Drivers of hospital nurse practitioner turnover: A national sample survey analysis

Esita Patel; Lindsay T Munn; Britney Broyhill; Erin P Fraher

doi:10.1016/j.outlook.2024.102180

Drivers of hospital nurse practitioner turnover: A national sample survey analysis

Nurs Outlook. 2024 May 10;72(4):102180. doi: 10.1016/j.outlook.2024.102180. Online ahead of print.

Authors

Esita Patel¹, Lindsay T Munn², Britney Broyhill³, Erin P Fraher⁴

Affiliations

¹ The Center for Advanced Practice, Atrium Health Carolinas Medical Center, Charlotte, NC; Public Health Sciences, Implementation Science, Wake Forest University School of Medicine, Winston-Salem, NC. Electronic address: esita.patel@atriumhealth.org.
² Public Health Sciences, Implementation Science, Wake Forest University School of Medicine, Winston-Salem, NC.
³ The Center for Advanced Practice, Atrium Health Carolinas Medical Center, Charlotte, NC.
⁴ The Carolina Health Workforce Research Center, The Cecil G. Sheps Center for Health Services Research, Chapel Hill, NC; Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.

PMID: 38733768
DOI: 10.1016/j.outlook.2024.102180

Abstract

Background: Hospital nurse practitioner (NP) turnover is costly and complex.

Purpose: Provide a pre-COVID-19 pandemic baseline of hospital NP turnover.

Methods: A secondary analysis of NSSRN18 data on 6,558 (67,863 weighted) NPs employed in hospitals on 12/31/2017. We describe rates of turnover, intention to leave, and reasons for leaving or staying. Using multivariate logistic regression, we examine the association between individual and organizational characteristics and turnover. Survey weights and jackknife standard errors were applied to analyses.

Discussion: Approximately 10% of NPs left their job the following year, and 53% of NPs that remained considered leaving at some point. The top reasons cited for leaving or staying were largely organizational factors. Regression analysis revealed not practicing to one's fullest scope, lower income, lack team-based care, and non-white race were associated with an increased likelihood to leave.

Conclusion: We find several modifiable factors associated with hospital NP turnover that can be used to tailor recruitment and retention strategies.

Keywords: Advanced practice provider; Hospital; Nurse practitioner; Population surveillance survey; Turnover.