The Nursing Turnover Study: Data Collection, Analysis & Findings

Thursday, 16 July 2009: 8:50 AM

Gail Tomblin Murphy, RN, PhD
School of Nursing, Dalhousie University, Halifax, NS, Canada

Purpose: The purpose of this presentation is to discuss the Nursing Turnover Study data collection, analysis and findings to better understand costs and outcomes of nursing turnover. The participant sample involved healthcare organizations consisting of 18 sites, representing over 41 hospitals and 181 nursing units across 10 provinces in Canada. Methods: The methods involved an electronic data collection system. The analysis involved 4,481 and 3,844 nurse respondents in wave 1 and 2, respectively; and 4,412 and 3,726 patient records extracted in wave 1 and 2, respectively. Since data was collected at both hospital unit level and at individual nurse and patient level, a multi-level analysis approach was used to better account for possible clustering of effects within units. In total, 19 hierarchical linear models (HLM) were employed to examine input, throughput and output outcomes in answering research questions. Results: Results show that the average turnover rate was 19.9% per year in Canada, with the highest level at almost 27% coming from ICU. The findings also show that for every 10 nurse vacancies in hospitals, the cost is about $250,000. The highest turnover costs are attributed to temporary replacements and decrease in initial productivity of new hires. Turnover is associated with decrease in job satisfaction, increase in likelihood of medical errors, overtime and environmental complexity. Role ambiguity and conflict on the units are associated with higher turnover rate for nurses. Higher proportion of full time nurses is associated with lower nursing turnover. As to the reasons for leaving, lack of team support was the most important consideration. Conclusion: Despite the challenges relating to the lack of standardized measures and definitions of terms and indicators, this study demonstrates great strength in answering questions concerning nurse turnover.