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The determinants and consequences of adult nursing staff turnover: a systematic review of systematic reviews.

Halter, M; Boiko, O; Pelone, F; Beighton, C; Harris, R; Gale, J; Gourlay, S; Drennan, V (2017) The determinants and consequences of adult nursing staff turnover: a systematic review of systematic reviews. BMC Health Serv Res, 17 (1). p. 824. ISSN 1472-6963
SGUL Authors: Drennan, Vari MacDougal

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BACKGROUND: Nurses leaving their jobs and the profession are an issue of international concern, with supply-demand gaps for nurses reported to be widening. There is a large body of existing literature, much of which is already in review form. In order to advance the usefulness of the literature for nurse and human resource managers, we undertook an overview (review of systematic reviews). The aim of the overview was to identify high quality evidence of the determinants and consequences of turnover in adult nursing. METHODS: Reviews were identified which were published between 1990 and January 2015 in English using electronic databases (the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Applied Social Sciences Index and Abstracts, CINAHL plus and SCOPUS) and forward searching. All stages of the review were conducted in parallel by two reviewers. Reviews were quality appraised using the Assessment of Multiple Systematic Reviews and their findings narratively synthesised. RESULTS: Nine reviews were included. We found that the current evidence is incomplete and has a number of important limitations. However, a body of moderate quality review evidence does exist giving a picture of multiple determinants of turnover in adult nursing, with - at the individual level - nurse stress and dissatisfaction being important factors and -at the organisational level - managerial style and supervisory support factors holding most weight. The consequences of turnover are only described in economic terms, but are considered significant. CONCLUSIONS: In making a quality assessment of the review as well as considering the quality of the included primary studies and specificity in the outcomes they measure, the overview found that the evidence is not as definitive as previously presented from individual reviews. Further research is required, of rigorous research design, whether quantitative or qualitative, particularly against the outcome of actual turnover as opposed to intention to leave. TRIAL REGISTRATION: PROSPERO Registration 17 March 2015: CRD42015017613 .

Item Type: Article
Additional Information: © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
Keywords: Consequences, Determinants, Nurses, Nursing staff, Personnel turnover, Research design (data quality, data reporting), Review, systematic, Workforce, Health Policy & Services, 1117 Public Health And Health Services, 0807 Library And Information Studies
Journal or Publication Title: BMC Health Serv Res
ISSN: 1472-6963
Language: eng
15 December 2017Published
7 November 2017Accepted
Publisher License: Creative Commons: Attribution 4.0
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PubMed ID: 29246221
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