| Summary: | 碩士 === 國立陽明大學 === 醫務管理研究所 === 103 === Introduction: The widespread nursing shortage and nurses’ high turnover rate are multifaceted and complex factors a global issue. In Taiwan, The implementation of National Health Insurance (NIH) in 1995 changed the needs and demands of healthcare consumers. There has been an increasing demand for nurses. Taiwan healthcare settings face difficulties in recruitment and retention of nursing staff. Previous studies on turnover intentions among nurses were limited by small sample size or including only a few institutions.
Purpose: The objectives of this study were to describe turnover intentions to leave nursing Professional and current organizational among hospital nurses in Taiwan and examine factors associated with turnover intentions.
Methods: This study was a cross-sectional nation-wide questionnaire survey. The data was collected via a structured questionnaire of the physical and mental health and safety needs in health care which was developed by the Bureau of Health Promotion. The study participants were age 18 to 65 of 23,700 full-time clinical nurses working at 100 hospitals across Taiwan in 2011. SAS 9.3 was used to do data analysis. Multiple logistic regressions were used to examine factors associated with intention to leave current hospital or intention to leave nursing profession.
Results: In this study, the mean age of nurses were 32.66 (SD=7.08) years. The majority were women(98.2%) and practicing less than 10 years (below 2years:10.82%；2-5 years: 36.6%; 5-10 years: 24.12%). Their workplaces included OPD (15.4%), OR/DR (11.3%) and general ward (47.05%), and ER/ICU(26.22%). About 57.1% of the nurses held a university or post-graduate degree. 58.07% of nurses were unmarried. The majority of institutions were metropolitan and private hospitals. More than half of the nurses worked at a certified HPH (56.5%). About 62.45% and 64.33% of nurses plan to leave current hospital and leave nursing profession, respectively. Factors that were positively associated with both intention to leave the hospital and nursing profession were younger age, unmarried, high educational level, workplace: General Ward、ICU/ER , job stress, in practice for 2-15 years, Work hours per week above 48hour, have continuing education opportunities and poor health status. While a positive expectation of the hospital, sense of achievement, caring work environment, and job satisfaction were negatively associated with both intention to leave the hospital and nursing profession. Factors that were positively associated with intention to leave the hospital but not nursing profession were accredited HPH level, workplace: OR/DR、in practice for more than 15 year,、pay dissatisfaction and private hospitals (as compared to public hospitals). Factors that were positively associated with intention to leave the nursing profession but not hospital were male.
Conclusions: Many nurses in Taiwan intend to leave not only current hospital but also nursing profession. Strategies should be developed to decrease turnover intentions among nurses. Mitigating job stress, improving job satisfaction, and creating a positive working environment were among possible strategies.
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