Klinik Ortamda Hemşire Tutmanın Belirleyicilerini Anlama ve Güçlendirme

Year 2023, Volume: 3 Issue: 1, 28 - 39, 09.04.2023

Mail Özçelik , Selma Aktas

Abstract

Hemşirelik işgücünün kaybı, dünya çapında sağlık sistemlerini tehdit eden önemli bir insan kaynakları sorunudur. Hemşirelerin işini veya mesleğini bırakmasını etkileyen faktörler arasında stresli bir çalışma ortamı, yetki ve sorumluluklar arasındaki dengesizlik, fiziksel veya psikolojik şiddet, tükenmişlik, liderlik desteği eksikliği ve iletişim sorunları sayılabilir. Hasta bakım hizmetlerinde yüksek devir hızı insan kaynakları maliyetini artırmakta, üretkenliği ve verimliliği düşürmekte, hasta güvenliğini ve hasta bakım kalitesini olumsuz yönde etkilemektedir. Hemşirelik uygulamaları için olumlu ve sağlıklı bir ortam, hemşirelik bakımı ve hemşirelik bakımının kalitesi için esastır. Çalışmalar, iyi yönetişim ve hemşirelik liderliği, mesleki gelişim ve özerklik, doktor-hemşire ve meslektaş ilişkileri, yeterli hemşire kadrosu ve kaynaklar ile zorbalık ve şiddetten uzak bir işyeri, pozitif çalışma ortamlarının temel bileşenleri olduğunu göstermiştir. Klinik sistemlerde iyi yönetişim iklimine sahip ve çalışma ortamlarını iyileştirmiş kuruluşlar daha yüksek hemşire tutma oranlarına sahiptir.

Keywords

Hemşire Tutma, Olumlu İş Ortamı, Hemşire Devir Hızı, Güçlendirme, Nurse Retention

Supporting Institution

Yok

Project Number

Yok

Understanding and Empowering the Determinants of Nurse Retention in a Clinical Environment

Abstract

The loss of the nursing workforce is an essential human resources issue threatening healthcare systems worldwide. The factors affecting nurses leaving their employment or the profession include a stressful work environment, an imbalance between authority and responsibilities, physical or psychological violence, burnout, lack of leadership support, and communication issues. A high turnover rate in patient care services increases the cost of human resources, lowers productivity and efficiency, and negatively impacts patient safety and quality of patient care. A positive and healthy environment for nursing practice is essential for nursing retention and the quality of nursing care. The studies have shown that good governance and nursing leadership, professional development and autonomy, physician-nurse and colleague relations, adequate nursing staffing and resources, and a work environment free from bullying and violence are essential components of positive work environments. Organizations with good governance climate in clinical systems and improved work environments have higher nurse retention rates.

Keywords

Nurse Retention, Positive Work Environment, Nurse Turnover, Strengthening.

