Research Draft
Literature Review: Table of Evidence
Student Name: Dominica Thomas
Describe the barrier/health care administration issue addressed in your Business Research Paper (two or three sentences):
The main challenge is nurse short staffing and high turnover, which puts a lot of pressure on healthcare administrators. When there aren’t enough nurses, workloads get heavier, stress and burnout increase, and it’s harder to keep experienced staff. This cycle affects not only the quality of patient care but also the morale of the remaining team and the smooth running of the organization
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Criteria |
Article 1 |
Article 2 |
Article 3 |
Article 4 |
Article 5 |
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Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article
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Xia Li, JianLi Wang, Ningning Wang, Luan He, Ciawen Li, Yinmei Xie et al.,
https://doaj.org/article/142958820f8c42d9a6c0dbfadba6828f
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Hewko & Clow et al.,
https://research-ebsco-com.lopes.idm.oclc.org/c/ws2dot/viewer/pdf/pvjouiar3r
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Hayward D., Bungay V., Wolff A., Macdonald V
https://research-ebsco-com.lopes.idm.oclc.org/c/ws2dot/viewer/html/pwzn7elod5
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Liddle., Z., Fitts M., Bourke L., Murakami- Gold, L. 2024.
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Randa, M., Phale, Johana, M
https://www.sciencedirect.com/science/article/pii/S2214139123000550
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Article Title and Year Published
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Turnover intention and influential factors among primary healthcare workers in Guangdong province, China: a cross-sectional study. 2024
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High Turnover in Clinical Dietetics: A descriptive Analysis. 2022 |
A Qualitative study of experienced nurses’ voluntary turnover: learning from their perspectives. 2016 |
Attitudes to Short term Staffing and Workforce Priorities of Community- Controlled Health Services: A Qualitative Study. 2024
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The effects of high nurses ‘turnover on patient care: Perspectives of unit in critical care units. 2021. |
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Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study
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Purpose/Aim: Assess the prevalence of turnover intention among primary healthcare workers and identify key influencing factors Research Question: What demographic, work-related, and psychological factors are associated with turnover intention among primary healthcare workers in Guangdong Province, China?
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Purpose/Aim: Explore characteristics of clinical dietetic jobs with high turnover and examine consequences of turnover for managers and patients Research Question: What job characteristics and consequences of turnover do managers of clinical dietitians identify? |
Purpose/Aim: To understand the experiences and perspectives of experienced nurses who voluntarily leave their positions, focusing on work environment factors. Research Question (Qualitative): What workplace factors influence experienced nurses’ decisions to leave their jobs? |
Purpose/Aim: Explore community users’ perceptions of shortterm staffing and workforce issues in remote Aboriginal communitycontrolled health services Research Question: How do community members perceive the impact of shortterm staffing and workforce priorities on service quality, cultural safety, and continuity of care? |
Purpose/Aim: Examine how high nurse turnover affects quality of patient care in critical care units from unit managers’ perspectives Research Question: What impact does high nurse turnover have on patient care outcomes in critical care units? |
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Design (Quantitative, Qualitative, or Other)
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Quantitative |
Qualitative |
Qualitative |
Qualitative |
Qualitative |
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Setting/Sample
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Setting: Primary healthcare facilities in Guangdong province, China Sample: 16,573 primary healthcare workers (survey participants) |
Setting: Hospitals and surgical units, Australia Sample: Perioperative nurses (survey participants; exact number varies in qualitative responses) |
Setting: Hospitals in Canada Sample: 12 experienced nurses who voluntarily left their positions |
Setting: Remote Aboriginal community-controlled health services, Australia Sample: Community users (patients and service users); number not specified in abstract |
Setting: Critical care units in hospitals (location not specified) Sample: Unit managers from critical care units |
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Methods: Intervention/Instruments
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Cross-sectional survey using a structured questionnaire covering demographics, work characteristics, job satisfaction, emotional exhaustion, and turnover intention. No active intervention; observational study. |
Semistructured interviews with 10 managers of clinical dietitians; qualitative descriptive design.
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Semi-structured interviews with 12 experienced nurses in acute care; qualitative interpretive design. |
The researchers conducted interviews and focus groups with staff and community members at Aboriginal communitycontrolled health services. |
Researchers conducted facetoface interviews with nine experienced critical care unit managers at a public academic hospital in South Africa. |
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Analysis
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Descriptive statistics to summarize participant characteristics |
Thematic analysis to identify causes and consequences of turnover.
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Thematic analysis to identify patterns and reasons for leaving. |
They looked for common themes in what people said about staffing and workforce issues.
