Table 2 General characteristics of the included systematic reviews

Chan et al. (2013) [41]

To examine and describe the published empirical research on nurses’ intention to leave their current employment or the profession.

P

RNs working in non-specialty wards

International (by USA)

Total number

31

The reasons for nurses’ intention to leave are complex and influenced by many factors, categorised as individual and organizational factors. Individual factors are job satisfaction, burnout and demographic factors, whereas organizational factors comprise work environment, culture, commitment, work demands and social support. This review indicates that job satisfaction is the most influential.

I

determinants (aspects, factors)

2001–2010

Quantitative

29

C

Not stated

English

Experimental (quasi)

–

O

Intention to leave

Observational

29

S

All types of peer-reviewed primary studies (no literature reviews, dissertations)

Qualitative

–

Mix-Methods

–

Other

2

Coomber & Barriball (2007) [48]

To explore the impact of job satisfaction components on intent to leave and turnover for hospital-based nurses.

P

Hospital nurses

International (by UK)

Total number

9

From the four themes discussed, three were organisational factors (leadership, stress and pay) and only one an individual/ demographic factor (educational attainment).

I

determinants

1997–2004

Quantitative

6

The empirical evidence shows that stress and issues concerning leadership consistently exert both direct and indirect effects on job satisfaction and intent to leave

C

Not stated

Not stated

Experimental (quasi)

–

O

intent to leave/turnover

Observational

6

S

Primary and secondary research (no literature reviews)

Qualitative

3

Mix-Methods

–

Cowden et al. (2011) [46]

To examine the relationship between managers’ leadership practices and staff nurses’ intent to stay in or to leave their current position.

P

Staff nurses and their managers

International (by Canada)

Total number

23

The findings of the present study support a positive relationship between transformational leadership, supportive work environments and staff nurses intent to remain in their current position. Stated intentions to stay are strongly predictive of retention and turnover. Relational leadership styles attentive to the individual needs of the nurse promote staff nurses intentions to stay.

I

determinants

1985–2010

Quantitative

22

C

Non stated

English

Experimental (quasi)

–

O

Intention to stay (behavioural intention)

Observational

22

S

Peer-reviewed qualitative or quantitative studies

Qualitative

–

Mix-Methods

1

Other

–

D’Ambra & Andrews (2014) [42]

To determine the impact of incivility as experienced by new graduate nurse and negative effect of incivility on retention and patient care, and identify current organisational strategies suggested by that literature to mitigate the occurrence of incivility.

P

Newly graduated RNs

International (by USA)

Total number

16

The reasons for nurses’ intention to leave are complex and influenced by many factors, categorised as individual and organizational factors. Individual factors are job satisfaction, burnout and demographic factors, whereas organizational factors comprise work environment, culture, commitment, work demands and social support. This review indicates that job satisfaction is the most influential.

I

Interventions to reduce workplace incivility

2002–2012

Quantitative

3

C

–

English

Experimental (quasi)

–

O

Recommended

Observational

3

S

All types of peer-reviewed primary studies (no literature reviews, dissertations)

Qualitative

2

Mix-Methods

–

Other

11^

Flinkman et al. (2010) [11]

To review and critique the published empirical research on nurses’ intention to leave the profession

P

RNs or nurses with different educational background

International (by Finland)

Total number

31

A number of variables influencing nurses’ intention to leave the profession were identified, including demographic, work-related and individual-related variables. The proportion of nurses considering or intending to leave the profession varied considerably across studies.

I

Determinants

1995-Jul 2009

Quantitative

31

The timeframe for leaving intention also varied

C

Not stated

English, Swedish, Finnish

Experimental (quasi)

–

O

Intention to leave

Observational

31

Nurses’ retention

Qualitative

–

S

Not stated (no editorials, opinions or discussions)

Mix-Methods

–

Other

–

Li & Jones (2013) [43]

To describe the conceptualization of nurse turnover, to evaluate the methodologies and calculation of costs in those studies, to identify the range of nurse turnover costs reported in the literature and offer suggestions for future study.

P

Any type of nursing staff member

International (by USA)

Total number

10

Nurse turnover is costly for health-care organizations, as these costs must be paid using organizational resources and accounted for in organizational budgets. The costs of per nurse turnover ranged from $10,098 to $88,000. The ratio of nurse turnover costs relative to nurses’ salary ranged from 0.31 to 1.3. The total turnover costs also ranged from $0.55 million to $8.5 million.

I

Consequences

1990–2010

Quantitative

10

C

Not stated

English

Experimental (quasi)

–

O

Organisation: turnover costs

Observational

10

S

Not stated

Qualitative

–

Mix-Methods

–

Other

–

Schluter et al. (2008) [45]

Does unresolved moral distress and poor organizational ethical climate increase nurse turnover?

P

Predominantly nurses in hospital settings

International (by Australia)

Total number

9

There are a number of published articles characterized by loosely defined terms implying that poor ethical climate causes nurses to leave the profession. A systematic appraisal of these articles reveals that, …, it is not rigorously substantiated by the data presented

I

determinants

1980–2007

Quantitative

6

C

Not stated

English

Experimental (quasi)

–

O

Nurse turnover

Observational

6

S

Qualitative / quantitative primary studies (no theoretical or discussion-based articles)

Qualitative

3

Mix-Methods

–

Other

–

Toh et al. (2012) [47]

The aim of this review was to establish the best available evidence regarding the relationship between the nursing shortage and nurses’ job satisfaction, stress and burnout levels in oncology/haematology settings.

P

RNs at inpatient and outpatient oncology/ haematology units, wards or healthcare facilities

International (by Singapore)

Total number

7

RNs suffered from job satisfaction, stress and burnout, which ultimately led to them leaving the specialty (oncology) or profession.

I

Determinants

1990–2010

Quantitative

7

C

Not stated

English

Experimental (quasi)

–

O

Intention to leave current nursing position

Observational

7

S

Not stated

Qualitative

–

Mix-Methods

–

Other

–

Wagner (2007) [44]

(1) What is the predictability of organizational commitment as a variable in nursing turnover studies, (2) how do organizational commitment and job satisfaction compare as predictor variables in nursing turnover studies and (3) what is the usefulness of organizational commitment in nursing turnover research?

P

Nurses

International (by USA)

Total number

23

Organizational commitment had statistically significant predictive ability in the 23 nursing turnover studies; but only 5 studies substantiated this as direct relationship. The research revealed that when using mediator variables such as intent to leave or intent to remain in turnover studies, organizational commitment is a highly desirable component. Finally, the literature demonstrated that organizational commitment is a stronger predictor of nursing turnover than is job satisfaction.

I

Determinants

1960–2006

Quantitative

23

C

–

English

Experimental (quasi)

–

O

Turnover

Observational

23

Intent to leave or intent to remain

Qualitative

–

S

Primary studies (type not stated)

Mix-Methods

–

Other

–