Addressing nurse retention with healthcare worker safety

High turnover among healthcare workers is an increasingly common phenomenon in hospitals worldwide, especially in intensive care units.1 According to the World Health Organisation, the healthcare workforce shortage is projected to reach 4.1 million in the EU-28 by 2030.2

Healthcare workers, and nurses in particular, face a wide range of hazards in the workplace,3 and it is imperative to keep them protected and empowered so we can secure uninterrupted, resilient patient care in the future.

Learn more about the factors that impact nurse retention, and how you can implement greater healthcare worker safety to help retain staff.

Healthcare worker safety hazards

In 2017, before the COVID-19 pandemic, the healthcare and social assistance industries were already reporting more injury and illness cases than other private industry sectors in the United States.3 In the same study, nursing assistants reported the highest rates of musculoskeletal disorders out of all occupations.3

Nurses risk exposure to bloodborne pathogens, hazardous drugs and radiation as well as psychological and ergonomic hazards, such as stress, burnout and musculoskeletal disorders.3-5

The physical hazards may also result in psychological trauma. According to research by Ipsos MORI on behalf of the European Biosafety Network, 25% of nurses in Germany suffer from mental or psychological health disorders as a direct result of an adverse safety event in the workplace.6

Learn more about the psychological consequences of adverse safety events: Feeling down after a needlestick injury? You’re not alone.

European nurse retention and recruitment rates are low

Health Europa goes so far as to say that nurses are leaving the workforce at an “unprecedented pace.”7 Globally, turnover rates among nurses are reportedly around 20% per year, while rates in some countries reach as high as 40%.1,8-10  Stress, fatigue, emotional exhaustion, understaffing and poor patient safety can be seen as predictors of nurses’ intention to leave.1

A 2022 UK National Health Service (NHS) study found that staff members who had a recent sick leave due to physical symptoms were more likely to subsequently leave the acute sector.11 This rate was even stronger when absences were related to mental health.11 The cycle continues for the healthcare workers that remain on the job, as high turnover in a hospital ward may lead to increased overtime, fatigue, stress and low job satisfaction among the remaining staff.1

Staff shortages may also have an impact on patient care: one systematic review found that poor wellbeing and moderate to high levels of burnout were associated with poor patient safety outcomes.12

Keeping nurses safe keeps them at work

Nurse retention and healthcare worker safety work hand-in-hand: to retain nurses, you must keep them safe.

There are a number of safety steps that you can take to help protect nurses from on-the-job hazards:

  • Switch to safety-engineered needles and sharps13
  • Implement closed-system transfer devices and safe handling practices for hazardous drugs14
  • Routinely monitor the workplace for surface contamination15
  • Adopt no-lift policies and/or patient lift teams to help prevent musculoskeletal disorder16
  • Transition to a continuous learning approach with regular training on workplace hazards16

As well, social support and job satisfaction can be mediators between nurse burnout and turnover intention.1 A 2021 analysis of nurse retention among French hospitals found that social support from colleagues and supervisors was associated with significantly lower rates of turnover.To enhance social support, the authors of the analysis recommended implementing solutions that enable healthcare workers to effectively and collaboratively work together and facilitate social communication and interaction.1

Learn more about preventing musculoskeletal disorders: Six tips to prevent repetitive strain injuries

 

 

 

#Nurse #Nurse retention


References

  1. Daouda OS, Hocine MN, Temime L. Determinants of healthcare worker turnover in intensive care units: A micro-macro multilevel analysis. PLoS One. 2021;16(5):e)251779. Doi: 10.1371/journal.pone.0251779.
  2. Michel JP, Ecamot F. The shortage of skilled workers in Europe: its impact on geriatric medicine. European Geriatric Medicine. 23 April 2020;11:345-347. Doi: 10.1007/s41999-020-00323-0.
  3. Occupational Safety and Health Administration (OSHA). Accessed 20 March 2023 at: https://www.osha.gov/healthcare
  4. Gnerre P, Rivetti C, Rossi AP, et al. Work stress and burnout among physicians and nurses in Internal and Emergency Departments. Italian Journal of Medicine. 2017;11(2):151-158. Doi: 10.4081/itjm.2017.740.
  5. Krishnan KS, Raju G, Shawkataly O. Prevalence of Work-Related Musculoskeletal Disorders: Psychological and Physical Risk Factors. Int J Environ Res Public Health. 2021 Sep; 18(17):9361. Doi: 10.3390/ijerph18179361.
  6. European Biosafety Network. Mental and Psychosocial Health in Healthcare; Preventing Medication Errors and Adverse Events and Disorders in Healthcare Workers. Accessed 20 March 2023 at: https://www.europeanbiosafetynetwork.eu/mental-and-psychosocial-health-in-healthcare-preventing-medication-errors-and-adverse-events-and-disorders-in-healthcare-workers/
  7. Health Europa. The registered nurse shortage in Europe is a ‘ticking time bomb’. Published 10 November 2022. Accessed 20 March 2023 at: https://www.healtheuropa.com/the-registered-nurse-shortage-in-europe-is-a-ticking-time-bomb/119272/#:~:text=Nurses%20in%20the%20EU%2C%20and,workers%20taking%20over%20their%20tasks.
  8. Duffield C, Roche MA, Homer C, Buchan J, Dimitrelis S. A comparative review of nurse turnover rates and costs across countries. J Adv Nurs. 2014;70: 2703–2712. Doi: 10.1111/jan.12483
  9. Kim Y, Han K. Longitudinal associations of nursing staff turnover with patient outcomes in long-term care hospitals in Korea. Journal of Nursing Management. 2018;26: 518–524. Doi: 10.1111/jonm.12576
  10. Roche MA, Duffield C, Homer C, Buchan J, Dimitrelis S. The rate and cost of nurse turnover in Australia. 2015;22: 353–358. Doi: 10.1016/j.colegn.2014.05.002
  11. Kelly E, Stoye G, Warner M. Factors associated with staff retention in the NHS acute sector. Institute for Fiscal Studies. Published 23 August 2022. Accessed 20 March 2023 at: https://ifs.org.uk/publications/factors-associated-staff-retention-nhs-acute-sector
  12. Hall LH, Johnson J, Watt I, Tsipa A, O’Connor DB. Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review. PLoS One. 2016;11(7):e0159015. Doi: 10.1371/journal.pone.0159015.
  13. Cooke CE, Stephens JM. Clinical, economic and humanistic burden of needlestick injuries in healthcare workers. Med Devices (Auckl). 2017;10:225-235. Doi: 2147/MDER.S140846
  14. Gurusamy KS, Best LM, Tanguay C, Lennan E, Korva M, Bussières JF. Closed-system drug-transfer devices plus safe handling of hazardous drugs versus safe handling alone for reducing exposure to infusional hazardous drugs in healthcare staff. Cochrane Database Syst Rev. 2018 Mar 27;3(3):CD012860. doi: 10.1002/14651858.CD012860.pub2.
  15. Kiffmeyer TK, Tuerk J, Hahn M et al. Application and Assessment of a Regular Environmental Monitoring of the Antineoplastic Drug Contamination Level in Pharmacies – The MEWIP Project. The Annalys of Occupational Hygiene. 2013 May;57(4):444-455. Doi: https://doi.org/10.1093/annhyg/mes081
  16. Trinkoff AM, Geiger-Brown JM, Caruso CC, et al. Personal Safety for Nurses. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Published April 2008. Accessed 20 March 2023 at: https://www.ncbi.nlm.nih.gov/books/NBK2661/

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