Kamu Hastanelerinde Çalışan Hemşireleri İşte Tutmayı Etkileyen Faktörler: Sistematik Derleme

Günümüzde, hemşireleri işte tutma konusu sağlık kurumlarında kaliteli bakım hizmetinin sunulması için önemlidir. Bu araştırmada, kamu hastanelerinde çalışan hemşireleri işte tutmayı etkileyen faktörlerin belirlenmesi amaçlanmaktadır. Araştırmada; verileri toplaması, analiz etmesi, yorumlaması ve bulguların sunulmasında sistematik derleme yöntemi kullanılmıştır. İnceleme sonucunda dâhil edilme kriterlerine uygun olan 20 çalışma araştırma kapsamında değerlendirilmiştir. Araştırma kapsamında kamu hastanelerinde çalışan hemşireleri işte tutmayı etkileyen 24 faktör tanımlanmış ve bu faktörler, örgütsel faktörler/ iş ve rol faktörleri/ bireysel faktörler olarak üç tema altında incelenmiştir. Kamu hastanelerinde hemşireyi işte tutmayı en fazla etkilediği vurgulanan örgütsel faktörler örgütsel güçlendirme ve örgütsel kültürdür. İş/rol faktörleri ise iş tatmini, iş-yaşam dengesi ve ücret olarak belirlenmiştir. Kamu hastanelerinde hemşireyi işte tutmayı en çok etkilediği vurgulanan bireysel faktörler hemşirelerin işe karşı tutumu, çalışma süresi ve eğitimdir. Kamu hastanelerinde çalışan hemşireleri işte tutmayı etkileyen faktörler çok yönlüdür ve bu faktörler örneklem yetersizliği ve iş ortamına bağlı birtakım kısıtlılıklar nedeniyle iyi anlaşılmamakta ve yeterli uygulama alanlarında incelenememektedir. Kamuda çalışan hemşireleri işte tutmayı etkileyen faktörleri inceleyen bu araştırmada elde edilen bulgular, konuya ilişkin bütüncül bir bakış açısı sunarak ileride yapılacak olan çalışmalara rehber olacağı düşünülmektedir.

The Factors Affecting the Retention of Nurses in Public Hospitals: A Systematic Review

Nowadays, the retention of nurses in healthcare facilities is essential for maintaining quality nursing care. This study aimed to assess factors influencing the retention of nurses in public hospitals. The systematic review method was used for data collection, analysis, interpretation, and presentation of findings in this study to assess factors influencing the retention of nurses in public hospitals. As a result of the review, 20 publications that meet the inclusion criteria have been evaluated within the scope of the research. The study identified 24 factors that affected the retention of nurses in public hospitals and examined these factors as organizational factors/business and role factors/individual factors under three themes. The organizational factors emphasized that organizational empowerment and organizational culture were the most influencing the retention of nurses in public hospitals. Business/role factors are determined as work satisfaction, work-life balance, and fee. The individual factors emphasized that the most influencing the retention of nurses in public hospitals found as attitude towards work, working time, and education. The factors affecting nurse retention in public hospitals are versatile, and these factors are not well understood and examined in sufficient areas of practice due to a lack of sampling and some restrictions associated with the work environment. The findings of this research, which study factors affecting nurse retention in public hospitals, guide future studies by providing a holistic perspective on this issue.

___

  • Agrawal, V., Berlin, B., Grote, K., & Scheidler, G. (2012). Creating and sustaining change in nursing care delivery. Health International, 12, 52-63.
  • Aiken, L. H., Cerón, C., Simonetti, M., Lake, E. T., Galiano, A., Garbarini, A., ... & Smith, H. L. (2018). Hospital nurse staffing and patient outcomes. Revista Médica Clínica Las Condes, 29(3), 322-327.
  • Al Sabei, S. D., Labrague, L. J., Miner Ross, A., Karkada, S., Albashayreh, A., Al Masroori, F., & Al Hashmi, N. (2020). Nursing work environment, turnover intention, job burnout, and quality of care: The moderating role of job satisfaction. Journal of Nursing Scholarship, 52(1), 95-104. https://doi.org/10.1111/jnu.12528.
