1. 450 PRESENTATION
NURSING TURNOVER

2. 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

3. 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.

4. 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),

5. 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.

6. 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

7. 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”

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

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