Turnover Factors for Certified Registered Nurse Anesthetists

A Scoping Review

Abstract

Objective: The objective of this scoping review is to understand the extent and type of evidence related to occupational turnover factors for certified registered nurse anesthetists (CRNA) in the United States.       

Introduction: Demand for anesthesia services is increasing dramatically. CRNAs provide a significant number of anesthetics each year and are crucial to accessible anesthesia in the U.S. Understanding occupational turnover factors for CRNAs is vital to providing cost effective, reliable anesthesia services for Americans.

Inclusion criteria: Studies relevant to CRNA turnover in the U.S. were included for this review. Due to differences in education, scope of practice, and practice environment, studies involving nurse anesthetists outside the U.S. were excluded. Studies with mixed provider populations including physicians, registered nurses, other advanced practice providers, and students were also excluded.

Methods: MEDLINE Complete, Embase, and Google Scholar were sources searched for relevant literature. Studies were only limited to those published in English. No publication date limitations were used. Titles and abstracts were reviewed, with potential papers retrieved for independent review by the authors. Data extraction was conducted independently by the authors using the Joanna Briggs Institute (JBI) data extraction instrument template. Themes identified after data extraction are described in narrative format.

Results: After review of the literature, five studies were included for data extraction. All the studies employed electronic or mailed questionnaires. Common factors associated with occupational turnover were compensation, retirement, job satisfaction, and burnout.

Conclusions: Findings suggest that occupational turnover factors are multifactorial and include broad concepts such as job satisfaction, burnout, and organizational climate.