title: Investigating the adequacy of the Competence-Turnover Intention Model: how does nursing competence affect nurses' turnover intention?
abstract: OBJECTIVE
  The aim of this study was to test the adequacy of the Competence-Turnover Intention Model, which was developed to identify how nursing competence could affect nurses' turnover intention (nurses' intention to voluntarily leave an organisation).
  
  
  BACKGROUND
  Recent studies have suggested that the level of nursing competence is negatively related to nurses' intention to leave their jobs, suggesting that a lack of competence threatens both the quality and quantity of the nursing workforce. However, the mechanism of how nursing competence affects nurses' turnover intention has not been explored previously.
  
  
  METHODS
  A cross-sectional survey design was used.
  
  
  METHODS
  Surveys were distributed to 1337 Japanese registered nurses/midwives in October, 2013. The adequacy of the model was analysed using structural equation modelling.
  
  
  RESULTS
  In total, 766 questionnaires were returned, with a return rate of 57%. The model fitted well with the data. The results showed that the level of nursing competence was related positively to the quantity of organisational rewards they felt they had received, and negatively related to the level of exhaustion they experienced. Moreover, the perceived organisational rewards and exhaustion were correlated with nurses' turnover intention through affective commitment.
  
  
  CONCLUSIONS
  The Competence-Turnover Intention Model is useful for explaining how nursing competence impacts on their turnover intention.
  
  
  CONCLUSIONS
  Clinical implications derived from the findings are that: promoting nursing competence is key to improving not only the quality of care provided by nurses, but also to retaining the nursing workforce, and the model can be used to develop strategies that would mitigate their turnover intention.
authors.affiliation: Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima City, Hiroshima, Japan.
authors.forename: Miyuki
authors.initials: M
authors.lastname: Takase
authors.forename: Sachiko
authors.initials: S
authors.lastname: Teraoka
authors.forename: Yabase
authors.initials: Y
authors.lastname: Kousuke
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000523:psychology*; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D033182:Intention; D007564:Japan; D007588:Job Satisfaction; D008297:Male; D009741:Nursing Staff, Hospital / Q000523:psychology*; D010563:Personnel Turnover; D012456:Salaries and Fringe Benefits; D011795:Surveys and Questionnaires
keywords: affective organisational commitment; exhaustion; nurses; nursing competence; organisational rewards; turnover intention