  • Anis, A., Rehman, H., Khan, M. A., & Humayoun, A. A. (2011). Impact of organizational commitment on job satisfaction and employee retention in pharmaceutical industry. African Journal of Business Management, 5(17), 7316. https://doi.org/10.5897/AJBM10.1296.
  • Balakrishnan, G., & Coetzee, D. (2013). Predicting student retention in massive open online courses using hidden markov models. Electrical Engineering and Computer Sciences University of California at Berkeley, 53, 57-58.
  • Barney, S.M. (2002). The nursing shortage: why is it happening?. Journal of Healthcare Management, 47(3),153-155.
  • Brown, L.K., Schultz, J.R., Forsberg, A.D., King, G., Kocik, S.M., & Butler, R.B. (2002). Predictors of Retention among HIV/Haemophilia Health Care Professionals. General Hospital Psychiatry, 24, 48-54. http://dx.doi.org/10.1016/S0163-8343(01)00172-4
  • Brunetto, Y., Shacklock, K., Bartram, T., Leggat, S. G., Farr-Wharton, R., Stanton, P., & Casimir, G. (2012). Comparing the impact of leader–member exchange, psychological empowerment and affective commitment upon Australian public and private sector nurses: implications for retention. The International Journal of Human Resource Management, 23(11), 2238-2255. https://doi.org/10.1080/09585192.2011.616524.
  • Brunetto, Y., Xerri, M., Shriberg, A., Farr‐Wharton, R., Shacklock, K., Newman, S., & Dienger, J. (2013). The impact of workplace relationships on engagement, well‐being, commitment and turnover for nurses in Australia and the USA. Journal of advanced nursing, 69(12), 2786-2799. https://doi.org/10.1111/jan.12165.
  • Buchan, J., & Aiken, L. (2008). Solving nursing shortages: a common priority. Journal of clinical nursing, 17(24), 3262-3268. https://doi.org/10.1111/j.1365-2702.2008.02636.x.
  • Cangelosi, J. D., Markham, F. S., & Bounds, W. T. (1998). Factors related to nurse retention and turnover: an updated study. Health Marketing Quarterly, 15(3), 25-43. https://doi.org/10.1300/J026v15n03_02.
  • Chen, M. F., Ho, C. H., Lin, C. F., Chung, M. H., Chao, W. C., Chou, H. L., & Li, C. K. (2016). Organisation‐based self‐esteem mediates the effects of social support and job satisfaction on intention to stay in nurses. Journal of nursing management, 24(1), 88-96.
  • Das, B. L., & Baruah, M. (2013). Employee retention: A review of literature. Journal of business and management, 14(2), 8-16.
  • de Oliveira, D. R., Griep, R. H., Portela, L. F., & Rotenberg, L. (2017). Intention to leave profession, psychosocial environment and self-rated health among registered nurses from large hospitals in Brazil: a cross-sectional study. BMC health services research, 17, 1-10. https://doi.org/10.1186/s12913-016-1949-6.
  • Denton, J. W. (2000). Using Web-based projects in a systems design and development course. Journal of Computer Information Systems, 40(3), 84-87.
  • dit Dariel, O. P., & Regnaux, J. P. (2015). Do Magnet®-accredited hospitals show improvements in nurse and patient outcomes compared to non-Magnet hospitals: a systematic review. JBI Evidence Synthesis, 13(6), 168-219.
  • Drennan, V. M., Halter, M., Gale, J., & Harris, R. (2016). Retaining nurses in metropolitan areas: insights from senior nurse and human resource managers. Journal of Nursing Management, 24(8), 1041-1048. https://doi.org/10.1111/jonm.12402.