Project Number

Yok

References

• World Health Organization. Global strategy on human resources for health: Workforce 2030. WHO, 2016. https://apps.who.int/iris/bitstream/handle/10665/250368/9789241511131-eng.pdf. Accessed :05.10.2022.
• Twigg D, McCullough K. Nurse retention: A review of strategies to create and enhance positive practice environments in clinical settings. Int J Nurs Stud. 2014;51(1):85–92.
• Heidari M, Seifi B, Gharebagh ZA. Nursing staff retention: Effective factors. Ann Trop Med Public Heal. 2017;10(6):1587–90.
• Satoh M, Watanabe I, Asakura K. Determinants strengthening japanese nurses’ intention to stay at their current hospital. Tohoku J Exp Med. 2018;246(3):175–82.
• Li Y, Jones CB. A literature review of nursing turnover costs. J Nurs Manag. 2013;21(3):405–18.
• Buchan J, Shaffer FA, Catton H. Policy Brief: Nurse Retention. International Council of Nurses. 2018. https://www.icn.ch/sites/default/files/inline-files/2018_ICNM%20Nurse%20retention.pdf. Accessed: 01.10.2022.
• World Health Organization. Technical Meeting on Health Workforce Retention in Countries of the South-eastern Europe Health Network. 2011. https://www.euro.who.int/__data/assets/pdf_file/0018/152271/e95775.pdf. Accessed: 05.10.2022.
• Health Workforce Autralia (HWA). Health Workforce 2025 Doctors , Nurses and Midwives.2012; (1):1- 178.
• Kocaman G, Seren Ş, Kurt S, Danış B, Erer T. Üç Üniversite Hastanesinde Hemşire Devir Hızı. Hemşirelikte Eğitim ve Araştırma Derg. 2010;7(1):34–8
• Efendi F, Kurniati A, Bushy A, Gunawan J. Concept analysis of nurse retention. Nurs Heal Sci. 2019;21(4):422–7.
• Alzahrani MS. Impact of Work Environment on Nurse’s Retention at Hospital: Scoping Review. Evidence-Based Nurs Res. 2022;4(2):39–53.
• Spence Laschinger HK, Almost J, Tuer-Hodes D. Workplace empowerment and magnet hospital characteristics: Making the link. J Nurs Adm. 2003;33(7–8):410–22.
• Hayes LJ, O’Brien-Pallas L, Duffield C, Shamian J, Buchan J, Hughes F, et al. Nurse turnover: A literature review. Int J Nurs Stud. 2006;43(2):237–63.
• World Health Organization. WHO guideline on health workforce development, attraction, recruitment and retention in rural and remote areas.2021: 82. file:///C:/Users/mail/Downloads/9789240024229-eng.pdf. Accessed: 01.10.2022.
• Lake ET, de Cordova PB, Barton S, Singh S, Agosto PD, Ely B, et al. Missed Nursing Care in Pediatrics. Hosp Pediatr. 2017;7(7):378–84.
• Dawson AJ, Stasa H, Roche MA, Homer CSE, Duffield C. Nursing churn and turnover in Australian hospitals: Nurses perceptions and suggestions for supportive strategies. BMC Nurs. 2014;13(11):1–10.
• Tourangeau AE, Cranley LA. Nurse intention to remain employed: Understanding and strengthening determinants. J Adv Nurs. 2006;55(4):497–509.
• Chen HC, Chu CI, Wang YH, Lin LC. Turnover factors revisited: A longitudinal study of Taiwan-based staff nurses. Int J Nurs Stud. 2008;45(2):277–85.
• Johnson SL, Rea RE. Workplace bullying: Concerns for nurse leaders. J Nurs Adm. 2009;39(2):84–90.
• Nurdiana N, Hariyati RTS.Retention Strategy to Minimize Nurse Turnover: A Systematic Review. Int J Nurs Heal Serv. 2019;1(2):99–109.
• Aydoğmuş S, Özlük B. The Relationship between Work Environments and Intention to Leave in Nursing: A Cross-sectional and Correlational Study. Clin Exp Heal Sci. 2022;12:629–35.
• Dotson MJ, Dave DS, Cazier JA, Spaulding TJ. An empirical analysis of nurse retention: What keeps rns in nursing? J Nurs Adm. 2014;44(2):111–6.
• Ellenbecker CH, Porell FW, Samia L, Byleckie JJ, Milburn M. Predictors of home healthcare nurse retention. J Nurs Scholarsh. 2008;40(2):151–60.
• Juraschek SP, Zhang X, Ranganathan VK, Lin VW. United States Registered Nurse Workforce Report Card and Shortage Forecast. Am J Med Qual. 2012;27(3):241–9.
