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Health Series: Research Spotlight

How do we successfully reduce turnover rates of early career nurses?

Research review suggests that 6 to 12 month long internship and transition to practice programmes may be a cornerstone to retaining nursing students and early career nurses.

by Shamim Quadir (Senior Communications Officer)
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.

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.
Nursing students involved in training session at City, University of London

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.

To shed much needed light on the issue academics at City 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 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.

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.


Judy Brook
, first author of the systematic review, chairing training session with nursing students at City, University of London 

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.

Professor Debra Salmon, Dean of the School of Health Sciences at City, University of London and Principal Investigator of the systematic review said:

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.

The systematic review was published in the International Journal of Nursing Studies, and funded through a grant from the Burdett Trust for Nursing.
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