Effective strategies for nurse retention in acute hospitals: a mixed method study.
BACKGROUND
The realization of an organizational context that succeeds to retain nurses within their job is one of the most effective strategies of dealing with nursing shortages.


OBJECTIVE
First, to examine the impact of nursing practice environments, nurse staffing and nurse education on nurse reported intention to leave the hospital. Second, to provide understanding of which best practices in the organization of nursing care are being implemented to provide sound practice environments and to retain nurses.


METHODS
3186 bedside nurses of 272 randomly selected nursing units in 56 Belgian acute hospitals were surveyed. A GEE logistic regression analysis was used to estimate the impact of organization of nursing care on nurse reported intention to leave controlling for differences in region (Walloon, Flanders, and Brussels), hospital characteristics (technology level, teaching status, and size) and nurse characteristics (experience, gender, and age). For the second objective, in-depth semi-structured interviews with the chief nursing officers of the three high and three low performing hospitals on reported intention to leave were held.


RESULTS
29.5% of Belgian nurses have an intention-to-leave the hospital. Patient-to-nurse staffing ratios and nurse work environments are significantly (p<0.05) associated with intention-to-leave. Interviews with Chief Nurse Officers revealed that high performing hospitals showing low nurse retention were--in contrast to the low performing hospitals--characterized by a flat organization structure with a participative management style, structured education programs and career opportunities for nurses.


CONCLUSIONS
This study, together with the international body of evidence, suggests that investing in improved nursing work environments is a key strategy to retain nurses.
Center for Health Service and Nursing Research, Katholieke Universiteit Leuven, Leuven, Belgium. koen.vandenheede@med.kuleuven.be
Koen
K
Van den Heede
Mieke
M
Florquin
Luk
L
Bruyneel
Linda
L
Aiken
Luwis
L
Diya
Emmanuel
E
Lesaffre
Walter
W
Sermeus
D001530:Belgium; D006801:Humans; D007857:Leadership; D016015:Logistic Models; D009741:Nursing Staff, Hospital / Q000523:psychology; D010558:Personnel Loyalty