Nurses are a vital part of any healthcare system, and their retention is essential for providing high-quality patient care and positive outcomes. We can see the impact of nurse retention on patient care and outcomes in many areas, from reduced costs to improved patient safety and satisfaction. In this blog post, we will discuss how nurse retention can affect patient care and outcomes and what healthcare organizations can do to improve nurse retention.

Nurse Turnover vs. Retention: Quality of Care

Nurses comprise the largest percentage of the healthcare workforce, making nurse turnover and retention a hot topic in healthcare organizations and circles. Not only does the turnover of nursing staff create a substantial economic impact, but it also affects patient outcomes, quality of care, and patient trust. The correlation between nursing satisfaction and patient satisfaction is closely linked because, according to an article in Health Services Research, nurses who are satisfied with their current position are more likely to interact with patients positively than nurses who are dissatisfied.Increased nurse turnover can affect patient quality outcomes due to a rise in novice nurses, staff fatigue and stress, and low job satisfaction. A study described in a PLOS One article explains how high turnover in the ICU can lead to disrupted continuity of care, which can result in the following issues:

• Potential increase in medication errors
• Increased falls
• Increased health-care-associated infections
• Central line-associated bloodstream infection
• Catheter-associated Urinary Tract Infections
• Surgical site infections
• Ventilator-associated Pneumonia

Conversely, nurse retention substantially impacts patient care and outcomes, in which hospitals with high retention rates show increased staff and patient satisfaction and performance in patient quality metrics.

Benefits of Nurse Retention

Hospital systems can reduce the causes of nurse turnover, increase job satisfaction, and decrease intent to leave the profession. BMC Nursing explains that when you decrease nurses' intent to leave the nursing profession, the overall turnover decreases; there is a connection between intent to leave the profession and job satisfaction. Job satisfaction increases resilience, hope, and optimism, resulting in better patient satisfaction and outcomes.Becoming an employer of choice for nurses is one way to improve nurse retention. Jones and Gates tell us that hospital systems can do this in the following ways:

• Top-level nursing leadership
• Supportive nursing supervision
• Nurses involved in decision-making related to patient care
• Ergonomic workstations
• Creating a culture of safety

Once healthcare organizations implement these programs for nurses, retention continues to improve. Once retention improves, you’ll see the following:

• Reduction in hiring cost
• Decreased patient errors
• Increased productivity and quality measures
• Improved culture of safety, work environment, and nurse recruitment

The Contribution of Nurse Turnover to Nursing Improvement

The impact of nurse turnover on our healthcare organizations and the profession has not all been negative. Because of public fear of nursing shortages, more healthcare systems are turning to organizations like the American Nurses Credentialing Center that encourage the empowerment of nurses and drive institutional healthcare change. Magnet status achievement includes the following requirements:

• Transformational leadership: nurse managers lead their staff in new and innovative approaches
• Structural empowerment: nurses having the power to achieve desired evidence-based outcomes
• Exemplary professional practice: providing evidence-based, high-quality care to patients through inter-departmental communication and collaboration
• New knowledge, innovation, and improvements: promotes an atmosphere of evolving care and learning how to improve patient experience and outcomes
• Empirical quality results: reviewing and analyzing quality outcomes to ensure higher standards of care and better patient outcomes

Improving Nurse Turnover Rates to Improve Patient Care

Improving nurse turnover rates is essential to improving patient satisfaction and quality of care. When nurses intend to leave or do leave their nursing positions, there can be an interruption of care, decreased quality metrics, and less experienced nursing staff. The Inquiry journal states that leaders can strongly affect a nurse's intent to leave through the following behaviors:

• Enhancing the meaning of nurses’ work
• Allowing nurses the opportunity to make decisions
• Recognizing and empowering high performance and accomplishments
• Providing resources to improve skills and knowledge
• Minimizing constraints to allow for maximum efficiency and creativity

Nurses are vital to the healthcare community and advocate for patient satisfaction and outcomes. In addition, nurse turnover is costly in recruiting and hiring new nurses and significantly affects patient quality measures like healthcare-associated infections. If organizations want to maintain safe and effective patient care, they must take a closer look at the impact of nurse retention on quality care.The risk of a dwindling nursing population has led to programs that encourage nursing leadership within healthcare organizations and the empowerment of nurses in their units. Healthcare organizations can improve retention and nurse satisfaction through empowerment opportunities like clinical ladder programs. If you’d like to know more, request a demo with Staffgarden today.  

References

Daouda, O. S., Hocine, M. N., & Temime, L. (2021). Determinants of healthcare worker turnover in intensive care units: A micro-macro multilevel analysis. PLOS ONE, 16(5), e0251779. https://doi.org/10.1371/journal.pone.0251779Hu, H., Wang, C., Lan, Y., & Wu, X. (2022). Nurses’ turnover intention, hope and career identity: The mediating role of job satisfaction. BMC Nursing, 21(1). https://doi.org/10.1186/s12912-022-00821-5Jones, C., & Gates, M. (2007). The costs and benefits of nurse turnover: A business case for nurse retention. OJIN: The Online Journal of Issues in Nursing, 12(3). https://doi.org/10.3912/ojin.vol12no03man04Mudallal, R. H., Othman, W. M., & Al Hassan, N. F. (2017). Nurses’ burnout: The influence of leader empowering behaviors, work conditions, and demographic traits. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 54, 004695801772494. https://doi.org/10.1177/0046958017724944Perry, S. J., Richter, J. P., & Beauvais, B. (2018). The effects of nursing satisfaction and turnover cognitions on patient attitudes and outcomes: A three‐level multisource study. Health Services Research, 53(6), 4943-4969. https://doi.org/10.1111/1475-6773.12997

Rebecca Flynn, MSN, RN, AMB-BC, NE-BC is a writer that specializes in nursing management, health, and wellness. She has 20 years of experience as a Licensed Vocational Nurse and 8 years as a Registered Nurse working in primary care and nursing management. Her years of working as a patient advocate and leader provide her with the knowledge to write with an understanding of the needs of patients and nursing staff.