Interventions to Reduce Adult Nursing Turnover: A Systematic Review of Systematic Reviews

Mary Halter1, *, Ferruccio Pelone2, Olga Boiko1, Carole Beighton1, Ruth Harris3, Julia Gale1, Stephen Gourlay4, Vari Drennan1
1 Faculty of Health, Social Care and Education, Kingston University and St George’s, University of London, London, England
2 National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, London, England
3 Nursing & Midwifery, King's College London, England
4 Faculty of Business & Law, Kingston University, London, England

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© 2017 Halter et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this authors at the Faculty of Health, Social Care and Education Kingston University and St George’s, University of London, Cranmer Terrace, London, SW17 0RE; Tel: 00 44 (0)20 8725 0337; E-mail:



Nurse turnover is an issue of concern in health care systems internationally. Understanding which interventions are effective to reduce turnover rates is important to managers and health care organisations. Despite a plethora of reviews of such interventions, strength of evidence is hard to determine.


We aimed to review literature on interventions to reduce turnover in nurses working in the adult health care services in developed economies.


We conducted an overview (systematic review of systematic reviews) using the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Applied Social Sciences Index and Abstracts, CINAHL plus and SCOPUS and forward searching. We included reviews published between 1990 and January 2015 in English. We carried out parallel blinded selection, extraction of data and assessment of bias, using the Assessment of Multiple Systematic Reviews. We carried out a narrative synthesis.


Despite the large body of published reviews, only seven reviews met the inclusion criteria. These provide moderate quality review evidence, albeit from poorly controlled primary studies. They provide evidence of effect of a small number of interventions which decrease turnover or increase retention of nurses, these being preceptorship of new graduates and leadership for group cohesion.


We highlight that a large body of reviews does not equate with a large body of high quality evidence. Agreement as to the measures and terminology to be used together with well-designed, funded primary research to provide robust evidence for nurse and human resource managers to base their nurse retention strategies on is urgently required.

Keywords: Intervention, Nurses, Nursing staff, Personnel turnover, Review, Systematic, Workforce.