Determinants and impact of turnover rate among nursing staff: The exploratory retrospective follow-up study in Taiwan

This retrospective hospital-based study was conducted to explore the turnover rate and correlated factors using the survival analysis approach. The study period was from 01 July 2000 to 31 December 2006 in a teaching hospital in Southern Taiwan. Based on the registration data bank, 515 (82.5%) out of 624 nurses were studied. The results, from the Kaplan-Meier method, show that the 3-, 6-, 9-month and 1-, 3-, 5-year turnover rates were 6.3, 11.2, 12.6, 16.5, 37 and 50%, respectively. To assess the independent contribution to the turnover rate of nursing staff, the variables were further examined using Cox regression model. The main reasons related to turnover rate included: (1) excessive clinical and paper work (RR=2.35, 95% CI: 1.33-4.01); (2) the rotation system resulting in the imbalance of work and rest (RR=3.12, 95%CI: 1.26-5.41); (3) medical disputes due to clinical work (RR=2.00, 95%CI: 1.19-3.42) and (4) the lack of life quality due to the inability to take holidays or vacations (RR=2.44, 95%CI: 1.76-4.71). In conclusion, multiple strategy for the encouragement of nursing staff are necessary to increase the quality of the nursing service in Taiwan.