The Nursing Turnover Study: Aims, Theoretical Framework & Research Design

Thursday, 16 July 2009: 8:30 AM

Judith Shamian, RN, PhD
VON Canada, Ottawa, ON, Canada

Purpose: The presentation purpose is to introduce the Nursing Turnover Study by describing the objectives, its relevance, theoretical framework, research questions and research design. Healthcare organizations world-wide have reached such critical nursing shortages that decision makers are now being forced to seek effective interventions.  Although nursing turnover has become a priority issue, most of the investigation to date has concentrated on nurse turnover determinants relating to the work environment and the individual nurse. Methods: The study methods were guided by the Patient Care System and Nurse Turnover Model. The model states that characteristics of patients, nurses and system (including system behaviours) interact with nurse turnover, staffing employment, environmental complexity and care delivery activities to produce system outputs (patient, nurse, and system outcomes) which also feed back into the entire system. The research questions addressed were: 1) What is the nature of the relationship between system inputs and system outputs?  2) How do system inputs influence system throughput?  3) How does system throughput mediate both inputs and outputs? 4) How do system outputs feed back into the system and what are the implications for nurses, patients and the system? 5) How might modifications of throughputs alter system outcomes? Involvement of hospital units, individual nurses and patients was necessary to answer the research questions. The study design had both repeated cross-sectional and longitudinal components executed over two waves of data collection. The analysis approach enhanced the generalizability of study results, making it possible for policy makers and managers to apply the new evidence to specific institutions and nursing units. Results: The study results will be discussed in the following presentation. Conclusion: It will be shown that the Nursing Turnover Study provides unit-level evidence to inform development of mechanisms to address staffing problems.