Effectiveness appraisal of interventions to increase retention of newly qualified nurses implemented in the final year of pre-registration programmes: A literature review

Abstract

Aim: To understand the effectiveness of interventions to increase retention of early career nurses, implemented during the pre-registration programme.

Background: Retention of nurses is an issue of global concern. The transition period spanning the final year of pre-registration nurse education programmes and the first year of qualified practice is a point of high risk for attrition from the profession.

Design: A systematic review without meta-analysis and a thematic synthesis of wider literature, reported using SWiM and ENTREQ guidelines.

Methods: A convergent segregated approach was used to capture qualitative and quantitative study designs. A systematic review of quantitative papers reporting intervention and retention data and scoping review of a wider body of literature related to interventions supporting transition to qualified practice were conducted. Searches used Medline and CINAHL databases in October 2021. Data extracted from wider literature were inductively collated into themes relating to the intervention type and synthesised.

Results: Six papers were included in the systematic review and 27 papers were included in the scoping review. Interventions included internships, externships, clinical immersion programmes, capstone projects, preceptorships and psychological wellbeing programmes. There was a lack of consensus about the benefits of implementing interventions during the final year of pre-registration programmes, but some evidence that interventions incorporating preceptors, expose students to the clinical environment and involve academic/clinical collaboration, report positive outcomes related to transition to qualified practice, which potentially has an impact on motivation to stay in the profession.

Conclusion: Greater understanding of interventions supporting student nurses to reduce likelihood of leaving once qualified has been achieved. There is some evidence these interventions lead to increases in retention, but this is limited by the quality of the reporting and the scarcity of data. Consideration should be given to maximizing students' exposure to clinical practice and the benefits that interventions with alternative approaches such as psychological wellbeing programmes may bring. This review has potential to influence effective implementation of interventions to increase retention of early career nurses if clinical practice and academic settings review proposed or actual interventions to maximise added value. REPORTING METHOD: the manuscript has been written in adherence with the EQUATOR guidelines following the SWiM reporting guidelines for the systematic review and the ENTREQ guidelines for the scoping review.

Keywords: I; Immersion; Internship and residency; Interventions; Nurses; Nursing; Preceptorship; Retention; Students; Work Environment.