Abstract Background Hospitals facing financial uncertainty have sought to reduce nurse staffing as a way to increase profitability. However, nurse staffing has been found to be important in terms of quality of patient care and nursing related outcomes. Nurse staffing can provide a competitive advantage to hospitals and as a result better financial performance, particularly in more competitive markets Purpose In this study we build on the Resource-Based View of the Firm to determine the effect of nurse staffing on total profit margin in more competitive and less competitive hospital markets in Florida.
This article has been cited by other articles in PMC. Nursing turnover is a serious issue that can compromise patient safety, increase health care costs and impact on staff morale. Results Key factors affecting nursing turnover were limited career opportunities; poor support; a lack of recognition; and negative staff attitudes.
The nursing working environment is characterised by inappropriate skill-mix and inadequate patient-staff ratios; a lack of overseas qualified nurses with appropriate skills; low involvement in decision-making processes; and increased patient demands.
These issues impacted upon heavy workloads and stress levels with nurses feeling undervalued and disempowered. Nurses described supportive strategies: Conclusion Nursing turnover is influenced by the experiences of nurses.
Positive steps can be made towards improving workplace conditions and ensuring nurse retention. Improving performance management and work design are strategies that nurse managers could harness to reduce turnover.
In Australia, few studies have examined nursing turnover rates [ 67 ], however recent reports indicate a turnover rate in one state New South Wales of 1 per cent to 1. It is also important to consider this aspect of turnover also as such staff movement can negatively impact upon skill-mix, scheduling and continuity of care [ 10 ].
Minimising turnover rates is an important priority for health service managers for a number of reasons. Secondly, turnover affects the roles [ 11 ], morale and stress levels of remaining staff, impacting upon nurse productivity [ 112 ]. Finally, turnover Analyzing the impact of stress on nurse productivity and retention on patient safety and outcomes with registered nurse RN turnover found to be related to both increased infection and subsequent hospitalization [ 13 ]; an increased likelihood of medical error [ 114 ]; and reduced patient satisfaction [ 15 ].
Factors contributing to nursing turnover In order to reduce the rate of turnover, it is necessary to identify exactly which factors contribute to this phenomenon. A number of descriptive studies from different countries have used surveys to examine some of the reasons for nurse turnover [ 61416 ].
In the international literature, the work environment has been identified as one important factor in nurse turnover. For example, Aiken and colleagues in their research in the US, Canada, England, Scotland and Germany, found that low morale, management issues, workload, and the amount of time spent on non-nursing tasks all contributed to turnover [ 18 ].
In Canada, Leiter and Maslach [ 19 ] found that burnout or exhaustion mediated the occurrence of turnover. In the US, Johnson and Rea [ 21 ] found that workplace bullying was associated with turnover from both the organization and the nursing profession.
This is problematic, because it is possible that individual differences between nurses and groups of nurses are also influential in turnover [ 2324 ]. For instance, one Australian study found that for some nurses individual affective professional commitment was significantly related to intention to change professions [ 25 ].
Other individual factors which may play a role in turnover are generational membership and age [ 2627 ] or years of experience [ 4 ]. Reducing nursing turnover Of the research which has examined ways to reduce nursing turnover, Gess and colleagues found that changing organizational processes, so that the nursing staff had additional autonomy and were offered rewards and recognition for their work improved organizational commitment, and decreased turnover [ 28 ].
In another study, Porter and co-workers instituted a nursing labour management partnership NLMP program, which encouraged a collaborative approach between management and the nursing union [ 29 ].
This collaborative approach was found to improve satisfaction and reduce turnover. There is little Australian research on the causes of nurse turnover.
Additionally, of the research which has been done, most of it has been in the form of survey data, or quantitative analysis, rather than qualitative studies [ 30 ]. This could result in a limited understanding of factors associated with nurse turnover.
Whilst quantitative data can provide a broad snapshot of the findings, survey data usually lacks the rich insight needed to gain a better understanding of the causes of turnover.
