Turnover intention among nurses in Iranian hospitals: a systematic review and meta-analysis.

Abstract

Background: The turnover intention of nurses from their current positions have become a critical global public health challenge. In Iran, as a country facing with several of healthcare challenges, understanding the rate of nurses' turnover intention is of paramount importance. This study aimed to determine the pooled proportion of turnover intention among Iranian hospital nurses through systematic review and meta-analysis.

Methods: This systematic review and meta-analysis adhered to PRISMA guidelines. Relevant studies were identified through a comprehensive search of English and Persian databases, including Web of Science, PubMed, Scopus, Science Information Database, IranMedex, and Magiran from January 2000 to November 2024. The Joanna Briggs Institute checklist was employed to assess the methodological quality of included studies. Pooled mean and standard error with 95% CI were calculated using a random effect model. Data analysis was performed using Comprehensive Meta-Analysis software, with the I² statistic used to evaluate heterogeneity among studies and Egger's test and visual inspection of funnel plots used to investigate the publication bias.

Results: Overall, 42 studies were included in this systematic review and meta-analysis. In total, 12,898 nurses participated in the 42 included studies. The overall turnover intention was 2.96 ± 0.056 (95% CI: 2.85-3.07, P = 0.001). Based on subgroup analysis, the turnover intention was 2.95 ± 0.123 and 2.96 ± 0.064 before and after the implementing of health transformation plan (HTP). Also, subgroup analysis by COVID-19 pandemic showed that the turnover intention was 2.97 ± 0.072 and 2.94 ± 0.095 after and before COVID-19 pandemic, respectively. Based on visual inspection of the funnel plot, and egger's test (2.04 ± 2.96, p = 0.45), no evidence of publication bias was observed.

Conclusion: Nurses turnover intention in Iran are at a moderate level, in general and, before and after the implementation of the HTP and the COVID-19 pandemic. These results support the need to formulate evidence-based policies and plans to enhance nurse retention, contributing to the overall stability of the Iranian health system.