ArticleNursing outlook
Operationalizing the RETAIN Framework: Calculating the cost of nurse turnover in practice.
Article in Nursing outlook. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Nurse retention in Europe: why economic evidence matters.The Lancet regional health. Europe · 2026Review
- Professional Nurses Engagement in Non-Nursing Work? An Examination of Reasons and Outcomes.Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing · 2026Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundThis Part II study operationalizes the RETAIN Framework to close a two-decade gap in primary evidence on nurse turnover costs and provide contemporary benchmarks for health systems.
methodsWe used event-level, bottom-up costing to link expenditures to discrete turnover events and assign costs to individual nurses. Analyses covered 1,501 medical-surgical nurses (23% of the nursing workforce) across seven hospitals in an academic medical center.
resultsIn 2023, 360 turnover events yielded a 24% turnover rate. Mean time to fill vacancies was 21.7 weeks; 75.5% of backfill hours were covered by contract labor. Per-nurse turnover cost with contract replacement was $85,498, totaling $27.9 million. DISCUSSION: Nurse turnover costs are substantial, measurable, and driven by operational decisions. The RETAIN dashboard translated drivers into actionable evidence that informed a $150 million salary investment, adding $9,000 annually to nurses' pay.
conclusionRETAIN links event-level costs to organizational outcomes, establishing turnover reduction as a financial imperative and strategic opportunity.
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Registered trials
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