Improving retention rates of early career nurses • City St George's, University of London

The researchers:

Professor Debra Salmon (Principal Investigator)

Research status:Ongoing

In summary

Researchers from City St George's, University of London are working in partnership with Barts Health NHS Trust to develop a new intervention which aims to improve nurse retention for students and early career nurses.

Nurse turnover and retention had previously been identified as central to the sustainability of the healthcare workforce and delivery of clinical care across the world, recognised as a key issue by the World Health Organisation (WHO).

A critical time for nurses to leave the profession is during the first year after qualification.

The three year project, which is supported by a grant from The Burdett Trust for Nursing and involves Professor Debra Salmon, Judy Brook and Dr Julie MacLaren from the School of Health & Psychological Sciences at City St George's, also hopes to empower students and early career nurses to build professional networks, work effectively within them and embed their sense of connectedness to their employing organisation.

As part of this, the research team aim to identify new and early career nurses at risk of leaving the profession through assessment of social capital and access to professional networks and then work with them to co-produce appropriate interventions.

A review of existing research from across the globe suggests that 6 to 12 month long internship and transition to practice programmes that include teaching and a mentor and/or assessor, may be key to improving retention of nursing students and early career nurses.

Whilst various interventions to reduce turnover and increase retention of nurses have been put into practice in different countries, there has been little understanding of which characteristics of these interventions contribute to their success.

What did we explore and how?

To shed much needed light on the issue academics at City St George's reviewed 53 studies published in the English language, including 48 from the United States, two from Australia, one from Canada, one from the United Kingdom and one from Taiwan.

Led by Professor Debra Salmon, Dean of the School of Health & Psychological Sciences, they looked at a variety of component characteristics of interventions used in the studies, including intervention length, whether teaching or training was involved, whether formal assessment was involved and the impact of these characteristics on nurse turnover and retention outcomes.

This is an important research study, as it is the first to establish through an evidence review the most effective approach to delivering interventions aimed at early career nurse retention.
Understanding how best to structure these interventions is an important finding for healthcare leaders across the sector. This will have important impacts in terms of nurse workforce retention globally, as it will allow health care and education providers to develop training which supports early career nurses to flourish.

– Professor Debra Salmon

Benefits and influence of this research

Whilst the authors of the systematic review acknowledge the wide range of study and reporting types covered, their findings still suggests that promising interventions for early career nurses appear to be:

either internship and residency programmes or transition to practice programmes interventions lasting between 27-52 weeks
contain both a teaching and mentor (and/or preceptor) component
Clinical practice areas should assess their current interventions against these criteria to guide the development of their effectiveness.

They also stress that future research should follow a rigorous methodology and focus on standardising the reporting of both the interventions to reduce turnover and retention themselves and the outcome measures used to evaluate the interventions. Evaluations of cost-effectiveness are also considered an important next step.