A study review, carried out by researchers at City, University of London, suggested that six to 12-month long internships and transition to practice programmes that incorporate elements of teaching, mentoring and preceptorship, may be a cornerstone to improving retention rates for newly qualifieds.
“It is clear that support for early career nurses is important to encourage retention”
Led by Professor Debra Salmon, City’s dean of the school of health sciences, the research team reviewed 53 studies from across the globe in a bid to uncover which was most successful intervention to reduce staff turnover.
According to the review, interventions with the “highest benefit” were an internship or residency programme and an orientation or transition to practice programme that incorporates formal teaching, a preceptorship element and the addition of a mentorship element that lasts 27 to 52 weeks.
Findings showed that interventions with both a preceptor and mentor component appeared to have “merit”, although the inclusion of both appeared to have a “larger impact” on turnover.
The review found an average of 15% increase in retention for interventions with both preceptor and mentor components and an average 23% increase for those with preceptors only.
“If the requirement for this support were to be enshrined in policy, early career nurses would feel more confident about their transition”
In addition, it noted that another “promising component” for early career nurses appeared to be teaching or training, often referred to as continuing professional development.
The taught element was evaluated in 37 studies “with a generally positive effect on retention and turnover,” authors of the study noted.
The researchers highlighted that the findings should help to “to inform policy and practice related to retention of early career nurses”, though acknowledged that healthcare systems internationally are subject to funding restraints.
They noted that, given that even the shortest interventions had a positive effect, further cost-benefit analysis would be beneficial to determine where the point of maximum benefit for minimal financial outlay lies.
Though they acknowledged that the complexity of the benefit of these interventions in terms of increased confidence, competence and patient satisfaction may not be easily captured using economic analysis tools.
“It is clear that support for early career nurses is important to encourage retention and if the requirement for this support were to be enshrined in either local or national policy, early career nurses would feel more confident about their transition from student to qualified practitioner,” the authors said.
“The results of this review offer policy makers guidance for the development of such strategy,” they added.
Principal investigator of the review, Professor Salmon, said: This is an important research study, as it is the first to establish through an evidence review the most effective approach to delivering interventions aimed at early career nurse retention.
“Understanding how best to structure these interventions is an important finding for healthcare leaders across the sector.
“This will have important impacts in terms of nurse workforce retention globally, as it will allow health care and education providers to develop training which supports early career nurses to flourish,” she added.
The systematic review was published in the International Journal of Nursing Studies, and funded through a grant from the Burdett Trust for Nursing.
Judy Brook first author of the systematic review