Retention of Primary Healthcare Nurse Practitioners

The Nurse Practitioner (NP) role has emerged to meet the growing need for access to primary health care (PHC). To ensure that the NP role is sustainable and provides access to PHC for Ontarians, there is a need to examine NP work environments and NP responses to their work environments, such as retention. Currently, factors influencing the retention of primary health care NPs in Ontario are not well known. As Ontario continues to invest a large amount of health care spending in emerging PHC organizational structures to enable access to primary care, health human resource strategies for NP retention are essential. However, there is a paucity of literature on NP work, work environments, and their impact on important NP and health care system outcomes, including retention.

The primary objective of this study was to investigate the underlying factors influencing retention of NPs in PHC in Ontario. The primary research question was: what are the effects of individual NP characteristics, NP practice characteristics, and NP organizational characteristics on PHC nurse practitioner intent to remain employed (ITR) in Ontario?

A non-experimental descriptive cross-sectional survey design was implemented. Self-administered surveys were mailed to primary health care NPs in Ontario with follow-up using a modified Dillman approach. Two hundred and seventy-three surveys were completed resulting in a useable response rate of 52.9%. A hypothesized model of the underlying factors influencing ITR of NPs in PHC in Ontario was tested using multiple regression. Regression results indicate that administration-NP relations, work-life balance, and family situation significantly explained 14% of the variance in primary health care NP intent to remain employed in Ontario

(p < 0.0001).

This research provides knowledge about factors influencing PHC NP intent to remain employed in primary health care settings in Ontario. Results identify relationships among individual NP characteristics and NP work and organizational practice setting characteristics with NP retention in Ontario. Understanding factors influencing primary health care NP ITR narrows the gap in the literature and can lead to development and implementation of strategies to promote NP retention. This knowledge enables optimal use of NPs in PHC.