Ward-level nurse turnover and related workplace factors in long-term care hospitals: A cross-sectional survey.

AIM

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.

BACKGROUND

Nurse turnover adversely impacts not only LTC hospitals through higher recruitment and replacement costs but also resident health outcomes.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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).

IMPLICATIONS FOR NURSING MANAGEMENT

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.