Research and impact | By Amy Ripley

City research: How do we successfully reduce turnover rates of early career nurses?

The first year of qualification has been found to be a critical period for nurses to leave the profession. However, new research suggests that a 6 to 12 month internship supported by transition to practice programmes may be a cornerstone to retaining nursing students and early career nurses.

The World Health Organisation (WHO) has previously identified nurse turnover and retention as central to the sustainability of the healthcare workforce and delivery of clinical care across the world. It has found that many nurses leave the profession during the first year of qualifying.


While various interventions to reduce turnover and increase retention have been put into practice across several countries, there has been little understanding of which characteristics of these interventions contribute to the success of nurse retention.


To shed some much needed light on the issue, academics at City reviewed 53 studies published in English, including 48 from the United States, two from Australia, one from Canada, one from the United Kingdom and one from Taiwan.


Led by Professor Debra Salmon, Dean of the School of Health Sciences, the systematic review examined a variety of retention efforts, including length of intervention and whether teaching, training or formal assessment were involved in the intervention process. The impact of these efforts on nurse turnover and retention outcomes were also reviewed.


Even though the research covered a wide range of study and reporting methods, it still found common intervention characteristics that were successful in the retention of early career nurses.


These are:

  • internship and residency programmes or transition to practice programmes lasting between 27-52 weeks
  • inclusion of a teaching and mentor (and/or preceptor) component
  • assessment of intervention process to guide the effectiveness of the methods used.

The academics also stress that future studies should follow a rigorous methodology and focus on standardising the reporting of both the intervention methods employed to reduce nurse turnover and retention and the outcome measures used to evaluate the success of the interventions. Evaluations of cost-effectiveness are also considered an important next step.


Professor Debra Salmon, who is also the Principal Investigator of the systematic review said:


“This is an important research study as it is the first to establish the most effective approach to delivering interventions aimed at early career nurse retention through an evidence review. Understanding how best to structure these interventions is an important finding for healthcare leaders across the sector. This will have important impact on nurse workforce retention globally as it will allow healthcare and education providers to develop training which supports early career nurses to flourish.”


It is hoped that the findings of this research will help with the retention of early career nurses, which will in turn, support the sustainability of healthcare infrastructures across the world.