Construction Of Predicting Models On Turnover Intention For Clinical Nurses

[Objectives]1.To investigate the turnover status quo of nurse in Nanjing;2.To assess the intention of turnover about clinical nurses,the environment of nursing practice,the job satisfaction,job burnout and organization commitment in 3-level general hospitals;3.To explore the influence of social demography,nursing practice environment,job satisfaction,job burnout,organizational commitment on nurses' turnover intention(the tendency to leave the ward,work unite and nursing profession)and establish the corresponding prediction models;4.To provide theory basis for managers to develop effective intervention strategies and stabilize nursing group.[Method]The study includes two parts.The first part adopts the purpose sampling method,and makes survey and analysis of turnover status quo of nurse of five 3-level general hospitals in Nanjing from 2010 to 2015 by self-designed questionnaire,to understand the distribution characteristics of turnover nurse.In the second part,based on the survey results and literature review,the prediction model of clinical nurse was constructed.A multi-stage cluster sampling method was used and the questionnaire surveys were conducted on 437 clinical nurses chosen from 24 wards consisting of each ward of departments of internal medicine,surgery,gynecology,pediatrics,emergency and intensive care unit.The questionnaire consisted of six parts:the General Information Questionnaire,the Nursing Work Index-Revised Scale,the McClokey/Mueller satisfaction Scale,the Maslach burnout inventoryScale,the Organization Commitment Questionnaire and thethree-ITL-type Scale.SPSS 18.0 software was adopted to make statistical analysis of survey results on the general data of clinical nurses,turnover intention,nursing practice environment,job satisfaction,job burnout and organizational commitment by some methods such as descriptive statistical analysis,t test,variance analysis,Pearson correlation analysis,multivariate order logistic regression and so on.[Result]The survey results of first part:the total number of turnover nurses is 619 and the turnover rate of each hospital is 1.29%,1.81%,1.93%,2.05%,2.13%and 2.14%,respectively.The turnover rate of women has the biggest share,97.75%.The turnover rate of nurses aged from 25 to 30 accounts for 51.3%and the turnover rate of nurses with 1-5 working years is 63.49%.In terms of diploma,51.2%of turnover nurses are college diploma.In terms of technical title,most are primary and departments that high turnover rate occurred in mainly focused on ones with high job stress and working strength.The survey results of second parts:1.Descriptive analysis:the average score about turnover intention of clinical nurses in Nanjing is 2.053±0.61.The average score about tendency of leaving nursing profession,work unite and ward is 2.35±0.10,1.76±0.78,2.05±0.94,respectively.The score about the perception of nursing practice environment,nursing job satisfaction,job burnout and organization commitment is 3.11±0.51,3.68±0.7,19.99±5.41,3.33±0.90,respectively.2.Univariate factor analysis:the difference of turnover tendency exists in different age,work years,department,position and title and the effect of overtime hours per week on tendency of nurse turnover is statistically significant(P<0.05).The relationship between the intention of nurse turnover,each dimension and the perception of nursing practice environment,job satisfaction,affective and normative commitment shows significantly negative correlation(P<0.01),meanwhile,it shows positive correlation when it refers to job burnout and continuous commitment(P<0.01).3.Ordinal logistic regression analysis:the Emotional exhaustion,job control and continuous commitment exert a significant effect on the tendency to leave the nursing profession(P<0.05).Emotional exhaustion,depersonalization,familyand work balance,affective commitment,continuous commitment,age and overtime hour strongly influence the tendency to leave work unite(P<0.05).The Emotional exhaustion,depersonalization,involving in hospital management,benefits,affective commitment and continuous commitment turn a strong effect on the tendency to leave ward(P<0.05).[Conclusion]1.The rate of nursing turnover shows increasing tendency in Nanjing.The majority of turnover nurses belong to low qualification and young junior nurses and another phenomenon appears that the number of turnover nurses with high diploma and title also increase gradually.The nurses who work in the department of high work stress and strength possess an obvious tendency to leave their department.2 In words,nursing practice environment of clinical nurses is relatively poor,the level of job satisfaction is low,the level of job turnout is high,the level of organization commitment and the intention of nurse turnover are middle.3.The intention of turnover and each dimension have correlation with age,work years,diploma,title,position,department,overtime hour per week,nursing practice environment,job satisfaction,job burnout and organization commitment.4.Emotional exhaustion,work control and continuous commitment are major predictive factors causing clinical nurses toleave nursing profession.Emotional exhaustion,depersonalization,work andfamily balance,affective commitment,continuous commitment,age and overtime hour are major predictive factors propelling clinical nurses to leave work unite.TheEmotional exhaustion,depersonalization,overtime hour,involving in hospital management,benefits,affective commitment and continuous commitment become major predictors driving clinical nurses to leave ward.