Ward‐level nurse turnover and related workplace factors in long‐term care hospitals: A cross‐sectional survey

Abstract

Aim To explore the association between the ward‐level nurse turnover rate and the ward's organisational, patient and nurse characteristics in long‐term care (LTC) hospitals. Background Nurse turnover adversely impacts not only LTC hospitals through higher recruitment and replacement costs but also resident health outcomes. Methods This study employed a cross‐sectional design with secondary analyses. Participants were 199 ward managers and 2,508 nurses in LTC hospitals across Japan. Data were collected between September and November 2015. Results The wards with higher nurse turnover were significantly associated with a non‐12‐hr work shift, higher rate of patients with intravenous hyperalimentation (IVH), lower average of nurse emotional exhaustion, lower average of nurse‐perceived quality of the care process and lower rate of employment stability as the reason for choosing the workplace. Conclusions Actual ward‐level nurse turnover can be influenced by factors related to the organisation (e.g. shift style and employment stability), patient (e.g. patients with IVH) and nurse attributions (e.g. burnout, perceived care quality). Implications for Nursing Management To minimize nurse turnover in LTC hospitals, multifactorial ward‐level interventions would be possible, such as adjusting for shift work, attending to medical procedures or improving nurses’ emotional exhaustion and perceptions regarding care quality.

Professional attractiveness among long-term care workers in nursing homes in China: a cross-sectional study

“…Besides, higher professional attractiveness is obtained when long-term care workers on 12-hour shifts compared to 8-hour shifts. Previous literature points out that when wards are on 12-hour nursing shifts, there is even decreased turnover intention in the LTC industry [ 41 ], which is similar to our findings. Whereas other studies indicated that longer shifts are associated with job burnout, dissatisfaction, and turnover intention [ 42 ].…”

Taiwan's National Health Insurance at the Emergency Department following the COVID‐19 outbreak

“…Taiwan recommends a lower ratio of nurses to patients especially in EDs (medical center 1:9, regional hospital 1:12, local hospital 1:15, ED 1:12) (Taiwan Ministry of Health and Welfare, 2015) than most other countries (ranging from 1:4 to 1:8) (Driscoll et al, 2018;Sharma & Rani, 2020;Wu et al, 2021), and such lower ratios are known to lead to adverse patient outcomes, including in-hospital cardiac arrests or mortality, 30days mortality, unplanned readmission, falls and infections, especially in ED and acute care settings (Driscoll et al, 2018). The continuing shortage of health workers is further exacerbated by nurses' burnout, job dissatisfaction, and higher intent to leave (Chao et al, 2013;Li & Yamamoto-Mitani, 2021;Lin et al, 2019). These result from occupational safety challenges such as increasing needlestick injury (Shin et al, 2018), exposure to patients with COVID-19, and elevated risk of testing positive for COVID-19 even under adequate personal protective equipment (PPE) (Nguyen et al, 2020).…”

Mediating effects of social support and presenteeism on turnover intention and post-traumatic stress disorder among Chinese nurses in the post-pandemic era: a cross-sectional study

“…The turnover intention of nurses may be related to their psychological trauma during the pandemic, which further leads to a series of symptoms such as post-traumatic stress disorder ( 15 , 18 ). In recent years, studies have shown that PTSD in nurses is significantly related to turnover intention on the job ( 14 ).…”

“…Due to inadequate or poor protective measures, nurses may fear for their health and safety, which may exacerbate their intention to leave their jobs (14). Previous studies have also shown that higher Turnover intention is associated with higher work stress and frequent night shifts during epidemics (15,16). A higher Turnover intention in the workforce also reduces the quality of healthcare and nursing care, with serious implications for patient safety (17).…”