Halter Mary, Pelone Ferruccio, Boiko Olga, Beighton Carole, Harris Ruth, Gale Julia, Gourlay Stephen, Drennan Vari
Faculty of Health, Social Care and Education, Kingston University and St George's, University of London, London, England.
National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, London, England.
Open Nurs J. 2017 Aug 15;11:108-123. doi: 10.2174/1874434601711010108. eCollection 2017.
Nurse turnover is an issue of concern in health care systems internationally. Understanding which interventions are effective to reduce turnover rates is important to managers and health care organisations. Despite a plethora of reviews of such interventions, strength of evidence is hard to determine.
We aimed to review literature on interventions to reduce turnover in nurses working in the adult health care services in developed economies.
We conducted an overview (systematic review of systematic reviews) using the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Applied Social Sciences Index and Abstracts, CINAHL plus and SCOPUS and forward searching. We included reviews published between 1990 and January 2015 in English. We carried out parallel blinded selection, extraction of data and assessment of bias, using the Assessment of Multiple Systematic Reviews. We carried out a narrative synthesis.
Despite the large body of published reviews, only seven reviews met the inclusion criteria. These provide moderate quality review evidence, albeit from poorly controlled primary studies. They provide evidence of effect of a small number of interventions which decrease turnover or increase retention of nurses, these being preceptorship of new graduates and leadership for group cohesion.
We highlight that a large body of reviews does not equate with a large body of high quality evidence. Agreement as to the measures and terminology to be used together with well-designed, funded primary research to provide robust evidence for nurse and human resource managers to base their nurse retention strategies on is urgently required.
护士流失是国际医疗保健系统中备受关注的问题。了解哪些干预措施能有效降低流失率对管理人员和医疗保健机构而言至关重要。尽管对此类干预措施已有大量综述，但证据的力度却难以确定。
我们旨在综述关于减少发达经济体中从事成人医疗保健服务的护士流失的干预措施的文献。
我们使用Cochrane系统评价数据库、MEDLINE、EMBASE、应用社会科学索引与摘要、护理学与健康领域数据库（CINAHL plus）以及Scopus进行了一项概述（系统评价的系统评价）并进行了向前搜索。我们纳入了1990年至2015年1月间以英文发表的综述。我们采用多重系统评价评估法进行平行双盲筛选、数据提取和偏倚评估。我们进行了叙述性综合分析。
尽管已发表了大量综述，但只有七篇综述符合纳入标准。这些综述提供了质量中等的证据，尽管来自控制不佳的原始研究。它们提供了少数干预措施产生效果的证据，这些措施可减少护士流失或提高护士留任率，即新毕业生导师制和促进团队凝聚力的领导力。
我们强调大量综述并不等同于大量高质量证据。迫切需要就所使用的措施和术语达成一致，并开展设计良好、资金充足的原始研究，以便为护士和人力资源管理人员提供有力证据，使其能够据此制定护士留任策略。
