In 2023, the average turnover rate for registered nurses that worked in hospitals across the United States stood at 18.4 percent. This was lower than the turnover rate of 22.5 percent in 2022. According to this survey, the percentage of registered nurses (RN) that left hospitals in 2023 ranged from roughly 13 percent to nearly 24 percent, depending on the discipline. The highest RN turnover was found among Telemetry nurses. On the other hand, RN turnover was the lowest in Pediatrics.

In 2023, the average turnover rate of all registered nurses (RNs) in U.S. hospitals stood at 18.4 percent. The percentage of employees leaving hospitals has decreased since 2021, yet it is still 2.5 percent higher than in 2019. At the same time, the turnover rate of all hospital staff was 20.7 percent. For RNs who were full or part-time employees, turnover was consistently lower.

In 2023, the average staff turnover rate of hospitals in the U.S. stood at 20.7 percent. The percentage of employees leaving hospitals has decreased since 2021, yet it is still 2.9 percent higher than 2019. A closer look at turnover reveals that most was among less tenured staff, with the highest rates among certified nursing assistants.

The turnover rate of nurses in skilled nursing facilities (SNFs) in the U.S. varies by the quality rating of the facility. Among facilities with just a one-star rating, turnover stood as high as 53.9 percent in Q1 2024. Among facilities with a five-star rating, turnover was almost 10 percent lower, yet still high at, 44.3 percent.

According to a survey from 2023, certified nursing assistants (CNA) had the highest turnover rate among all hospital staff. Every four in ten CNAs left during the year. The second-highest turnover rates were among patient care technicians (PCT), followed by registered nurses (RN).

Abstract (en): This is the second wave of a multi wave panel survey that studied newly licensed registered nurses who obtained their first license to practice between September 1, 2004 and August 31, 2005. It was conducted as part of the RN Work Project, a national study of new nurses funded by the Robert Wood Johnson Foundation. The survey interviewed the nurses about their jobs, turnover, intentions and attitudes--including intent, satisfaction, organizational commitment, and preferences about work. ICPSR data undergo a confidentiality review and are altered when necessary to limit the risk of disclosure. ICPSR also routinely creates ready-to-go data files along with setups in the major statistical software formats as well as standard codebooks to accompany the data. In addition to these procedures, ICPSR performed the following processing steps for this data collection: Checked for undocumented or out-of-range codes.. Response Rates: 71 percent of the nurses who responded in wave 1 also responded in wave 2. Datasets:DS1: Dataset Nurses who responded to the first wave of the survey: Newly Licensed Registered Nurses, 2006 (ICPSR 36773). The first wave interviewed nurses who obtained their first license to practice between September 1, 2004 and August 31, 2005. The wave 2 survey attempted to interview all of the nurses who responded in wave 1. The wave 1 respondents were selected using a random stratified cluster design which mirrored the sampling design of the Community Tracking Study (ICPSR 2524, 2597, 3199, 3267, 3764, 3820, 4216 and 4584). The baseline sample was nested in the 60 CTS sites (51 Metropolitan Statistical Areas and nine groups of non-MSA counties in 35 states across the contiguous United States) and was designed to select nurses with equal probabilities of selection across the sites. 2020-01-30 Online variable search capabilities have been added for this study.2017-09-28 Carol Brewer was added as a principal investigator of the study; documentation files were updated accordingly. Funding institution(s): Robert Wood Johnson Foundation (51120). mail questionnaire

In long-term care, frontline supervisors play a central role in direct care workers' (DCW) job quality and turnover and are critical to the implementation of management changes. To better understand supervisors' perceptions of management practices, the quality of supervision, and the effect on DCW turnover and job quality, the Office of the Assistant Secretary for Planning and Evaluation in the United States Department of Health and Human Services contracted with Pennsylvania State University to conduct this survey of supervisors participating in the Better Jobs, Better Care (BJBC) demonstration. Funded by the Robert Wood Johnson Foundation and The Atlantic Philanthropies, the BJBC demonstration -- which took place in Iowa, North Carolina, Oregon, Pennsylvania, and Vermont -- tested innovative policy and practice models designed to improve the quality of DCW jobs in an effort to improve recruitment and retention of these workers and strengthen capacity to meet future demand for long-term care. Frontline supervisors were interviewed from the four types of facilities and agencies that participated in the demonstration: skilled nursing facilities, assisted living facilities, home care agencies, and adult day service providers. The survey explored the supervisors' job responsibilities, formal training, job satisfaction, and thoughts about quitting. It investigated the culture of the organizations in which the supervisors worked, probed for problems with the supervisors' jobs, assessed how rewarding the supervisors felt their jobs were, inquired as to whether the supervisors felt respected by their clients, DCWs, and managers, gauged the supervisors' assessments of the overall competency level of the DCWs in their organizations, and explored the supervisors' beliefs about managerial support for the BJBC project, how well the BJBC programs were executed, and whether the overall impact of the project was positive. In addition, the respondents were queried about management practices (e.g., rotation of assignments to different services or units, mechanisms to handle employee concerns, and approaches used to handle poor performance or negative behaviors among employees). They were also asked about DCW training, mentoring, and career ladder programs, DCW participation in patient/resident/client care plans, and communication among DCWs and between DCWs and their supervisors. Respondents were also asked what was the most important thing that their employer could do both to improve the jobs of DCWs and to improve their own ability to do their jobs as supervisors of DCWs. Additional information collected by the survey includes the supervisors' age, sex, race, Hispanic origin, educational attainment, nursing degree or license (LPN, RN, Diploma RN, BSN, MSN, or Advanced Practice Nurse), wages, and health insurance coverage. This collection comprises three data files: (1) Supervisor Identification Instrument Data, (2) Supervisor Survey Data, and (3) Clinical Managers Who Are Also Supervisors Data. The first file contains information collected by the Supervisor Identification Instrument that was submitted to the clinical manager at each BJBC provider organization. This instrument instructed clinical managers to name all of the supervisors in their organization and to indicate which supervisory responsibilities each one performed. The second data file contains the responses to the Supervisor Survey questionnaire.The third data file contains the responses of clinical managers who also functioned as supervisors in their organization. These clinical managers responded to the same questions in the Supervisor Survey questionnaire, except for ten questions that were worded somewhat differently.