• Oulton JA. The global nursing shortage: An overview of issues and actions. Policy, Polit Nurs Pract. 2006;7(3):34–9.
• Duxbury ML, Armstrong GD. Calculating nurse turnover indices. J Nurs Adm. 1982;12(3):18–24.
• Hofmann PB. Accurate measurement of nursing turnover: The first step in its reduction. J Nurs Adm. 1981;11(12):37–9.
• Gess E, Manojlovich M, Warner S. An evidence-based protocol for nurse retention. J Nurs Adm. 2008;38(10):441–7.
• Hınshaw AS, Atwoo JR. Nursing StatT Turnover , Stress , and Satisfaction : Models , Measures , and Management. Ann Rev 1983;1133-153, Nurs Res. 1984;1:133–53.
• Schmalenberg C, Kramer M. Essentials of a productive nurse work environment. Nurs Res. 2008;57(1):2–13.
• Wieck KL, Dols J, Landrum P. Retention Priorities for the Intergenerational Nurse Workforce. Nurs Forum. 2010;45(1):7–17.
• Buffington A, Zwink J, Fink R, Devine D, Sanders C. Factors affecting nurse retention at an academic Magnet® hospital. J Nurs Adm. 2012;42(5):273–81.
• Force MVO. The Relationship Between Effective Nurse Managers and Nursing Retention. J Nurs Adm. 2005;35(7):336–41.
• Wagner CM. The Relationship between Organisational Commitment and Burnout: A Comparative Study of Nurses from a Health Care Service. Am J Nurs Res. 2007;60(3):235–47.
• Yeh TF, Chang YC, Feng WH, Sclerosis M, Yang CC. Effect of Workplace Violence on Turnover Intention: The Mediating Roles of Job Control, Psychological Demands, and Social Support. J Heal Care Organ Provision, Financ. 2020;57:1–11.
• Jones A. Experience of Protagonists in Workplace Bullying: An Integrated Literature Review. Int J Nurs Clin Pract. 2017;4(246):1–6.
• Upenieks V V. Assessing differences in job satisfaction of nurses in magnet and nonmagnet hospitals. J Nurs Adm. 2002;32(11):564–76
• Tourangeau A, Cranley L, Spence Laschinger HK, Pachis J. Relationships among leadership practices, work environments, staff communication and outcomes in long-term care. J Nurs Manag. 2010;18(8):1060–72.
• Flynn L, Liang Y, Dickson GL, Aiken LH. Effects of Nursing Practice Environments on Quality Outcomes in Nursing Homes. J Am Geriatr Soc.2010;58(12):2401–6.
• Davidson PM, Elliott D, Daly J. Clinical leadership in contemporary clinical practice: Implications for nursing in Australia. J Nurs Manag. 2006;14(3):180–7.
• Kaba NK, Ozturk H. Nurses’ Perceptions of Clinical Governance Climate. J Educ Res Nurs. 2022;19(2):198–207.
• Australian Commission on Safety and Quality in Health Care. Clinical Governance For Nurses And Midwives. 2017. https://www.safetyandquality.gov.au/sites/default/files/migrated/Clinical-governance-for-nurses-and-midwives.pdf. Accessed:10.10.2022.
• Beal JA, Riley JM, Lancaster DR. Essential elements of an optimal clinical practice environment. J Nurs Adm. 2008;38(11):488–93.
• Kramer M, Schmalenberg C, Maguire P, Brewer BB, Burke R, Chmielewski L, et al. Walk the talk: Promoting control of nursing practice and a patient-centered culture. Crit Care Nurse. 2009;29(3):77–93.
• Vollers D, Hill E, Roberts C, Dambaugh L, Brenner ZR. Healthy Work Environment Standarts and an Empowering Nurse Advancement System. Crit Care Nurse. 2009;29(6):20–7.
• Pullon S. Competence, respect and trust: Key features of successful interprofessional nurse-doctor relationships. J Interprof Care. 2008;22(2):133–47.
• Zhang L, Huang L, Liu M, Yan H, Li X. Nurse–physician collaboration impacts job satisfaction and turnover among nurses: A hospital-based cross-sectional study in Beijing. Int J Nurs Pract. 2016;22(3):284–90.
• Occupational Safety and Health Administration (OSHA). Preventing workplace violence: A road map for healthcare facilities. 2015:40. https://www.osha.gov/sites/default/files/OSHA3827.pdf. Accessed: 10.10.2022.
