The Nursing Turnover Study: Implications for Policy and Practice

Thursday, 16 July 2009: 9:10 AM

Linda L. O'Brien-Pallas, RN, PhD, FCAHS
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada

Purpose: The purpose of this presentation is to discuss implications of the Nursing Turnover Study for policy and practice, as the study indicates that nurse turnover is a major problem in Canadian hospitals.  Methods: Turnover rates must be considered in all sectors and all types of delivery systems. The variables that contribute to turnover must be clearly defined and measured across sectors. Turnover rates must be monitored on an ongoing basis within organizations and strategies developed to reduce the negative impact of turnover on patients, providers and systems.  Results: The Canadian Turnover study findings emphasize the importance of building leadership capacity at all levels of organizations in order to address predisposing factors of turnover intent. The evidence underscores the need for sustained investment in strategies that enhance nurse empowerment in their work environment and recognize nurses as a contributing asset to the delivery care system. Resources should be in place and tools made available to optimize competencies of providers and maximize practice scope.  With implementation of innovative care delivery models, appropriate skill mix, role clarity for team members and effective communication across caregiver groups is essential. Also important is to evaluate the impact of models of care which minimize competing resources and demands on frontline nurses to reduce turnover, promote patient safety and nurse satisfaction in the delivery care system.  Conclusion: Policy options must be informed by evidence that is good quality, comparable and readily accessible data. Linking data from a broad range of areas in organizations requires a sustainable investment in data and in capacity building. Coordinated collaborative intervention strategies from all levels – ministries of health, funders, regulatory bodies, institutional decision makers, nurse managers and clinical educators, and frontline healthcare providers – are needed to address the factors that influence turnover and to alleviate turnover costs.