Introduction
The introduction to the issue of nurse retention is opened with a summary of the issues discovered via SWOT analysis. Nurse retention has become a significant issue in healthcare organizations, which is characterized by constant challenges that require effective measures. The importance of nurse retention is emphasized, as it directly affects the sustainability and efficiency of healthcare systems. As an important part of patients’ care, nurses contribute significantly to the proper functioning of health institutions as a whole. This literature review is to analyze and synthesize evidence from three peer-reviewed articles focusing on interventions and intervention strategies for nurse retention. By conducting this analysis, the review intends to offer knowledge that could aid in improving nurse retention practices and therefore benefit both nurses and the healthcare delivery system as a whole
Summary of Three Peer-Reviewed Articles
In a mixed methods study, Brook et al. (2021), explored an intervention aimed at reducing burnout and improving retention of early career nurses. The study is published in BMC Nursing and concentrates on the perceptions of nursing students and academics who implement a certain intervention to determine its acceptability and feasibility. The approaches used were an explanatory sequential mixed-method design using questionnaires based on the Theoretical Framework for Acceptability and qualitative data collected through interviews, focus groups, and field notes. It was noted that the acceptability scores kept increasing positively with time, and student nurses found the intervention to help develop skills and experience for their careers. The planning element is highlighted as a crucial component to integrating the intervention into curricula and leveraging partnerships in placements. The conclusion emphasizes the need for assessment for acceptability and feasibility because the intervention’s potential to improve retention and decrease burnout among early career nurses should be considered by the participants more broadly.
Brook et al. (2019), evaluated the features of successful interventions that were designed to minimize turnover and promote retention among early career nurses. A systematic online search of databases like “Academic Search Complete,” “Medline,” and “CINAHL” was used to identify publications in the period April 2001 to April 2018. The quality assessment was based on the Joanna Briggs Institute Critical Appraisal tools, and the review was guided by the ‘Preferred Reporting Items for Systematic Reviews and Meta-analyses’ (PRISMA) guidelines. The findings, based on the 53 eligible studies out of 11,656 retrieved papers showed a wide array of interventions that had desirable properties in internship/residency programs and orientation/transition to practice lasting 27-52 weeks. However, the conclusion highlights methodological challenges and recommends standardized reporting of interventions and outcome measures, rigorous research designs, and cost-effectiveness evaluations to guide future nurse retention strategy research and maximize their efficacy.
The scoping review by McClain et al. (2021) is designed to assess what has been said about millennial nurse retention strategies and barriers, and how the evidence is mapped conceptually while finding any differences between Generation Y and Generation Z nurses. The review covers studies and reports covering registered nurses born in the 1980s to 2000, using a rigorous methodology that is consistent with JBI guidelines. Databases included MEDLINE, CINAHL, and Embase with eligible studies published in English between 2010 and the date of the search. In the scoping review that included 38 publications, strategies were identified in 21 publications, barriers in two publications, and both strategies and barriers in 15 publications. Findings are grouped into five concepts: Management, work environment, personal development, professional exhaustion and self-realization. The conclusion states that there is a need for more comprehensive research to validate the preliminary evidence base, focusing on the creation of a healthy work environment and evaluation of leadership as well as bedside nurse relationships to facilitate millennial retention.
Application of the Evidence
The three peer-reviewed articles show the need for intervention to deal with retention issues of early career nurses and millennials. The first article by Brook et al. (2021) investigated an intervention including mindfulness, psychological skills training and cognitive realignment showing increased acceptability over time with perceived benefits corresponding with protective factors against burnout. The second article (Brook et al., 2019) presents a systematic review of characteristics of internship/residency and orientation/transition programs that appear to be promising, with particular attention paid to standardized reporting and rigorous research methodologies. The third article by McClain et al. (2021) discusses millennial nurses and their strategies around leadership, workplace setting, occupational development, and self-actualization. Collectively, these studies highlight the multidimensionality of nurse retention interventions being both personal and organizational oriented.
The comparison and contrast of the interventions and strategies show both similarities as well as differences. All three articles recognize the importance of early career stages in nursing and suggest interventions to support retention. As opposed to the first two articles written by Brook et al., which focus on certain features of a program and the importance of standardized reporting, McClain et al. go into more general concepts such as leadership and professional development. Even though the contexts differ, there is a common understanding that proactive and comprehensive approaches are required to take into consideration the peculiarities of various stages of nurse careers. Differences in methodology and intervention elements reveal the challenges of addressing nurse retention, which require personalized approaches that reflect a wider range of factors shaping nurses’ job satisfaction and loyalty.
Impact on Healthcare Delivery
The identified interventions and nurse retention strategies have great impacts on healthcare delivery. Successful retention strategies lead to a stable and committed nursing workforce that provides better patient care services, contributing to enhanced performance of the whole healthcare system. Notably, the first article by Brook et al. (2021) shows that interventions intended to address burnout and retain early career nurses could enable healthcare professionals with the skills required to deliver quality patient care. This, in the meantime, helps create a healthier work environment and ensures better patient outcomes reinforcing the relationship between nurse well-being and healthcare delivery.
Nurse retention is highly associated with the overall effectiveness of healthcare systems. High turnover rates result in recruitment and training costs, break the continuity of nursing care, and affect nurse-patient relationships. The review by Brook et al. (2019) defines features of effective interventions that, when implemented on a larger scale, could prevent turnover and promote retention. The potential benefits are evident, however, challenges like resource scarcity, resistance towards change and commitment from healthcare institutions need to be taken into account. The success of these interventions would be realized through a systematic and coordinated approach by healthcare organizations, educational institutions, and policymakers to create an atmosphere that fosters and focuses on nurse retention thereby influencing the systemic level positively.
Conclusion
This literature review analyzed three peer-reviewed articles that discussed interventions and strategies for nurse retention. These articles’ synthesis indicates a shared perception of the complexity of nurse retention issues and the need for specific actions. As a whole, these studies highlight the necessity of taking into account different factors in designing retention initiatives. The implications for nurse retention are great, as effective measures do not only benefit the welfare of nursing staff but also affect health care provision directly. Better patient care, improved outcomes and higher overall performance of the healthcare system result from a stable and engaged nursing workforce. Nevertheless, the application of these approaches in a larger scope necessitates thoughtful analysis of possible issues and joint action among healthcare industry representatives.
References
Brook, J., Aitken, L. M., MacLaren, J.-A., & Salmon, D. (2021). An intervention to decrease burnout and increase retention of early career nurses: a mixed methods study of acceptability and feasibility. BMC Nursing, 20(1). https://doi.org/10.1186/s12912-020-00524-9
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(91), 47–59. https://doi.org/10.1016/j.ijnurstu.2018.11.003
McClain, A. R., Palokas, M., Christian, R., & Arnold, A. (2021). Retention strategies and barriers for millennial nurses: a scoping review. JBI Evidence Synthesis, 20(1), 121–157. https://doi.org/10.11124/jbies-20-00577
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