The effect of nurse manager turnover on patient fall and pressure ulcer rates
Article first published online: 18 JUL 2013
© 2013 John Wiley & Sons Ltd
Journal of Nursing Management
Special Issue: This issue: Nursing leadership and patient outcomes Issue editor: Greta G. Cummings
Volume 21, Issue 5, pages 725–732, July 2013
How to Cite
2013) Journal of Nursing Management 21, 725–732 The effect of nurse manager turnover on patient fall and pressure ulcer rates, , & (
- Issue published online: 18 JUL 2013
- Article first published online: 18 JUL 2013
- Manuscript Accepted: 27 MAR 2013
- College of Nursing at the University of Kentucky
- nurse manager;
- patient falls;
- pressure ulcers;
The purpose of this study was to explore the effects of nurse manager turnover on the occurrence of adverse events.
Nurse managers create professional nurse practice environments to support the provision of quality patient outcomes. Inconsistent findings were reported in the literature testing the relationship between nurse managers and patient outcomes. All prior studies assumed stable nursing management.
A longitudinal quasi-experimental study of 23 nursing units in two hospitals was used to determine whether unit characteristics, including nurse manager turnover, have an effect on patient falls or pressure ulcers. Statistical analyses included repeated measures and hierarchical modelling.
Patients in medical/surgical units experienced more falls than in intensive care units (F1,11 = 15.9, P = 0.002). Patients in units with a nurse manager turnover [odds ratio: 3.16; 95% confidence interval: 1.49–6.70] and intensive care units (odds ratio: 2.70; 95% confidence interval: 1.33–5.49) were more likely to develop pressure ulcers.
Nurse manager turnover and intensive care unit status were associated with more pressure ulcers. Medical/surgical unit status was associated with more falls. The study was limited by a small sample size.
Implications for nurse managers
Nurse manager turnover may negatively impact patient outcomes. Stable nursing management, strategic interim management and long-term succession planning may reduce adverse patient events.