Assessing the impacts of nurse staffing and work schedules on nurse turnover: A systematic review

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Aim: This study aimed to investigate and synthesize the impacts of nurse staffing and work schedules on nurse turnover in acute hospitals. Background: The retention of nurses during the COVID-19 pandemic was critical due to the increased demand for nurses. Among the multifaceted factors contributing to nurse turnover, it is worth examining nurse staffing and work schedules while considering policy intervention. Methods: The findings of this systematic literature review were reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Using eight databases, including CINAHL and PubMed, research articles published from January 2000 until June 2021 were reviewed. The inclusion criteria were original peer-reviewed research, nonexperimental studies published in English or Korean languages, and studies examining the impacts of nurse staffing and work schedules on nurses’ actual turnover. Results: Fourteen articles were reviewed. Among them, 12 studies investigated the relationship between nurse staffing and turnover, and four examined the impact of work schedules on nurse turnover. Nurse staffing levels are strongly related to nurse turnover in the expected direction. However, few studies have found that work schedules are significantly related to nurse turnover. Conclusion: Inadequate and unsafe nurse staffing leads to increased nurse turnover rates. More studies are needed to investigate the impacts of work schedules on nurse turnover. Implications for nursing, health, and social policy: Several states in the United States have adopted the nurse staffing policy during the COVID-19 pandemic. More hospitals and the government should adopt and implement policies to regulate nurse staffing, reduce nurse turnover, and increase retention. Policy intervention in nurse work schedules should also be considered to prevent nurse turnover.

Original languageEnglish
Pages (from-to)168-179
Number of pages12
JournalInternational Nursing Review
Issue number1
StatePublished - Mar 2024

Bibliographical note

Publisher Copyright:
© 2023 International Council of Nurses.


  • Hospital
  • nurse staffing
  • nurse turnover
  • nursing shortage
  • policy
  • work schedules


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