• Dos Santos JLG, Erdmann AL, de Andrade SR, de Mello ALSF, de Lima SBS, Pestana AL. Nursing governance: An integrative review of the literature. Rev da Esc Enferm. 2013;47(6):1414–21.
• Heat J, Johanson W, Blake N. Healthy Work Environments: A Validation of the Literature. J Nurs Adm. 2004;34(11):524–30.
• Hewko SJ, Brown P, Fraser KD, Wong CA, Cummings GG. Factors influencing nurse managers’ intent to stay or leave: a quantitative analysis. Nurs Manag. 2015;23(8):1058–66.
• Hogan P, Moxham L, Dwyer T. Human resource management strategies for the retention of nurses in acute care settings in hospitals in Australia. Contemp Nurse. 2007;24(2):189–99.
• Al-Ahmadi H. Anticipated nurses’ turnover in public hospitals in Saudi Arabia. Int J Hum Resour Manag. 2014;25(3):412–33.
• Han MR, Gu JA, Yoo IY. Influence of Workplace Bullying and Leader-Member Exchange on Turnover Intention among Nurses. J Korean Acad Nurs Adm. 2014;20(4):383.
• Wang Y, Yuan H. What is behind high turnover: A questionnaire survey of hospital nursing care workers in Shanghai, China. BMC Health Serv Res. 2018;18(1):1–8.
• Nowrouzi B, Rukholm E, Larivière M, Carter L, Koren I, Mian O. An examination of retention factors among registered practical nurses in north-eastern Ontario, Canada. Rural Remote Health. 2015;15(2):1–9.
• Phuekphan P, Aungsuroch Y, Yunibhand J. A model of factors influencing intention to leave nursing in thailand. Pacific Rim Int J Nurs Res. 2021;25(3):407–20.
• Hung MSY, Lam SKK. Antecedents and contextual factors affecting occupational turnover among registered nurses in public hospitals in Hong Kong: A qualitative descriptive study. Int J Environ Res Public Health. 2020;17(11):1–12.
• Rouhi-Balasi L, Elahi N, Ebadi A, Jahani S, Hazrati M. Professional autonomy of nurses: A qualitative meta-synthesis study. Iran J Nurs Midwifery Res. 2020;25(4):273–81.
• Tourangeau AN, Cummings G, Cranley LA, Ferron EM, Harvey S. Determinants of hospital nurse intention to remain employed: Broadening our understanding. Journal of Advanced Nursing.2009;66(1):22-32.
• Baik D, Zierler B. RN Job Satisfaction and Retention After an Interprofessional Team Intervention. Western Journal of Nursing Research.2019;41(4):615-630.
• El-Jardali F, Alameddine M, Jamal D, Dimassi H, Dumit NY, McEwen MK, et al. A national study on nurses’ retention in healthcare facilities in underserved areas in Lebanon. Hum Resour Health. 2013;11(1):1–13.
• Breau M, Rheaume A. Relationships between empowerment, work environment on job satisfaction, intent to leave, and quality of care among UCI Nurses. Dynamics 2014;25(3):16–24.
• Duffield CM, Roche MA, Blay N, Stasa H. Nursing unit managers, staff retention and the work environment. J Clin Nurs. 2011;20(1–2):23–33.
• Ulrich B, Barden C, Cassidy L, Varn-Davis N. Critical Care Nurse Work Environments 2018: Findings and implications. Crit Care Nurse. 2019;39(2):67–84.
• Kelly LA, Johnson KL, Bay RC, Todd M. Key elements of the critical care work environment associated with burnout and compassion satisfaction. Am J Crit Care. 2021;30(2):113–20.
• Aljohani KA, Alomari O. Turnover among Filipino nurses in Ministry of Health hospitals in Saudi Arabia: Causes and recommendations for improvement. Ann Saudi Med. 2018;38(2):140–2.
• Hairr DC, Salisbury H, Johannsson M, Redfern-Vance N. Nurse staffing and the relationship to job satisfaction and retention. Nurs Econ. 2014;32(3):142–7.
• Al Muharraq EH, Baker OG, Alallah SM. The Prevalence and The Relationship of Workplace Bullying and Nurses Turnover Intentions: A Cross Sectional Study. SAGE Open Nurs. 2022;8:1–10.