The Effect of the Bundle Intervention Used on the First Year New Nurses' Turnover Rate in Taiwan

Tuesday, 13 July 2010

Yea Wen Lee, MS, RN
Shu Chen Chang, MS, RN
Shu Chen Liu, BS, RN
Department of Nursing, Changhua Christian Hospital, Changhua, Taiwan

Learning Objective 1: realize the bundle intervention used on the new nurses' turnover rate.

Learning Objective 2: understand that the nusing shortage issue involves many departments,not only the nursing department.

Purpose: New nurses’ high turnover rate is the forced problem for the nurse administrator. There is no exception in our hospital. Our hospital is a medical center in the mid-Taiwan. There are about one thousand and five hundred nurses, and there are average two hundred new nurses annually. The first year new nurses’ turnover rate between 2005 to 2007 is nearly 31% annually. The purpose of this study explores the effect of the bundle intervention on the new nurses’ turnover rate.

Methods: In October 2007, under support from the DOH's fund(the Department of Health, 2007)  for a new nurses' retention program , we design the bundle intervention according to the “Eight Professional Core Value” (Taiwan Nurse Accreditation Council (TNAC), 2005), which are critical thinking and reasoning, general clinical skills, basic biomedical science, communication and teamwork capability, caring, ethics, accountability and life-long learning. Besides the core value, we also combine the nurse clinical ladder -N1 training scheduler. The bundle intervention consists of  5-day orientation, one to one preceptor, the 2-year mentor-mentree relationship (1:5) , a learning passport handout for guideline and  a 12-week residency program, which including bed-side teaching, 6 -kinds skill training, a test, and a speciality lecture,

Results: The  first year new nurses’ turnover rate between 2008 to 31,November,2009  is  from 38.6% (83/215) to 20.9%  (33/158).


The bundle intervention is useful.The result is so different from the single intervention (such as 12-week residency program) used for the new nurses’ retention in our hospital.Although we can’t differentiate which  has large effect, but its' end point finally really decreases the turnover rate. This bundle intervention is a good background reference for designing the new nurses’ retention program.