THE IMPACT OF REGISTERED NURSES’ TURNOVER ON PATIENT CARE AT TERTIARY CARE HOSPITALS OF PESHAWAR, KHYBER PAKHTUNKHWA; A CROSS SECTIONAL STUDY

Abstract

Background: Nurses’ turnover is a persistent global healthcare challenge, causing staff shortages, decreased care quality, and compromised patient safety. Tertiary care hospitals face significant disruptions due to frequent staff changes, affecting teamwork and care continuity. Pakistan's healthcare sector, particularly in Peshawar, struggles with nurses’ migration and job dissatisfaction. Aim: This study investigated the impact of nurses’ turnover on patient care in tertiary care hospitals of Peshawar.

Objectives: The objectives of this study were to assess the prevalence of nurses’ turnover on patient care and to determine the impact of nurses’ turnover on patient care outcomes.

Methods: A descriptive cross-sectional study was conducted among 204 registered nurses from Lady Reading Hospital and Khyber Teaching Hospital, using convenience sampling. The Anticipated Turnover Scale and MISSCARE Survey measured turnover intention and care quality, respectively. Data analysis involved descriptive statistics and Pearson correlation tests.

Results: Findings showed 13.2% of nurses planned to leave immediately, while 14.7% were considering resignation. Most respondents (83.3%) were young female nurses aged 20-29. A significant negative correlation existed between nurse turnover intention and patient care quality (r = -0.170, p = 0.015). High turnover rates were observed in general and emergency wards due to excessive workload and burnout.

Conclusion: Nurses’ turnover negatively impacts patient care outcomes by reducing service quality, continuity, and teamwork efficiency. Key contributors to turnover include excessive workload, lack of managerial support, and limited career opportunities. Strengthening leadership, improving working conditions, and implementing retention strategies can help stabilize the nursing workforce and ensure high-quality patient care.