School of Health Sciences City, University of London, Northampton Square, London, EC1V 0HB, UK.
School of Health Sciences City, University of London, Northampton Square, London, EC1V 0HB, UK; Faculty of Health and Medical Sciences, Section of Clinical Medicine and Ageing, Leggett Building, Daphne Jackson Road, University of Surrey, Guildford, Surrey, GU2 7XH, UK.
Int J Nurs Stud. 2019 Mar;91:47-59. doi: 10.1016/j.ijnurstu.2018.11.003. Epub 2018 Dec 31.
Nurse shortages have been identified as central to workforce issues in healthcare systems globally and although interventions to increase the nursing workforce have been implemented, nurses leaving their roles, particularly in the first year after qualification, present a significant barrier to building the nurse workforce.
To evaluate the characteristics of successful interventions to promote retention and reduce turnover of early career nurses.
This is a systematic review DATA SOURCES: Online databases including Academic Search Complete, Medline, Health Policy reference Centre, EMBASE, Psychinfo, CINAHL and the Cochran Library were searched to identify relevant publications in English published between 2001 and April 2018. Studies included evaluated an intervention to increase retention or reduce turnover and used turnover or retention figures as a measure.
The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies were quality-assessed using the Joanna Briggs Institute Critical Appraisal tools for Quasi Experimental and Randomised Controlled Trials. Retention/turnover data were used to guide the comparison between studies and appropriate measures of central tendency and dispersion were calculated and presented, based on the normality of the data.
A total of 11, 656 papers were identified, of which 53 were eligible studies. A wide variety of interventions and components within those interventions were identified to improve nurse retention. Promising interventions appear to be either internship/residency programmes or orientation/transition to practice programmes, lasting between 27-52 weeks, with a teaching and preceptor and mentor component.
Methodological issues impacted on the extent to which conclusions could be drawn, even though a large number of studies were identified. Future research should focus on standardising the reporting of interventions and outcome measures used to evaluate these interventions and carrying out further research with rigorous methodology. Clinical practice areas are recommended to assess their current interventions against the identified criteria to guide development of their effectiveness. Evaluations of cost-effectiveness are considered an important next step to maximise return on investment.
护士短缺已被确定为全球医疗保健系统劳动力问题的核心，尽管已经实施了增加护士人数的干预措施，但护士离职，特别是在获得资格后的第一年，这对建立护士队伍构成了重大障碍。
评估促进保留和减少早期职业护士离职率的成功干预措施的特征。
这是一项系统评价。
在线数据库，包括学术搜索全面、医学文献在线、健康政策参考中心、EMBASE、心理信息、CINAHL 和科克伦图书馆，以确定 2001 年至 2018 年 4 月期间以英文发表的相关出版物。研究评估了增加保留率或减少离职率的干预措施，并使用离职率或保留率数据作为衡量标准。
根据系统评价和荟萃分析的首选报告项目 (PRISMA) 指南进行综述。使用乔安娜布里格斯研究所的半实验和随机对照试验批判性评价工具对研究进行质量评估。根据数据的正态性，使用保留/离职数据来指导研究之间的比较，并计算和呈现适当的集中趋势和离散度的度量。
共确定了 11656 篇论文，其中 53 篇符合条件的研究。确定了各种各样的干预措施和干预措施中的组成部分，以提高护士的保留率。有前途的干预措施似乎是实习/住院医师计划或定向/过渡到实践计划，持续 27-52 周，具有教学和导师和导师组成部分。
即使确定了大量的研究，但方法学问题也影响了结论的程度。未来的研究应侧重于标准化干预措施的报告和用于评估这些干预措施的结果衡量标准，并使用严格的方法进行进一步的研究。建议临床实践领域根据确定的标准评估其当前的干预措施，以指导其有效性的发展。考虑到成本效益评估是下一步的重要步骤，以最大限度地提高投资回报。
