Interventions Promoting Work Engagement and Reducing Turnover of Newly Graduated Nurses: A Systematic Review

TL;DR

This paper reviews interventions to help new nurses stay engaged at work and reduce turnover, finding limited evidence of effectiveness.

Contribution

A systematic review of interventions for newly graduated nurses, highlighting gaps in evidence-based strategies.

Findings

Only three moderate-quality studies were found, with small to medium effects on reducing turnover intentions.

Mentoring and preceptor models showed some association with lower turnover.

No studies measured work engagement, burnout, or organizational commitment outcomes.

Abstract

To evaluate the effectiveness of interventions to enhance and maintain organisational commitment, work engagement and retention and to reduce burnout and turnover of newly graduated nurses (NGNs).

Nurses leave their profession at a rate of 5%–18% worldwide. NGNs transferring from being a nurse student to a registered nurse may face significant stress and difficulties. To support a successful transition and reduce turnover rates among new graduates, it is necessary to identify effective interventions to enhance and maintain organisational commitment, work engagement and retention of NGNs and to reduce their burnout and turnover.

The systematic review focused on newly graduated nursing professionals having worked within clinical practice at most 6 months after their graduation, in any social or health care setting. We excluded studies focusing solely on nursing assistants, licensed practical nurses, advanced nurse practitioners, or clinical nurse specialists. Of the interventions, residency programmes were excluded. Cochrane Library, CINAHL, MEDLINE, Scopus, the Joanna Briggs Institute and Medic were searched with a timeline from January 2012 to February 2023. Quality appraisal of the original studies was performed using specific criteria for each study design. The results of the original studies were synthesised narratively. Effect size was estimated with Cohen's d (d).

The review included three moderate to good quality original studies with 566 participants in total: a randomised controlled trial, a non‐randomised trial and a cohort study. Two interventions based on one‐to‐one mentoring strategy (d = −0.18) and 10‐minute preceptor model using educational strategies (d = −0.58) showed small or medium effects towards decreased turnover intentions. Psychological measures of work engagement, burnout or organisational commitment had not been addressed as an outcome in any of the studies.

We found very few good‐quality studies examining interventions to promote NGN's staying at work. Of the three studies, two showed an association with lower turnover. More research with high‐quality study designs is needed. The evaluations should include cost–benefit analysis.

The current evidence is insufficient to make recommendations for nursing management on interventions to promote NGN's staying at work. Thus, further research is needed to build evidence‐based interventions.

PROSPERO Registration CRD42022328406

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