School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
Department of Gerontological Homecare and Long-term Care Nursing, Graduate School of Health Sciences & Nursing, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
J Nurs Manag. 2021 Sep;29(6):1587-1595. doi: 10.1111/jonm.13293. Epub 2021 Mar 18.
To explore the association between the ward-level nurse turnover rate and the ward's organisational, patient and nurse characteristics in long-term care (LTC) hospitals.
Nurse turnover adversely impacts not only LTC hospitals through higher recruitment and replacement costs but also resident health outcomes.
This study employed a cross-sectional design with secondary analyses. Participants were 199 ward managers and 2,508 nurses in LTC hospitals across Japan. Data were collected between September and November 2015.
The wards with higher nurse turnover were significantly associated with a non-12-hr work shift, higher rate of patients with intravenous hyperalimentation (IVH), lower average of nurse emotional exhaustion, lower average of nurse-perceived quality of the care process and lower rate of employment stability as the reason for choosing the workplace.
Actual ward-level nurse turnover can be influenced by factors related to the organisation (e.g. shift style and employment stability), patient (e.g. patients with IVH) and nurse attributions (e.g. burnout, perceived care quality).
To minimize nurse turnover in LTC hospitals, multifactorial ward-level interventions would be possible, such as adjusting for shift work, attending to medical procedures or improving nurses' emotional exhaustion and perceptions regarding care quality.
探讨长期护理（LTC）医院病房护士离职率与病房组织、患者和护士特征之间的关系。
护士离职不仅通过更高的招聘和替代成本对 LTC 医院产生不利影响，还会影响居民的健康结果。
本研究采用横断面设计和二次分析。参与者为日本各地 LTC 医院的 199 名病房经理和 2508 名护士。数据收集于 2015 年 9 月至 11 月之间。
护士离职率较高的病房与非 12 小时轮班、更高的静脉高营养（IVH）患者比例、较低的护士情绪耗竭平均水平、较低的护士感知护理过程质量平均水平和较低的选择工作场所的就业稳定性比例显著相关。
实际病房层面的护士离职率可能受到与组织（例如轮班方式和就业稳定性）、患者（例如 IVH 患者）和护士归因（例如倦怠、感知护理质量）相关的因素的影响。
为了最大限度地减少 LTC 医院的护士离职率，可以采取多因素病房层面的干预措施，例如调整轮班工作、关注医疗程序或改善护士的情绪耗竭和对护理质量的看法。
