Nurse turnover in New Zealand: costs and relationships with staffing practises and patient outcomes
Version of Record online: 4 MAY 2012
© 2012 Blackwell Publishing Ltd
Journal of Nursing Management
Special Issue: This issue: Nurses' experience of the working environment Issue editor: Melanie Jasper
Volume 21, Issue 3, pages 419–428, April 2013
How to Cite
NORTH, N., LEUNG, W., ASHTON, T., RASMUSSEN, E., HUGHES, F. and FINLAYSON, M. (2013), Nurse turnover in New Zealand: costs and relationships with staffing practises and patient outcomes. Journal of Nursing Management, 21: 419–428. doi: 10.1111/j.1365-2834.2012.01371.x
- Issue online: 10 APR 2013
- Version of Record online: 4 MAY 2012
- Accepted for publication: 2 December 2011
- health services research;
- nurse turnover;
- staffing practices
Aims To determine the rates and costs of nurse turnover, the relationships with staffing practises, and the impacts on outcomes for nurses and patients.
Background In the context of nursing shortages, information on the rates and costs of nursing turnover can improve nursing staff management and quality of care.
Methods Quantitative and qualitative data were collected prospectively for 12 months. A re-analysis of these data used descriptive statistics and correlational analysis techniques.
Results The cost per registered nurse turnover represents half an average salary. The highest costs were related to temporary cover, followed by productivity loss. Both are associated with adverse patient events. Flexible management of nursing resources (staffing below budgeted levels and reliance on temporary cover), and a reliance on new graduates and international recruitment to replace nurses who left, contributed to turnover and costs.
Conclusions Nurse turnover is embedded in staffing levels and practises, with costs attributable to both. A culture of turnover was found that is inconsistent with nursing as a knowledge workforce.
Implications for nursing management Nurse managers did not challenge flexible staffing practices and high turnover rates. Information on turnover and costs is needed to develop strategies that retain nurses as knowledge-based workers.