Noneconomic and economic impacts of nurse turnover in hospitals: A systematic review.
Sung-Heui Bae
PMID 35654041WHAT IT FOUND
Nurse turnover drives up job demands and lowers staffing levels, with costs reaching three times the average nurse salary.
Patient safety links are inconsistent: some studies show higher error rates, while others find no relationship with falls or pressure ulcers.
Key findings
01Higher nurse turnover is associated with decreased nurse staffing hours per patient day and increased job demands, meaning remaining nurses care for more patients.
02The economic cost of turnover varies significantly but can reach up to three times the average nurse salary, with vacancy and training costs being major drivers.
03Evidence on patient outcomes is mixed: while some studies link turnover to increased medical errors and lower patient satisfaction, others find no significant relationship with falls, pressure ulcers, or medication errors.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included only 16 studies, and most were rated as medium or low quality. Definitions and measures of turnover varied widely across studies (e.g., monthly vs. annual, internal vs. external), making direct comparison difficult. Many cost studies were conducted in single hospitals, limiting generalizability. The search was limited to English and Korean articles published since 2000.
Declared interests
No specific funding sources or conflicts of interest were declared in the provided text.
The easy way to misread this
Do not assume that reducing nurse turnover will automatically lead to measurable improvements in patient safety outcomes like falls or pressure ulcers. The review found inconsistent and often non-significant associations between turnover and these specific clinical indicators, suggesting the relationship is complex and mediated by other factors like staffing levels and job demands.