Sellgren Stina F, Kajermo Kerstin N, Ekvall Göran, Tomson Göran
Medical Management Center, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
J Clin Nurs. 2009 Nov;18(22):3181-9. doi: 10.1111/j.1365-2702.2008.02770.x. Epub 2009 Jul 8.
The aim was to explore opinions on individual needs and other factors that may influence nursing staff turnover.
High staff turnover is a great problem for many hospitals. It is shown to have a negative effect on the quality of nursing care and to increase hospital costs.
In 2004 in a large university hospital in Sweden five focus group discussions (FGDs) including department heads (1), nursing managers (2) and members of nursing staff (2) were carried out. The questions to be addressed were 'Why do nurses leave?' and 'Why do nurses stay?' In addition, register data of staff turnover for 2002-2003 were analysed in relation to different facts about the units, such as number of employees, type of care and medical specialty. Categories of opinions identified in the FGDs were compared with results of the statistical analyses on the relationship between staff turnover and unit parameters to identify overall factors that may influence on nurse staff turnover.
Four major factors were identified as having a possible influence on staff turnover: 'intrinsic values of motivation', 'work load', 'unit size 'and 'leadership'. Smaller units had lower staff turnover as well as outpatient units and day care. It was not possible to compare statements from participants from smaller units with those from participants from larger units. Two factors had diverging data, 'salary' and 'spirit of the time'. A surprising finding was the little mention of patient care in relation to staff turnover.
It is important for managers to ensure that intrinsic values of nurses are met to minimise the risk for high turnover rates. Inpatient care must receive adequate staffing and nursing care could be organised into smaller units or work teams to avoid dissatisfaction and high turnover.
旨在探讨有关个人需求以及可能影响护理人员离职的其他因素的观点。
员工高离职率是许多医院面临的重大问题。研究表明，这会对护理质量产生负面影响，并增加医院成本。
2004年，在瑞典一家大型大学医院开展了五次焦点小组讨论（FGD），参与者包括科室主任（1名）、护理部经理（2名）和护理人员（2名）。讨论的问题是“护士为何离职？”以及“护士为何留下？”此外，还分析了2002 - 2003年员工离职的登记数据，这些数据与各科室的不同情况相关，如员工数量、护理类型和医学专科。将焦点小组讨论中确定的观点类别与员工离职率和科室参数之间关系的统计分析结果进行比较，以确定可能影响护士离职率的总体因素。
确定了四个可能影响员工离职率的主要因素：“内在激励价值”、“工作量”、“科室规模”和“领导力”。规模较小的科室以及门诊科室和日间护理科室的员工离职率较低。无法将规模较小科室参与者的陈述与规模较大科室参与者的陈述进行比较。有两个因素的数据存在差异，即“薪资”和“时代精神”。一个令人惊讶的发现是，在讨论员工离职率时很少提及患者护理。
对于管理人员而言，确保满足护士的内在价值以将高离职率风险降至最低非常重要。住院护理必须配备充足的人员，并且护理工作可以组织成较小的科室或工作团队，以避免不满情绪和高离职率。
