A multilevel model of RN workgroup intent to stay

Abstract

An understanding of how determinants of RN intent to stay on the unit vary by unit type is essential for developing the targeted retention strategies that are an important component of efforts to address the evolving nursing shortage. Relationships depicted in the multilevel RN Workgroup Intent to Stay Model were examined, after determining the appropriateness of a workgroup level measurement model for intent to stay. The model was examined using secondary analysis of cross-section data from the National Database of Nursing Quality Indicators™ (NDNQI®). The sample consisted of 373 medical unit RN workgroups, which included 7,730 RNs in 157 hospitals. Data from the 2006 RN Survey were combined with hospital characteristics, unit staffing, and unit type. Psychometric analysis found the workgroup level measurement model of intent to stay appropriate. Glick's (1985) criterion for group-mean reliability was supported by ICC(2) values ranging from .521 to .598. Bliese's (2000) criteria for emergent construct validity were supported by an ICC(1) of .064 and zero-order correlations with job satisfaction subscales that were consistently higher at the workgroup level than individual level. Mixed linear modeling fit indices (BIC=2575.330) supported the fit of the revised RN Workgroup Intent to Stay Model in medical units, and pseudo R2 indicated the model accounted for 56% of the variance in RN workgroup intent to stay. Higher ratings of RN workgroup satisfaction with task and appropriate RN assignments were the most important predictors of RN workgroup intent to stay. In addition, higher ratings of RN workgroup satisfaction with nurse management, lower percent of unit RNs taking a meal break, and greater RN workgroup diversity in unit tenure and age also contributed to RN workgroup intent to stay. Findings indicated that retention strategies for RN workgroups on medical units should target perceptions of appropriate RN assignments, as well as satisfaction with task and nurse management. Refinement of the RN Workgroup Intent to Stay Model should continue by examining model relationships in other unit types.