  • El-Jardali, F., Alameddine, M., Jamal, D., Dimassi, H., Dumit, N. Y., McEwen, M. K., Jaafar, M., & Murray, S. F. (2013). A national study on nurses’ retention in healthcare facilities in underserved areas in Lebanon. Human resources for health, 11, 1-13. https://doi.org/10.1186/1478-4491-11-49.
  • Eslami, J., & Gharakhani, D. (2012). Organizational commitment and job satisfaction. ARPN journal of science and technology, 2(2), 85-91.
  • Fitz-enz, J. (1990). Getting and Keeping Good Employees. In Personnel, 67, 25-29.
  • Galbany-Estragués, P., & Nelson, S. (2016). Migration of Spanish nurses 2009–2014. Underemployment and surplus production of Spanish nurses and mobility among Spanish registered nurses: A case study. International Journal of Nursing Studies, 63, 112-123. https://doi.org/10.1016/j.ijnurstu.2016.08.013.
  • Hamdan, M., & Hamra, A. (2015). Workplace violence towards workers in the emergency departments of Palestinian hospitals: a cross-sectional study. Human resources for health, 13(1), 1-9. https://doi.org/10.1186/s12960-015-0018-2.
  • Hamid, S., Malik, A. U., Kamran, I., & Ramzan, M. (2014). Job satisfaction among nurses working in the private and public sectors: a qualitative study in tertiary care hospitals in Pakistan. Journal of multidisciplinary healthcare, 7,25-35. https://doi.org/10.2147/JMDH.S55077.
  • Hämmig, O. (2018). Explaining burnout and the intention to leave the profession among health professionals–a cross-sectional study in a hospital setting in Switzerland. BMC health services research, 18(1), 1-11. https://doi.org/10.1186/s12913-018-3556-1.
  • Handley, M., Bunn, F., & Goodman, C. (2019). Supporting general hospital staff to provide dementia sensitive care: A realist evaluation. International journal of nursing studies, 96, 61-71. https://doi.org/10.1016/j.ijnurstu.2018.10.004.
  • Hayes, L. J., O’Brien-Pallas, L., Duffield, C., Shamian, J., Buchan, J., Hughes, F., ... & Stone, P. W. (2006). Nurse turnover: a literature review. International journal of nursing studies, 43(2), 237-263. https://doi.org/10.1016/j.ijnurstu.2005.02.007.
  • Heidari, M., Seifi, B., & Gharebagh, Z. A. (2017). Nursing staff retention: Effective factors. Annals of Tropical Medicine and Public Health, 10(6), 1467-1473.
  • Hirohara, M., Ozaki, A., & Tsubokura, M. (2019). Determinants and supporting factors for rebuilding nursing workforce in a post-disaster setting. BMC health services research, 19(1), 1-10. https://doi.org/10.1186/s12913-019-4765-y.
  • Holzer, H. J., & Wissoker, D. (2001). How Can We Encourage Job Retention for Welfare Recipients. The Urban Institute Series No. A-49, October.
  • Hunt, D. (2014). Does value congruence between nurses and supervisors effect job satisfaction and turnover?. Journal of nursing management, 22(5), 572-582. https://doi.org/10.1111/jonm.12055.
  • Jones, C. B., & Michael Gates, R. N. (2007). The costs and benefits of nurse turnover: A business case for nurse retention. Online Journal of Issues in Nursing, 12(3), 1-12.
  • Karaçam, Z. (2013). Sistematik derleme metodolojisi: Sistematik derleme hazırlamak için bir rehber. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi, 6(1), 26-33. https://dergipark.org.tr/en/pub/deuhfed/issue/46815/587078.
  • Karsh, B., Booske, B. C., & Sainfort, F. (2005). Job and organizational determinants of nursing home employee commitment, job satisfaction and intent to turnover. Ergonomics, 48(10), 1260-1281. https://doi.org/10.1080/00140130500197195.
  • Kaya, N., Babadağ, K., Yeşiltepe, Kaçar, G., & Uygur, E. (2010). Hemşirelerin Hemşirelik Model/Kuramlarını, Hemşirelik Sürecini ve Sınıflama Sistemlerini Bilme ve Uygulama Durumları. Maltepe Üniversitesi Hemşirelik Bilim ve Sanatı Dergisi, 3(3), 24-33.
