Factors influencing nurses' intentions to leave adult critical care settings

Nadeem Khan; Debra Jackson; Louise Stayt; Helen Walthall

doi:10.1111/nicc.12348

Factors influencing nurses' intentions to leave adult critical care settings

Nurs Crit Care. 2019 Jan;24(1):24-32. doi: 10.1111/nicc.12348. Epub 2018 Apr 10.

Authors

Nadeem Khan¹, Debra Jackson^{2

3

4}, Louise Stayt⁵, Helen Walthall⁶

Affiliations

¹ Oxford Institute of Nursing, Midwifery and Allied Health Research (OxINMAHR), Oxford Brookes University and Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
² Oxford Institute of Nursing, Midwifery & Allied Health Research (OxINMAHR); Principal Fellow, Oxford Biomedical Research Centre; Associate Chief Nurse (Research), Oxford University Hospitals NHS Foundation Trust; Professor of Nursing Research, Faculty of Health & Life Sciences, Oxford Brookes University, Oxford, UK.
³ University of Technology, Sydney, Australia.
⁴ Oxford Health NHS Foundation Trust; Visiting Professor, Health Education England, Thames Valley, UK.
⁵ Oxford Brookes University, Oxford, UK.
⁶ Department of Nursing, Oxford Brookes University, Oxford, UK.

PMID: 29635820
DOI: 10.1111/nicc.12348

Abstract

Background: The shortage of critical care and specialist nurses has been an ongoing issue for many decades. Although all areas of nursing are affected, critical care areas are especially vulnerable to recruitment and retention problems. High nursing turnover in critical care areas is evident; however, research into the factors that influence nurses' intentions to leave adult critical care areas is limited.

Aim: To explore factors that may influence nurses' intentions to leave adult critical care areas.

Objectives: To appraise existing evidence and highlight gaps in knowledge regarding factors that may influence nurses' intentions to leave adult critical care areas.

Methods: A systematic mixed-method literature review was conducted. The search strategy was developed using the List, Keep and Delete approach, a framework used to identify search terms for systematic health care reviews. The following key words were used: intentions to leave, nurses, adult and critical care. The databases searched were BNI, CINAHL, PubMed, PsycINFO, Embase and Health B Elite from 2005 to 2016. Primary data from non-critical care areas and neonatal and paediatric critical care areas were excluded. Comprehensive supplementary searching was performed. Papers were critically appraised using the NICE (2012) checklists. Data were analysed using the Braun and Clarke (2006) thematic framework.

Results: A total of 15 studies, including 13 cross-sectional studies and 2 qualitative studies, were reviewed. Three main themes emerged following data analysis. These themes were quality of the work environment, nature of working relationships and traumatic/stressful workplace experiences.

Conclusions: The literature review highlighted the need for further research and greater understanding of how these themes may impact critical care nurses. Nurse managers and leaders should consider these findings when developing strategies to improve nurse retention.

Relevance to practice: The shortage of critical care nurses is currently a global issue impacting costs and quality of patient care.

Keywords: Adult; Critical care; Factors; Intentions to leave; Nurses.

Publication types

Review

MeSH terms

Adult
Critical Care Nursing / trends*
Humans
Intention*
Job Satisfaction
Nursing Staff, Hospital / supply & distribution
Personnel Turnover / trends*
Qualitative Research
Workplace / psychology*