450 PRESENTATION NURSING TURNOVER

Introduction PICO question: Would adjusting staffing ratios and responsibilities on busy hospital floors increase employee satisfaction and decrease nurse turnover? Study type: meta-analysis Results: nurses’ satisfaction levels are highly related to their roles and ratios Satisfaction is the biggest reason for remaining in one’s current position

Method Databases Used: PubMed and CINAHL Search Terms Used: Nurse Job Satisfaction, Turnover, Workload, Retention, Patient Nurse Ratios Results: I found many articles relating multiple factors to reasons nurse turnover is so high. I chose two of the articles that relate job satisfaction to nurse turnover.

References Wen-Hsien, H., Ying-Ling, S., & Rong-Da, L. (2009). Effects of job rotation and role stress among nurses on job satisfaction and organizational commitment. BMC Health Services Research, 9(8). Lynn, M., & Redman, R. (2006). Staff nurses and their solutions to the nursing shortage. Western Journal Of Nursing Research, 28(6), 678-693.

Reasoning Wen-Hsien et al. shows the statistical proof that job satisfaction is a key to organizational commitment. They also explain that role stresses have huge impacts on satisfaction and therefore nurse retention. Lynn et al. asks current nurses about their ideas to improve the nurse shortage. They relate that to job satisfaction.

Article 1 Theory: Role stress has large impacts on satisfaction and thus on turnover rates Type: Quantitative Method & Design: 650 Questionnaires to nurses with job rotation experience (81.8% participated). The study used SPSS 11.0 and LISREL 8.54 (Linear Structural Relationship Model) for statistical analysis. Findings: High role stress= lower satisfaction Lower satisfaction = lower retention rates

Article 2 Theory: Nurses should have input to stop the shortage rather than just the organizational level Type: Qualitative Method & Design: Descriptive design Random sample drawn Survey filled out by RN’s from diverse pool Used the Satisfaction In Nursing Scale (SINS) to show job satisfaction Findings: 72.9 percent of nurses who responded with multiple ideas chose “mandate specific maximum nurse-to-patient ratios”

Ethical Considerations Article 1 Ethics committees at each facility approved Nurse supervisors posted surveys Nurses remained anonymous Article 2 Nurses remained anonymous so answers did not affect relationships or jobs

Article 1 Strength & Quality: Many validity standards- all acceptable values Limitations: Questionnaires have limited value Studied only correlation between nurses’ perceptions, not the factors that caused them Credibility: Peer-reviewed article All the authors have proper medical and academic credentials fitting the topic

Article 2 Strength & Quality: published in a highly regarded journal expert peer reviewed Limitation: Questionnaire format : list bias potential Budget- small sample size Both studies are well-designed correlation studies, but lack the proper designs to be used as 100 percent reliable truth Both contribute to EBP, but all the authors agree that further studies are necessary to eliminate limitations

Relevance to Nursing Communication Level: Professional level- Both articles outcomes communicated & carried out by the organizational leadership Implications: Limited generalizability due to the designs Influence on further studies Potential future policies (pending further research) Training and mentoring policy changes Staffing ratio policy changes

Potential Barriers Attitudes: Organizational Leadership willingness Nurses willingness to change and adjust Costs: Large enough studies Length of time for the studies Cost analysis for staffing ratios sufficient to increase job satisfaction enough to affect turnover rates Upfront costs of implementing new mentoring programs

Extra Possible PICO Variables P: similar studies on hospital leadership I: other interventions to increase satisfaction C: compare satisfaction and turnover among different hospitals or different careers O: The desired outcome for most of the studies would be increased satisfaction and increased company loyalty

Conclusion Problem of turnover rate among nurses Importance of job satisfaction among nurses Potential ways to increase satisfaction Further studies necessary