  • Kleinman, C. (2004). The relationship between managerial leadership behaviors and staff nurse retention. Hospital topics, 82(4), 2-9. https://doi.org/10.3200/HTPS.82.4.2-9.
  • Kyndt, E., Dochy, F., Michielsen, M., & Moeyaert, B. (2009). Employee retention: Organisational and personal perspectives. Vocations and Learning, 2, 195-215.
  • Lankshear, A. J., Sheldon, T. A., & Maynard, A. (2005). Nurse staffing and healthcare outcomes: a systematic review of the international research evidence. Advances in nursing science, 28(2), 163-174.
  • Lavieri, M. S., & Puterman, M. L. (2009). Optimizing nursing human resource planning in British Columbia. Health care management science, 12, 119-128. https://doi.org/10.1007/s10729-008-9097-0.
  • Lee, H. O. W., & Cummings, G. G. (2008). Factors influencing job satisfaction of front line nurse managers: a systematic review. Journal of nursing management, 16(7), 768-783. https://doi.org/10.1111/j.1365-2834.2008.00879.x.
  • Levine, C. (2002). Hospital-based family caregiver programs: building institutional resources and community ties. Journal of Palliative Medicine, 5(1), 175-179.
  • Li, J., Fu, H., Hu, Y., Shang, L. I., Wu, Y., Kristensen, T. S., ... & Hasselhorn, H. M. (2010). Psychosocial work environment and intention to leave the nursing profession: results from the longitudinal Chinese NEXT study. Scandinavian journal of public health, 38(3), 69-80. https://doi.org/10.1177/1403494809354361.
  • Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job burnout. Annual review of psychology, 52(1), 397-422.
  • Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & Prisma Group. (2009). Reprint—preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Physical therapy, 89(9), 873-880. https://doi.org/10.1093/ptj/89.9.873.
  • Mokoka, E., Oosthuizen, M. J., & Ehlers, V. J. (2010). Retaining professional nurses in South Africa: Nurse managers' perspectives. Health SA Gesondheid, 15(1), 1-9. https://doi.org/10.4102/hsag.v15i1.484.
  • Moody, L. E. (1990). Advancing Nursing Science Through Research. Newbury Park, Sage Company.
  • Mor Barak, M. E., Nissly, J. A., & Levin, A. (2001). Antecedents to retention and turnover among child welfare, social work, and other human service employees: What can we learn from past research? A review and metanalysis. Social service review, 75(4), 625-661. https://doi.org/10.1086/323166.
  • Muller, M. (2009). Nursing Dynamics.4th ed. Johannesburg, Heinemann.
  • Naqvi, S. M. M. R., & Bashir, S. (2015). IT-Expert Retention through Organizational Commitment: A Study of Public Sector Information Technology Professionals in Pakistan. Applied Computing and Informatics, 11, 60-75. http://dx.doi.org/10.1016/j.aci.2011.11.001.
  • Nejati, A., Rodiek, S., & Shepley, M. (2016). The implications of high‐quality staff break areas for nurses’ health, performance, job satisfaction and retention. Journal of nursing management, 24(4), 512-523. https://doi.org/10.1111/jonm.12351.
  • Nyikuri, M., Kumar, P., English, M., & Jones, C. (2020). “I train and mentor, they take them”: A qualitative study of nurses' perspectives of neonatal nursing expertise and its development in Kenyan hospitals. Nursing Open, 7(3), 711-719. https://doi.org/10.1002/nop2.442.
  • Osteraker, M. C. (1999). Measuring motivation in a learning organization. Journal of workplace Learning, 11(2), 73-77.
  • Oulton, J. A. (2006). The global nursing shortage: an overview of issues and actions. Policy, Politics, & Nursing Practice, 7(3), 34S-39S.
