title: Impact and determinants of nurse turnover: a pan-Canadian study.
abstract: OBJECTIVE
  As part of a large study of nursing turnover in Canadian hospitals, the present study focuses on the impact and key determinants of nurse turnover and implications for management strategies in nursing units.
  
  
  BACKGROUND
  Nursing turnover is an issue of ever-increasing priority as work-related stress and job dissatisfaction are influencing nurses' intention to leave their positions.
  
  
  METHODS
  Data sources included the nurse survey, unit managers, medical records and human resources databases. A broad sample of hospitals was represented with nine different types of nursing units included.
  
  
  RESULTS
  Nurses turnover is a major problem in Canadian hospitals with a mean turnover rate of 19.9%. Higher levels of role ambiguity and role conflict were associated with higher turnover rates. Increased role conflict and higher turnover rates were associated with deteriorated mental health. Higher turnover rates were associated with lower job satisfaction. Higher turnover rate and higher level of role ambiguity were associated with an increased likelihood of medical error.
  
  
  CONCLUSIONS
  Managing turnover within nursing units is critical to high-quality patient care. A supportive practice setting in which role responsibilities are understood by all members of the caregiver team would promote nurse retention.
  
  
  CONCLUSIONS
  Stable nurse staffing and adequate managerial support are essential to promote job satisfaction and high-quality patient care.
authors.affiliation: Nursing Human Resources, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada. l.obrien.pallas@utoronto.ca
authors.forename: Linda
authors.initials: L
authors.lastname: O'Brien-Pallas
authors.forename: Gail Tomblin
authors.initials: GT
authors.lastname: Murphy
authors.forename: Judith
authors.initials: J
authors.lastname: Shamian
authors.forename: Xiaoqiang
authors.initials: X
authors.lastname: Li
authors.forename: Laureen J
authors.initials: LJ
authors.lastname: Hayes
mesh_terms: D000328:Adult; D002170:Canada; D005260:Female; D006302:Health Services Research; D006305:Health Status Indicators; D006801:Humans; D007588:Job Satisfaction; D007857:Leadership; D016014:Linear Models; D008297:Male; D008603:Mental Health; D015399:Nursing Research; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D010563:Personnel Turnover / Q000706:statistics & numerical data*; D013315:Stress, Psychological / Q000517:prevention & control