Nurse Aide Turnover in Home Health Care: A Scoping Review

Abstract

Nurse Aides (NAs) delivering in-home care has increased in recent years in the United States and is expected to increase further by 2032. Understanding factors that affect turnover and retention of NAs in-home care is imperative to providing high-quality care for older adults. Eight scholarly databases were used to search for relevant peer-reviewed articles. Using a three-stage process, twenty-four articles published between 2003-2023 were included in this scoping review. Factors affecting turnover were categorized based on the Jobs Demands-Resource (JD-R) and Socioecological Model (SEM). Factors affecting turnover can be conceptualized by job demands and resources. Furthermore, intrapersonal, interpersonal, institutional, and community-level factors all influence nurse aide turnover and retention. Supervisor support, colleague or co-worker support, and performance feedback may augment home health NA’s retention and well-being. Many unique factors affect NA turnover. The problematic nature of the work, coupled with often low pay and low autonomy, means identifying job resources is imperative. Evidence supports that emphasis on support systems from the organization, co-workers, and supervisors coupled with constructive and frequent performance discussions where home health NA’s input is welcomed should substantially reduce turnover and significantly improve workplace experiences and patient care.

Keywords

• Home health
• Home Health Aids
• Nursing Assistants
• Certified Assistants
• Turnover

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