of the Nursing Workforce in the United States: Data, Trends, and Implications
43 Citations2008
The Future of the Nursing Workforce in the United States: Data, Trends and Implications provides a timely, comprehensive, and integrated body of data supported by rich discussion of the forces shaping the nursing workforce in the US.
Journal of Health Services Research & PolicyBeyond demographic change in human resources planning: an extended framework and application to nursing
41 Citations2003Stephen Birch, Linda O’Brien‐Pallas +3 more
The demands on nurses in acute care hospitals have increased as an increasing number of severity-adjusted episodes are served using fewer beds by a reduced number of nurses.
Nursing Administration QuarterlyIncentives and Procedures Effective in Increasing Survey Participation of Professional Nurses in Hospitals
32 Citations2009Marlene Kramer, Claudia Schmalenberg +1 more
As the use of surveys for quality improvement and workforce management increases, nurse leaders need to know what procedures and incentives encourage response rates large enough to produce valid, representative data.
Journal of Nursing ScholarshipEvaluation of “Magnet Journey to Nursing Excellence Program” in Russia and Armenia
31 Citations2009Linda H. Aiken, Lusine Poghosyan
PubMedNurses' health, age and the wish to leave the profession--findings from the European NEXT-Study.
27 Citations2007Hans Martin Hasselhorn, Peter Tackenberg +32 more
The findings indicate that 'the nurse with low health' is reality in many health care settings and prevention also will have to regard work organisational factors if the aim is to sustain nurses' health and to enable nurses to remain healthy in their profession until retirement age.
JONA The Journal of Nursing AdministrationNurse Outcomes in Magnet® and Non-Magnet Hospitals
14 Citations2011
