Chapter 8 – Evidence-Based Practice Questions
This activity contains 3 questions.
Evidence for Effective Leadership and Management
Citation: Bae, S., Mark, B., & Friend, B. (2009). Impact of nursing unit turnover on
patient outcomes in hospitals. Journal of Nursing Scholarship, 42(1), 40–49.
Overview: This secondary analysis study examined how nursing unit turnover impacts
workgroup processes. The review also considered how these processes mediate the
impact of nurse turnover on patient outcomes. RN and patient data from 268 nursing
units at 141 hospitals were used. Researchers examined the turnover rates for six
consecutive months; used a questionnaire to gather data about workgroup processes; and
analyzed data on patient outcomes (unit-level average lengths of stay, patient falls,
medication errors, and patient satisfaction). Results indicate that moderate levels of
turnover rates have lower workgroup learning levels (how groups learn from their
experiences), lower turnover levels have fewer patient falls, and workgroup cohesion and
relational coordination have a positive impact on patient satisfaction.
Application: Nursing unit turnover is a critical concern throughout the country in all
types of healthcare settings. This study offers an interesting perspective on the
interrelationship of nurse unit turnover, workgroup issues, and patient outcomes.
1.
Why do you think nurse unit turnover impacts patient outcomes and workgroup
effectiveness?
2.
What other factors might impact workgroup cohesion?
3.
As a chief nurse executive, how might you use the results of this study in your
management decisions?
Finkelman, Leadership and Management for Nurses: Core Competencies for Quality Care, 3e
Chapter 8 – ANSWER KEY Evidence-Based Practice Questions
1.
[Answers may vary]
The costs of turnover are great: most notably the costs incurred during the recruiting and
hiring process, orientation, and additional staff member support, such as human resources
records, staff development, and so on. The study discussed above noted that cost can be
as much as $6.4 million for a large acute care hospital. The variation in cost depends on
2.
[Answers may vary]
When new staff are oriented and become part of the team, this affects the overall
productivity of a unit or a team, which is costly. If the turnover becomes a more extensive
problem, the HCO as a whole suffers, leading to stress and frustration as more and more
3.
[Answers may vary]
Organizations want to retain their best people, but this takes effort. When management
assumes that staff must be satisfied when they are good at their jobs, this may lead to a
false sense of security. It is important to understand staff satisfaction and dissatisfaction
Finkelman, Leadership and Management for Nurses: Core Competencies for Quality Care, 3e