Monday, November 3, 2003

This presentation is part of : An International Examination of the Cost of Turnover and Its Impact on Patient Safety and Nurse Outcomes

An International Examination of the Cost of Turnover and its Impact on Patient Safety and Nurse Outcomes - The Pilot Study

Patricia W. Stone, PhD, MPH, RN, Columbia University, New York, NY, USA, Christine Duffield, RN, BScN, MHP, PhD, FACHSE, Centre for Health Services Management, University of Technology, Sydney, New South Wales, Australia, Pat Griffin, RN, PhD, Office of Nursing Policy, Health Policy and Communications Branch, Health Canada, Ottawa, ON, Canada, Patricia Hinton Walker, PhD, RN, FAAN, Graduate School of Nursing, Uniformed Services University of the Health Sciences, Bethesda, MD, USA, Heather K. S. Laschinger, RN, PhD, School of Nursing, Faculty of Health Sciences, University of Western Ontario, London, ON, Canada, Linda L. O'Brien-Pallas, RN, PhD, Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada, and Judith Shamian, RN, PhD, Health Canada, Nursing Policy, Ottawa, ON, Canada.

Purpose: The purpose of this international collaboration is to determine the costs associated with nurse turnover and staffing and the related impact on patient and nurse safety outcomes across countries. This paper will report on a pilot study completed to examine the cost of turnover.

Design: A purposive cross section of medical and surgical units was selected from one province or state in each of the countries studied.

Population, Setting, and Sample: Unit Managers from two medical and two surgical units from each country were asked to participate in the pilot study. Surveys were distributed in Australia, Canada, New Zealand, the United Kingdom, the United States, and Scotland.

Methods: The survey used in this pilot study was adapted from Buchan’s (1999) earlier work and included a series of questions related to budgeted full-time equivalents, new hires, turnover, and direct and indirect costs of turnover on the nursing unit in the last six months. Respondents were asked to indicate actual responses to the questions and availability of data for the study.

Findings: Data from 11 medical and surgical nursing units across all six countries were used in the final analysis. Findings revealed that the average cost of turnover per nurse was $21,514 US (SD=$12,226). The pilot study allowed us to identify the availability of data and where further refinement of definitions of variables was needed.

Conclusions: As a result of the pilot work, changes have been made to the survey, definitions of variables, and the sampling frame. Secondary data sources will be used whenever possible to reduce the cost of primary data collection.

Implications: This pilot work has provided us with information to enhance our approach to measuring turnover in different countries. A larger collaboration is underway which will involve a random sample of hospitals in each country.

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