Buckley Laura, McGillis Hall Linda, Price Sheri, Visekruna Sanja, McTavish Candice
University of Toronto, Toronto, Ontario, Canada
University of Toronto, Toronto, Ontario, Canada.
BMJ Open. 2025 Mar 4;15(3):e096333. doi: 10.1136/bmjopen-2024-096333.
The COVID-19 pandemic highlighted the deterioration of nurses' working conditions and a growing global nursing shortage. Little is known about the factors, strategies and interventions that could improve nurse retention in the peri- and post-COVID-19 period. An improved understanding of strategies that support and retain nurses will provide a foundation for developing informed approaches to sustaining the nursing workforce. The aim of this scoping review is to investigate and describe the (1) factors associated with nurse retention, (2) strategies to support nurse retention and (3) interventions that have been tested to support nurse retention, during and after the COVID-19 pandemic.
Scoping review.
This scoping review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. MEDLINE, Embase, CINAHL and Scopus databases were searched on 17 April 2024. The search was limited to a publication date of '2019 to present'.
Qualitative, quantitative, mixed-methods and grey literature studies of nurses (Registered Nurse (RN), Licenced Practical Nurse (LPN), Registered Practical Nurse (RPN), Publlic Health Nurse (PHN), including factors, strategies and/or interventions to support nurse retention in the peri- and post-COVID-19 period in English (or translated into English), were included. Systematic reviews, scoping reviews and meta-syntheses were excluded, but their reference lists were hand-screened for suitable studies.
The following data items were extracted: title, journal, authors, year of publication, country of publication, setting, population (n=), factors that mitigate intent to leave (or other retention measure), strategies to address nurse retention, interventions that address nurse retention, tools that measure retention/turnover intention, retention rates and/or scores. Data were evaluated for quality and synthesised qualitatively to map the current available evidence.
Our search identified 130 studies for inclusion in the analysis. The majority measured some aspect of nurse retention. A number of factors were identified as impacting nurse retention including nurse demographics, safe staffing and work environments, psychological well-being and COVID-19-specific impacts. Nurse retention strategies included ensuring safe flexible staffing and quality work environments, enhancing organisational mental health and wellness supports, improved leadership and communication, more professional development and mentorship opportunities, and better compensation and incentives. Only nine interventions that address nurse retention were identified.
Given the importance of nurse retention for a variety of key outcomes, it is imperative that nursing leadership, healthcare organisations and governments work to develop and test interventions that address nurse retention.
新冠疫情凸显了护士工作条件的恶化以及全球护理人才短缺问题日益严重。对于在新冠疫情期间及之后可提高护士留职率的因素、策略和干预措施，我们知之甚少。更好地理解支持和留住护士的策略，将为制定明智的方法以维持护理人员队伍奠定基础。本范围综述的目的是调查并描述在新冠疫情期间及之后，（1）与护士留职相关的因素，（2）支持护士留职的策略，以及（3）已进行测试的支持护士留职的干预措施。
范围综述。
本范围综述按照系统评价与Meta分析扩展版的首选报告项目进行。2024年4月17日检索了MEDLINE、Embase、CINAHL和Scopus数据库。检索限于“2019年至今”的出版日期。
纳入对护士（注册护士（RN）、执业护士（LPN）、注册执业护士（RPN）、公共卫生护士（PHN））进行的定性、定量、混合方法和灰色文献研究，包括在新冠疫情期间及之后支持护士留职的因素、策略和/或干预措施，语言为英文（或已翻译成英文）。排除系统评价、范围综述和Meta综合分析，但对其参考文献列表进行手动筛选以寻找合适的研究。
提取以下数据项：标题、期刊、作者、出版年份、出版国家、研究背景、研究人群（n=）、减轻离职意愿的因素（或其他留职指标）、解决护士留职问题的策略、解决护士留职问题的干预措施、衡量留职/离职意愿的工具、留职率和/或得分。对数据进行质量评估并进行定性综合，以梳理当前可用证据。
我们的检索确定了130项研究纳入分析。大多数研究测量了护士留职的某些方面。确定了一些影响护士留职的因素，包括护士人口统计学特征、安全人员配置和工作环境、心理健康以及新冠疫情的特定影响。护士留职策略包括确保安全灵活的人员配置和优质的工作环境、加强组织心理健康和福利支持、改善领导和沟通、增加专业发展和指导机会，以及提供更好的薪酬和激励措施。仅确定了九项针对护士留职的干预措施。
鉴于护士留职对各种关键结果的重要性，护理领导层、医疗保健组织和政府必须努力制定和测试解决护士留职问题的干预措施。
