The Nurse Turnover Intentions; A Systematic Review

Abstract

Nurse turnover intention (TI) has become a critical concern for healthcare systems worldwide due to its impact on workforce shortages, financial costs, and patient safety. High TI is a strong predictor of actual turnover, threatening the stability of healthcare delivery and exacerbating global nursing shortages. This systematic review aimed to synthesize empirical evidence on the prevalence and determinants of nurse turnover intention, evaluate the role of organizational and psychosocial factors, and identify research and policy gaps to inform workforce retention strategies. The review followed PRISMA 2020 guidelines. Electronic searches were conducted across PubMed, Scopus, Web of Science, and Google Scholar, covering literature from January 2000 to March 2025. Eligible studies included peer-reviewed empirical research and systematic reviews that examined turnover intention among nurses. Exclusion criteria included non-English language studies, theoretical papers, and studies without measurable outcomes on turnover intention. Screening and data extraction were performed independently by two reviewers, with quality appraisal guided by the JBI and MMAT tools. A total of 25 studies met the inclusion criteria. The prevalence of turnover intention among nurses ranged from 30% to over 50%, with the highest rates observed in intensive care and emergency settings. Key determinants included job dissatisfaction, burnout, stress, poor work environments, and lack of organizational support. Protective factors were supportive leadership, recognition, professional commitment, and vocational calling. The COVID-19 pandemic significantly increased turnover intention, with studies reporting heightened emotional exhaustion and new dynamics such as quiet quitting. Nurse turnover intention is a multifactorial issue shaped by individual, organizational, and systemic factors. Effective retention strategies must go beyond individual resilience-building to include structural reforms, such as improving staffing adequacy, strengthening leadership and recognition systems, and expanding mental health support. Addressing turnover intention proactively is vital for workforce sustainability, healthcare quality, and patient safety.