Qualitative research provides a deeper understanding and insight into the everyday realities of the nursing work environment from the perspectives of nurses themselves.
Ethical approval was sought from and granted by seven Human Research Ethics Committees representing the participating hospitals: Study participants Participants were part of a broader study, which examined the relationship between nurse turnover and patient, organizational and staff outcomes.
Patient, nurse and costing data were collected on 62 medical and surgical nursing units in 11 public hospitals across two states and one territory of Australia.
All RNs, ENs, and AINs engaged in clinical practice on sampled units were asked to complete a survey that gathered information about the practice environment, job satisfaction, physical and mental health, nurse leadership and demographics. A total of nurses provided written consent and completed the survey, a response rate of These data formed the basis of the analysis.
Data analysis The handwritten responses were entered into Excel and then imported into NVivo, a qualitative data analysis software tool. These were analyzed thematically [ 34 ] using an inductive process to categorise, tabulate and recombine the evidence, in line with the aim of the study reported in this paper.
Codes emerged during several readings of the responses and labels were assigned based upon the text and revised accordingly as new data were analysed. Codes were then grouped into categories and concept maps were drawn to identify relationships across all categories and sub categories which assisted to identify themes.
The rigour of the analysis process was ensured through ongoing discussion between the researchers, who agreed upon categories and emergent themes. Results Handwritten responses from nurses were gathered and analysed. The participant characteristics in this qualitative study show similarities with the entire survey sample.
Table 1 Characteristics of nurses who contributed qualitative responses to the turnover survey.Impact Of Stress On Employee Productivity, Performance And Turnover; An Important Managerial Issue Subha Imtiaz* and Shakil Ahmad** Stress is a universal element and persons from nearly every walk of life have to face stress.
Employers today are critically analyzing the stress management issues that. Impact Of Stress On Employee Productivity, Performance And Turnover; An Important Managerial Issue Subha Imtiaz* and Shakil Ahmad** Stress is a universal element and persons from nearly every walk of life have to face stress.
Employers today are critically analyzing the stress management issues that. WORK ENVIRONMENTAL FACTORS AFFECTING STAFF NURSE RETENTION A RESEACH PAPER SUBMITTED TO THE GRADUATE SCHOOL IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE MASTERS OF SCIENCE BY Nurses are experiencing increased stress and pressure in the work environment.
. Request PDF on ResearchGate | The Impact of Nurse Turnover on Patient, Nurse, and System Outcomes: A Pilot Study and Focus for a Multicenter International Study | Research about the economic. Object Moved This document may be found here. Using a Nursing Productivity Committee to Achieve Cost Savings and Improve Staffing Levels and Staff Satisfaction.
|Wage, Work Environment, and Staffing: Effects on Nurse Outcomes||Open in a separate window Note.|
|Improve Retention Rates and Reduce Costs by Keeping Staff Healthy and Happy||The hospital, which is the flagship hospital of the Baptist Memorial Health Care system, is also nine months into an employee wellness program called Well4Me, which includes components like a personal health challenge for employees and a blog with healthy lifestyle tips and content. John Lacy, head of human resources for Baptist Memorial Health Care, said committing to employee health and wellness may require a fundamental culture change.|
|Background||A study, done by the American Nurses Association inshowed that hospital-acquired events like postoperative infections, urinary tract infections, pneumonia and pressure ulcers were preventable conditions that could be reduced with increased nurse staffing.|
|Our Award-Winning Writers Cover the Latest Healthcare News, Views, and Features||Field study was conducted with questionnaire as the primary data collection instrument. Analysis showed immense support for negative relationship between stress and job performance; greatly affected career change over .|
|Table 6 Relationship between target for hours per patient day HPPD and nurse to patient ratios Once NPC members felt comfortable articulating HPPD and productive vs nonproductive time, the information was cascaded to the rest of the nursing management team through workshops led by the chief nursing officer and committee members.|
NPC mentors helped the nurse managers understand the impact of overtime on higher HPPD values and the implications of cost overruns. and high stress levels for staff and nurse managers alike.