Abstract

Nigeria has one of the largest stocks of human resources for health (HRH) in Africa. However, great disparities in health status and access to health care exist among the six geo-political zones, and between rural and urban areas. This assessment measures the size, skills mix, distribution, and growth rate of HRH in the public health sector in Nigeria. The assessment also quantifies the increase in HRH requirements in the public health sector necessary for reaching key PEPFAR targets and the health Millennium Development Goals. The findings are based on a survey conducted in April-May 2006 in 290 public health facilities representing all levels of care (primary, secondary, and tertiary). The study data enabled us to estimate the total number of doctors, nurses, midwives, lab and pharmacy staff, and community health workers currently employed in the public sector. The distribution of health workers by level of care, and HRH availability in rural and urban areas was also quantified.Staff attrition rates, measuring the number of those leaving the public sector as percent of total staff, were determined among all staff categories. The annual growth in HRH in the public sector from new graduates was also measured.

Geographic coverage

National

Analysis unit

Public Health Facilities

Universe

The survey focused on public health facilities representing all levels of care (primary, secondary, and tertiary).

Kind of data

Sample survey data [ssd]

Sampling procedure

Two-Stage Stratified Random Sample A survey was conducted in 290 public health facilities representing all levels of care (primary, secondary, and tertiary). The facilities were selected using two-stage stratified sampling. First, two states were selected from each of the six geo-political zones in Nigeria, with probability of selection of each state proportional to its population size. In addition, the Federal Capital Territory of Abuja (FCT) was added to the two states selected in the North Central zone. The selected states in each zone cover between 32 and 50 percent of the zone's population and in total, the 13 states included in the sample account for 40 percent of Nigeria's population. In the second stage of sampling, a sample of facilities at each level of care was chosen in each selected state. All Federal Medical Centers and teaching hospitals in the sampled states were selected with certainty. All other facilities were selected using systematic random sampling. A higher proportion of hospitals, compared to smaller facilities, were included in the sample in order to increase the number of facilities that have most of the data being collected. Primary care facilities include health centers, health clinics, maternities, and dispensaries. There was non-response from two facilities selected with certainty.

Mode of data collection

Face-to-face [f2f]

Research instrument

Data collection instrument In each of the selected facilities, a questionnaire was administered to eligible facility managers and health staff. These were staff in charge of the services included in the survey – for example, information regarding immunizations in a hospital was obtained from the nurse in charge at the hospital’s child health clinic. The questionnaire collected information on: 1. Number of staff employed in 2004, 2005, and at the time of survey (April 2006); 2. Number of incoming and outgoing staff in 2005 by reason for leaving or starting work at the facility; 3. Types of services provided at the facility for HIV/AIDS, TB, malaria, maternal and child health, and family planning; 4. Number of patients seen at the facility in the three months preceding the survey for each of these services; 5. Which types of health staff provide each service; 6. Average time spent per patient-visit for each of the services related to the five focus areas.

Cleaning operations

Data from the survey questionnaires was entered electronically using an EpiInfo database, and all data analysis was performed using Stata v.8 software.

In 2021, shortages of healthcare staff in the United States were expected and especially among clinical roles. According to this survey, 83 percent of responding hospital and health system executives predicted nursing staff shortages. Furthermore, 30 percent of respondents expected to face an insufficient number of physicians. A shortfall of leadership roles, on the other hand, was far less envisioned by the responding healthcare executives.

BackgroundThe delivery of high quality care is a fundamental goal for health systems worldwide. One policy tool to ensure quality is the regulation of services by an independent public authority. This systematic review seeks to identify determinants of compliance with such regulation in health and social care services.MethodsSearches were carried out on five electronic databases and grey literature sources. Quantitative, qualitative and mixed methods studies were eligible for inclusion. Titles and abstracts were screened by two reviewers independently. Determinants were identified from the included studies, extracted and allocated to constructs in the Consolidated Framework for Implementation Research (CFIR). The quality of included studies was appraised by two reviewers independently. The results were synthesised in a narrative review using the constructs of the CFIR as grouping themes.ResultsThe search yielded 7,500 articles for screening, of which 157 were included. Most studies were quantitative designs in nursing home settings and were conducted in the United States. Determinants were largely structural in nature and allocated most frequently to the inner and outer setting domains of the CFIR. The following structural characteristics and compliance were found to be positively associated: smaller facilities (measured by bed capacity); higher nurse-staffing levels; and lower staff turnover. A facility’s geographic location and compliance was also associated. It was difficult to make findings in respect of process determinants as qualitative studies were sparse, limiting investigation of the processes underlying regulatory compliance.ConclusionThe literature in this field has focused to date on structural attributes of compliant providers, perhaps because these are easier to measure, and has neglected more complex processes around the implementation of regulatory standards. A number of gaps, particularly in terms of qualitative work, are evident in the literature and further research in this area is needed to provide a clearer picture.