影响护士离开成人重症监护病房意愿的因素。
Factors influencing nurses' intentions to leave adult critical care settings.
机构信息
Oxford Institute of Nursing, Midwifery and Allied Health Research (OxINMAHR), Oxford Brookes University and Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Oxford Institute of Nursing, Midwifery & Allied Health Research (OxINMAHR); Principal Fellow, Oxford Biomedical Research Centre; Associate Chief Nurse (Research), Oxford University Hospitals NHS Foundation Trust; Professor of Nursing Research, Faculty of Health & Life Sciences, Oxford Brookes University, Oxford, UK.
出版信息
Nurs Crit Care. 2019 Jan;24(1):24-32. doi: 10.1111/nicc.12348. Epub 2018 Apr 10.
BACKGROUND
The shortage of critical care and specialist nurses has been an ongoing issue for many decades. Although all areas of nursing are affected, critical care areas are especially vulnerable to recruitment and retention problems. High nursing turnover in critical care areas is evident; however, research into the factors that influence nurses' intentions to leave adult critical care areas is limited.
AIM
To explore factors that may influence nurses' intentions to leave adult critical care areas.
OBJECTIVES
To appraise existing evidence and highlight gaps in knowledge regarding factors that may influence nurses' intentions to leave adult critical care areas.
METHODS
A systematic mixed-method literature review was conducted. The search strategy was developed using the List, Keep and Delete approach, a framework used to identify search terms for systematic health care reviews. The following key words were used: intentions to leave, nurses, adult and critical care. The databases searched were BNI, CINAHL, PubMed, PsycINFO, Embase and Health B Elite from 2005 to 2016. Primary data from non-critical care areas and neonatal and paediatric critical care areas were excluded. Comprehensive supplementary searching was performed. Papers were critically appraised using the NICE (2012) checklists. Data were analysed using the Braun and Clarke (2006) thematic framework.
RESULTS
A total of 15 studies, including 13 cross-sectional studies and 2 qualitative studies, were reviewed. Three main themes emerged following data analysis. These themes were quality of the work environment, nature of working relationships and traumatic/stressful workplace experiences.
CONCLUSIONS
The literature review highlighted the need for further research and greater understanding of how these themes may impact critical care nurses. Nurse managers and leaders should consider these findings when developing strategies to improve nurse retention.
RELEVANCE TO PRACTICE
The shortage of critical care nurses is currently a global issue impacting costs and quality of patient care.
背景
几十年来，重症监护和专科护士的短缺一直是一个持续存在的问题。尽管所有护理领域都受到影响，但重症监护领域尤其容易受到招聘和留用问题的影响。重症监护领域的护士高离职率显而易见；然而，对影响护士离开成人重症监护领域意愿的因素的研究有限。
目的
探讨可能影响护士离开成人重症监护领域意愿的因素。
目标
评估现有证据并突出知识空白，了解可能影响护士离开成人重症监护领域意愿的因素。
方法
进行了系统的混合方法文献综述。使用清单、保留和删除方法（一种用于确定系统医疗保健审查搜索词的框架）制定了搜索策略。使用了以下关键词：离职意愿、护士、成人和重症监护。搜索的数据库包括 BNI、CINAHL、PubMed、PsycINFO、Embase 和 Health B Elite，时间范围为 2005 年至 2016 年。排除了非重症监护区和新生儿及儿科重症监护区的原始数据。进行了全面的补充搜索。使用 NICE（2012）检查表对论文进行了严格评估。使用 Braun 和 Clarke（2006）主题框架对数据进行了分析。
结果
共审查了 15 项研究，包括 13 项横断面研究和 2 项定性研究。数据分析后出现了 3 个主要主题。这些主题是工作环境质量、工作关系性质和创伤/压力工作场所经历。
结论
文献综述强调需要进一步研究和更深入地了解这些主题如何影响重症监护护士。护士管理人员和领导者在制定提高护士留用率的策略时应考虑这些发现。
相关性到实践
重症监护护士短缺目前是一个全球性问题，影响着患者护理的成本和质量。
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