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Interview transcripts were analyzed using Tesch’s method to identify themes and subthemes related to nurse turnover causes and effects. |
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Key Findings
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High prevalence of turnover intention among primary healthcare workers |
Turnover driven by high workload, burnout, limited growth, poor managerial support, and role undervaluation; leads to staff strain and disrupted patient care. |
Nurses left due to heavy workload, high patient acuity, poor leadership support, and strained workplace relationships. |
Frequent use of short-term staff and high turnover made it harder to provide consistent, culturally safe care and affected the trust communities had in their health services. |
High turnover caused by short staffing and heavy workloads, leading to reduced care quality, delays, and higher patient risk. |
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Recommendations
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Improve job satisfaction through professional development, better leadership support, and workload management |
Improve managerial support, workload management, career development, and retention strategies. |
Improve leadership support, teamwork, communication, and staffing practices. |
Focus on keeping staff long-term, improve hiring and retention strategies, and make workforce planning more responsive to community needs. |
Improve staffing ratios, create specialist nurse positions, and plan for adequate nurse coverage. |
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Explanation of How the Article Supports Your Identified Barrier or Issue in Health Care |
Workload, emotional burnout, and inadequate support are key drivers of turnover, which directly impacts short staffing and quality of care in primary healthcare facilities. |
Improve managerial support, workload management, career development, and retention strategies. |
Shows short staffing and poor leadership increase nurse turnover and threaten workforce stability. |
Shows that staffing instability and turnover hurt both the workforce and the quality of care, highlighting the importance of stable staffing for better patient and community outcomes. Top of Form
Bottom of Form
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Confirms that short staffing and turnover directly harm patient care and unit stability. |
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Criteria |
Article 6 |
Article 7 |
Article 8 |
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Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article
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Li, Gege., Wang, Waner., Pu Jiangfeng., Xie Zhanghao., Yixuan., Shen, Tiemei., Huang, Huigen. 2024.
https://pmc-ncbi-nlm-nih-gov.lopes.idm.oclc.org/articles/PMC11363875/
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Xie, Ada., Xu Hui., Duff, Jed.
https://linkinghub-elsevier-com.lopes.idm.oclc.org/retrieve/pii/S2405603025000445 |
Al- Rjoub, Saleem
https://research-ebsco-com.lopes.idm.oclc.org/c/ws2dot/viewer/html/uh6nadpyy5
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Article Title and Year Published
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Relevant factors affecting nurse staffing: a qualitative study from the perspective of nursing managers. 2024 |
Factors influencing perioperative nurses’ retention and turnover decisions: A qualitative analysis. 2025. |
When leadership drives nurses away: Empirical Research Qualitative on High Turnover Rates Reason. 2025 |
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Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study
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Purpose/Aim: To explore factors affecting nurse staffing and provide insights for improving staffing levels and HR planning in healthcare. Research Question: What factors influence nurse staffing from nursing managers’ perspectives?
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Purpose/Aim: Explore factors affecting perioperative nurses’ decisions to stay or leave Research Questions: What workplace and organizational factors influence perioperative nurses’ retention and turnover decisions? |
Purpose/Aim: To explore the lived experiences of nurses who leave their jobs, focusing on leadership and organizational factors that contribute to turnover. Research Question (Qualitative): How do nurses perceive the influence of leadership and organizational practices on their decisions to leave? |
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Design (Quantitative, Qualitative, or other)
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Qualitative |
Qualitative |
Qualitative |
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Setting/Sample
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Setting: Hospitals (China) Sample : 14 nursing managers |
Setting: Hospitals and surgical units, Australia Sample: Perioperative nurses (survey participants; exact number varies in qualitative responses) |
Setting: Hospitals (location not specified, likely Middle East) Sample: Nurses who voluntarily left their positions; exact number not specified |
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Methods: Intervention/Instruments
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Semi-structured interviews with 14 nursing managers; qualitative design. |
Qualitative analysis of openended survey responses from 900 perioperative nurses across Australia.
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Interview guide developed by the researcher focused on nurses’ experiences with leadership and reasons for leaving |
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Analysis
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Thematic content analysis using NVivo 9 themes across hospital, department, patient, and nurse levels. |
Inductive and deductive thematic analysis; coding reviewed by multiple researchers. |
Giorgi’s phenomenological method: interviews transcribed and coded into themes.
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Key Findings
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Staffing influenced by policies, department workload, patient acuity, nurse shortages, and limited career development. |
Turnover driven by staffing shortages, heavy workload, poor leadership, negative culture, inflexible schedules, and lack of professional development. |
Turnover influenced by poor leadership communication, lack of support, chronic understaffing, workload, and limited professional development. |
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Recommendations
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Improve staffing policies, support career growth, develop flexible nurse pools, and foster supportive culture. |
Improve leadership quality, workplace culture, staffing management, and retention strategies (flexible scheduling, professional support). |
Improve leadership skills, mentorship, professional growth, and staffing management. |
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Explanation of How the Article Supports Your Identified Barrier or Issue in Health Care |
Confirms that nurse shortages, high workloads, and weak policies contribute to short staffing and turnover. |
Confirms that short staffing and poor organizational support increase turnover, reduce nurse satisfaction, and compromise workforce stability.
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Confirms that short staffing and poor leadership drive nurse turnover, contributing to workforce instability and care challenges. |
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