Evid Based Nurs doi:10.1136/eb-2012-101114
  • Nursing issues
  • Cross-sectional study

Hospital nursing units in the USA: government ownership, Magnet designation, unit population age group and higher skill mix are associated with lower nursing turnover

  1. Patricia A Patrician
  1. Department of Community Health, Outcomes, and Systems, University of Alabama at Birmingham School of Nursing, Birmingham, Alabama, USA
  1. Correspondence to : Dr Patricia A Patrician
    Department of Community Health, Outcomes, and Systems, University of Alabama School of Nursing, 1720 Second Ave South, NB 324, Birmingham, AL 35294, USA; ppatrici{at}

Commentary on: Staggs VS, Dunton N. Hospital and unit characteristics associated with nursing turnover include skill mix but not staffing level: an observational cross-sectional study. Int J Nurs Stud 2012;49:1138–45.

Implications for practice and research

  • Registered nurse (RN) and total nurse turnover are the organisational variables that should be measured and tracked routinely.

  • Working in highly specialised areas is associated with lower turnover, therefore future research should explore characteristics of these areas and how they may be applied to less specialised areas of nursing practice.

  • Future studies should explore determinants of low turnover in government hospitals.


Replacing nurse vacancies in hospitals is a substantial expense and hospitals are wise to explore strategies that minimise nursing turnover. The US hospitals that attracted and retained a high-quality RN workforce despite severe nursing shortages in the early 1980s were termed ‘magnet hospitals’. Magnet hospital certification by the American Nurses …

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