Review of the Literature: NP turnover was found to be costly and to disrupt continuity of patient care as well as expensive both monetarily and in terms of patient satisfaction. NPs also experience similarities in job satisfaction and dissatisfaction perception which in turn leads to retention or turnover.
Commonalities of job satisfaction and retention: job benefits, time spent with and relationship between patients, salary, holistic care, working to the fullest of their scope of practice, schedules and flexibility of hours, autonomy, independent prescribing authority, experience – greater than ten years, mentorship, positive patient experiences, increased access to and quality of health care, and decreased costs to health care organizations.
Commonalities of job dissatisfaction and turnover: professional and monetary recognition, assertive influence, administrative support, collegial relationships, autonomy, inexperience – less than ten years, inability to serve on committees due to time constraints, reporting to a supervisor who is not a NP, professional growth, intrapractice partnership, caseload/workload, bonus availability, research involvement, negative patient experiences, decreased access to and quality of health care for patients, and increased costs to health care organizations.
Methods: A program evaluation was conducted using the ATS and the MNPJSS, and administered to currently employed, non-supervisory NPs, who had been in HBPC for more than six months. The conceptual framework used to guide this project was Cheryl Stetler’s model of research utilization. The framework used to evaluate this project was Katz and Kahn's nursing services delivery theory.
Results: The response rate was 87.5%. The ATS responses reflected 57.1% of the participants intended to stay; however, mean responses to individual questions represented the group was equally divided on intent to leave. Of the 43 MNPJSS questions, 24 were answered as dissatisfied and 19 were answered as satisfied by participants.
Implications for Practice: The outcomes identified from the program evaluation are recommendations to leadership aimed to reduce HBPC NP turnover. By decreasing NP voluntary turnover, the VA can also decrease organizational costs associated with turnover, improve recruitment and orientation and maintain alignment with the VA’s 2018-2024 strategic goals. Non-VA institutions can also implement a program evaluation and identify employee perception of anticipated turnover and job satisfaction within their organization.
Conclusions: Program evaluations can benefit health care administrators by providing evidence-based data through systematic methods of collecting, analyzing, and interpreting data to observe the effectiveness and efficiency of programs and to contribute to ongoing program improvement. When a program evaluation is supported by literature and presented as objective and unbiased, intended and expected outcomes are best practice recommendations addressing identified problems and improving care processes.