Bedside clinicians retain nurses through turnover analysis and best practices

Nina Hawthorne-Spears, Mary Shepherd


The nursing shortage is projected to grow to well over 500,000 by 2020. Health care organizations are faced with increasing vacancies, mandating that strategic initiatives be developed to address the imperative of retaining their registered nurses (RNs). The implications for reducing RN turnover include improved safety and quality outcomes for patients. RN turnover also has financial implications. The average annual hospital cost of RN turnover is between $5.2 and $8.1 million dollars. Houston Methodist Hospital in the Texas Medical Center is a large, 1,200-bed metropolitan facility that employs over 3,000 nurses. By using shared governance to engage bedside clinicians and the ADKAR change model, nurse leaders were able to reduce organizational RN turnover from 16.39% to 10.57%, outperforming the national average and the American Nurses Credentialing Center’s benchmark for Magnet facilities with greater than or equal to 700 beds. This article will discuss the role of nurse leaders in creating a culture of retention, methods that were implemented at Houston Methodist Hospital to engage and empower beside clinicians to assume a lead role in reducing RN turnover, and the best practices discovered and implemented by bedside clinicians to improve RN turnover.

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Journal of Nursing Education and Practice

ISSN 1925-4040 (Print)   ISSN 1925-4059 (Online)

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