Nursing practice environment influences on retention and turnover intention: An umbrella review

Abstract

Background The global shortage of nurses impacts the quality of healthcare, especially in the hospital setting. A favourable nursing practice environment is essential for effective care and nurse retention. Favourable environments reduce turnover, while unfavourable ones increase intention to leave. In the current scenario, retaining nurses is crucial for the healthcare services sustainability and the quality of care. Aim Identify systematic reviews that describe the characteristics of the nursing practice environment that contribute to nurse retention or turnover intention in hospitals. Methods An umbrella review was conducted using JBI methodology, and the results were reported following the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Results Sixteen systematic reviews were included, highlighting factors such as nurses' participation in organisational decisions and adequate material and staff resources. Discussion Transformational and supportive leadership strengthens the practice environment, promoting lower turnover rates. The existence of sufficient staff and resources is essential, and collaborative relationships between nurses and doctors also promote retention. Work–life balance emerged as an important factor, with Generation Y being particularly vulnerable to unfavourable work environments. The COVID-19 pandemic has amplified these challenges, increasing the lack of nurses and highlighting the need for more studies in the actual context. Conclusions Innovative strategies that support leadership, staffing, and nurses' involvement in institutional decision-making will be necessary on the part of healthcare organisations to actively address the shortages in nursing. Investing in practice environments may be crucial for the sustainability of healthcare organisations, given the shortage and the characteristics of the current workforce.

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