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Module 6 Short Paper
Research into nurse turnover and effective retention interventions is an important topic for healthcare administrators with a looming effect of nursing shortages. Developing appropriate research methods in conjunction with data collection and analysis has the ability to provide substantial information regarding efficacy of interventions, along with exposing necessities for additional research. Using PICO formatted questions with key search terms such as nurses or turnover to discover current and relevant data for nurse retention intervention effects and using comparative statistics to determine levels of association can help craft important decisions to decrease nurse turnover. Throughout the process, awareness to gaps or inconsistencies in research is necessary to provide knowledge of additional research requirements and present bias.
The research methods used to address the research questions within the chosen studies mainly consist of secondary data analysis through literature review for systematic reviews, along with obtaining completed interviews and surveys to obtain information. The systematic reviews utilized peer-reviewed, published articles in English and were included based on quality assessment tools within the data collection procedures, all appropriate for the research method. The interviews conducted surrounding financial incentives could have been combined with an anonymous survey to establish mixed method results, further corroborating the evidence; however, the surveys obtained, while contributory to the research question, allowed for current workers only, not incorporating nurses who had left the career field (Yeager & Wisniewski, 2017).
The data collection methods for the systematic reviews are similar based on the research question being answered. A combination of PICO formed questions and key search words populated relevant articles for review and allowed for blinded reviews and quality assessment tools to be used for inclusion criteria, with the exception of one study who used the quality assessment tool to interpret results rather than allow for inclusion (Mbemba, Gagnon, Paré, & Côté, 2013). Key search words included intervention, nurses, nurse retention, personnel turnover, recruitment, and a combination of several other terms (Brook, Aitken, Webb, MacLaren, & Salmon, 2019; Halter, et al., 2017; Yeager & Wisniewski, 2017). The data collection format enabled researchers to have current and applicable data for review, most appropriate for synthesis. Data analysis was primarily performed with the use of simpler statistics such as means, medians, and sample sizes to determine positive or negative correlations with different intervention types and establish a measure of association. One of the more effective uses of statistical analysis was the median and IQR utilized to establish effects of nurse retention and turnover based on different interventions (Brook, et al., 2019). The use of comparative statistics and direction of association between groups and/or interventions within the systematic reviews is the most effective and appropriate method for the integrated review due to the review methods of each included research article.
Despite best research and data collection methods, several gaps and inconsistencies were located throughout the review process with indications showing additional research is required to fully decipher the effectiveness of specific interventions on nurse retention. One of the routine gaps in the literature was the lack of controlled trials and limited reliable observational studies; however, several were subject to publication bias by lacking any negative findings in the research. Alternatively, Yeager and Wisniewski (2017) reported low response rates on surveys, though the lack of data on non-respondents left an inability to test for bias. Additionally, the surveys only included current workers, not workers who had previously left the career field (Yeager & Wisniewski, 2017). Another gap located was the inconsistency of quality review scores for inclusion purposes, as some data was allowed regardless of the quality assessment score received (Salt, Cummings & Profetto-McGrath, 2008). Lastly, no guarantee was submitted to ensure only nurse-responses were involved in the data collection, allowing interventions and responses from other medical professionals to skew results for effective nurse retention methods (Mbemba, et al., 2013).
Utilizing secondary data analysis, quality data assessments and comparative statistics to find associations between nurse retention methods and effective interventions provides an ability to retrieve current data with specific relevance to the nursing population. The use of blind reviews helps to eliminate data irrelevance and bias; however, utilizing only published reviews can exhibit publication bias and a lack of negative findings. A lack of reliable trials and controlled studies regarding nurse retention methods provides limited evidence and data to support effective interventions. More research in this field is necessary to determine consistent positive associations in interventions for the retention of nurses.
References
Brook, J., Aitken, L., Webb, R., MacLaren, J., & Salmon, D. (2019). Characteristics of successful interventions to reduce turnover and increase retention of early career nurses: A systematic review. International Journal of Nursing Studies, 91, 47-59. doi:10.1016/j.ijnurstu.2018.11.003
Halter, M., Pelone, F., Boiko, O., Beighton, C., Harris, R., Gale, J., Gourlay, S., & Drennan, V. (2017). Interventions to reduce adult nursing turnover: A systematic review of systematic reviews. The Open Nursing Journal, 11(1), 108-123. doi:10.2174/1874434601711010108
Mbemba, G., Gagnon, M., Paré, G., & Côté, J. (2013). Interventions for supporting nurse retention in rural and remote areas: an umbrella review. Human Resources for Health, 11(1). doi:10.1186/1478-4491-11-44
Salt, J., Cummings, G. G., & Profetto-McGrath, J. (2008). Increasing retention of new graduate nurses. JONA: The Journal of Nursing Administration, 38(6), 287-296. doi:10.1097/01.nna.0000312788.88093.2e
Yeager, V. A., & Wisniewski, J. M. (2017). Factors that influence the recruitment and retention of nurses in public health agencies. Public Health Reports, 132(5), 556-562. doi:10.1177/0033354917719704
