The race to retain nursing workforce in healthcare: an umbrella review of effectiveness of retention interventions and strategies.

backgroundThe global healthcare industry is facing a critical challenge in recruiting and retaining skilled nursing workforce. In recent decades, several retention interventions and strategies have been documented in numerous systematic literature reviews worldwide. However, the available information remains broad and fragmented due to the absence of dedicated umbrella reviews to synthesize and consolidate this top-notch evidence together.

aimTo summarize from systematic literature reviews, the effectiveness of various interventions and strategies in retaining the nursing workforce in healthcare.

designAn umbrella review.

methodsThis umbrella review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search of systematic reviews published within the past ten years was performed in July 2024, using PubMed, Ovid Medline, EMBASE, CINAHL, Scopus, and gray literature databases. Eligible studies were screened using Covidence, and A Measurement Tool to Assess Systematic Reviews (AMSTAR) was used to assess the methodological quality.

resultsThe search yielded 1,094 articles, of which 14 met the inclusion criteria. A narrative synthesis categorized effective retention strategies into five primary groups: (1) onboarding and early career interventions (e.g., externships, internships, extended orientation, transition-to-practice programs, nursing residency, special track programs, preceptorship, mentorship, and clinical ladder programs); (2) leadership; (3) work environment and organizational factors; (4) individual factors; and (5) the use of innovation, technology, and robotization. These interventions demonstrated effectiveness in enhancing nurse retention and lowering turnover.

conclusionsNurse retention is a complex and multifaceted issue. No single intervention works in isolation; but rather, a network of strategies and interventions is necessary to effectively reduce turnover and retain nursing staff. Future research should focus on retention strategies in Low- and Middle-Income Countries and explore the impact of technological innovations and robotization to align nurses' retention with the evolving healthcare landscape. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Urgent and coordinated action is needed to address nurse retention. Nurse managers and policymakers must adopt an early robust onboarding program, transformative leadership styles, supportive nursing work environments while embracing innovation, technology, and robotization to achieve better retention.