Title: Interventions to enhance nurse job satisfaction and retention: A Systematic review
Abstract:
Background: Nursing shortages and high turnover rates are long-standing challenges in global healthcare systems. The retention of experienced nurses is particularly crucial, as they are a valuable resource often lost due to stress, burnout, and job dissatisfaction. High levels of job stress not only decrease nurse satisfaction but also increase the likelihood of attrition, exacerbating the nursing shortage. This systematic review aimed to identify evidence-based interventions that address intrinsic factors like stress and job satisfaction to enhance nurse retention.
Objectives: The primary objective of this systematic review was to examine the effectiveness of interventions focused on reducing nurse stress and improving job satisfaction, with the ultimate goal of enhancing nurse retention. The review focused on intrinsic determinants of job satisfaction, such as stress, burnout, in contrast to extrinsic factors like salary and benefits, which have been shown to have limited long-term impact on retention.
Methods: A comprehensive search of ten databases, including Ovid MEDLINE, PubMed, Cochrane Library, and CINAHL, etc. was conducted in September 2024. The search focused on studies that involved nurses and interventions aimed at reducing stress and improving job satisfaction. Eligible studies were randomized controlled trials (RCTs), quasi-experimental studies, or pre-post intervention studies. Studies that focused solely on COVID-19-related stress interventions or involved non-hospital settings were excluded. A total of 20 studies were included after screening 5,297 articles. Data from these studies were extracted and synthesized, and the risk of bias was assessed using the ROBVIS tool.
Results: The 20 included studies examined a variety of interventions aimed at reducing nurse stress and improving job satisfaction. Mindfulness-based interventions (MBIs) were the most commonly studied, implemented in 17 out of the 20 studies. These interventions varied in format, ranging from traditional 8-week Mindfulness-Based Stress Reduction (MBSR) programs to brief mindfulness sessions and web-based self-practice formats. The results consistently showed that MBIs led to significant reductions in stress, burnout, and anxiety, while improving resilience and job satisfaction. Shortened or brief MBSR programs were found to be more feasible for nurses due to their time constraints, with some studies reporting the effectiveness of interventions as short as 5 minutes per session. Limited studies measured the direct effect of nurse retention. In addition to MBIs, interventions such as resilience training, career identity programs, and aromatherapy massage were also explored, with mixed results. Resilience training showed positive effects on stress reduction, while career identity training and aromatherapy demonstrated limited impact on nurse stress and job satisfaction.
Conclusions: This systematic review highlights the effectiveness of mindfulness-based interventions in reducing nurse stress and improving job satisfaction, ultimately contributing to nurse retention. The review also identifies the need for feasible, scalable interventions that can be integrated into nurses’ busy work schedules. While MBIs are promising, further research is needed to explore the long-term sustainability of these effects and to develop interventions that address the intrinsic determinants of nurse retention and measure the outcomes on intention to stay. Further studies should also consider the direct effect on job satisfaction, intention to stay by reducing nurse stress.