  • Parveen, M., Maimani, K., & Kassim, N. M. (2017). Quality of work life: The determinants of job satisfaction and job retention among RNs and OHPs. International Journal for Quality Research, 11(1), 173. https://doi.org/10.18421/IJQR11.01-11.
  • Pillay, R. (2009). Work satisfaction of professional nurses in South Africa: a comparative analysis of the public and private sectors. Human resources for Health, 7(1), 1-10. https://doi.org/10.1186/1478-4491-7-15.
  • Price, J. L., & Mueller, C. W. (1981). A causal model of turnover for nurses. Academy of management journal, 24(3), 543-565. https://doi.org/10.5465/255574.
  • Reggio, E., A., (2003). Introduction to Industrial/Organizational Psychology (4th Ed.). Prentice Hall, New Jersey
  • Rispel, L. C., Chirwa, T., & Blaauw, D. (2014). Does moonlighting influence South African nurses’ intention to leave their primary jobs?. Global health action, 7(1), 25754. https://doi.org/10.3402/gha.v7.25754.
  • Rodwell, J., Brunetto, Y., Demir, D., Shacklock, K., & Farr‐Wharton, R. (2014). Abusive supervision and links to nurse intentions to quit. Journal of Nursing Scholarship, 46(5), 357-365. https://doi.org/10.1111/jnu.12089.
  • Sasso, L., Bagnasco, A., Catania, G., Zanini, M., Aleo, G., Watson, R., & RN4CAST@ IT Working Group. (2019). Push and pull factors of nurses' intention to leave. Journal of nursing management, 27(5), 946-954. https://doi.org/10.1111/jonm.12745.
  • Shoaib, M., Noor, A., Tirmizi, S. R., & Bashir, S. (2009). Determinants of employee retention in telecom sector of Pakistan. Proceedings of the 2nd CBRC, Lahore, Pakistan, 14(1), 1-18.
  • Sillero-Sillero, A., & Zabalegui, A. (2020). Analysis of the work environment and intention operioperative nurses to quit work. Revista latino-americana de enfermagem, 28,e3256. https://doi.org/10.1590/1518-8345.3239.3256.
  • Sillero, A., & Zabalegui, A. (2018). Organizational factors and burnout of perioperative nurses. Clinical practice and epidemiology in mental health: CP & EMH, 14,132-142.
  • Spence Laschinger, H. K., Leiter, M., Day, A., & Gilin, D. (2009). Workplace empowerment, incivility, and burnout: Impact on staff nurse recruitment and retention outcomes. Journal of nursing management, 17(3), 302-311. https://doi.org/10.1111/j.1365-2834.2009.00999.x.
  • Takase, M., Teraoka, S., & Yabase, K. (2016). Retaining the nursing workforce: Factors contributing to the reduction of nurses' turnover intention in Japan. Journal of nursing management, 24(1), 21-29.
  • Torgerson, C. (2003). Systematic reviews. Bloomsbury Publishing. New York.
  • Vahey, D. C., Aiken, L. H., Sloane, D. M., Clarke, S. P., & Vargas, D. (2004). Nurse burnout and patient satisfaction. Medical care, 42(2 Suppl), II57. https://doi.org/10.1097/01.mlr.0000109126.50398.5a.
  • Van der Heed, K., & Aiken, L.H. (2013). Nursing workforce a global priority area for health policy and health services research: a special issue. Int. J. Nurs Stud., 50,141–142.
  • Walker, J.W. (2001). Zero Defections?. Human Resource Planning, 24, 6-8.
  • Wang, Y., & Yuan, H. (2018). What is behind high turnover: a questionnaire survey of hospital nursing care workers in Shanghai, China. BMC Health Services Research, 18(1), 1-7. https://doi.org/10.1186/s12913-018-3281-9.
  • World Health Organisation (WHO) (2017). Global Strategy on Human Resources for Health: Workforce 2030. https://apps.who.int/gb/ebwha/pdf_files/WHA69/A69_R19-en.pdf?ua=1&ua=1. adresinden 25.05.2023 tarihinde alınmıştır.