Date of Award

Spring 4-28-2024

Document Type


Degree Name

Doctor of Nursing Practice (DNP)




Chai Sribanditmongkol, PhD, RN, IBCLC, CNS,

First Committee Member

Dr. Joy Shoemaker DNP, APRN, FNP-BC, Team Member

Second Committee Member

Dr. Amy Bishop, DNP, AGCNS-BC, Team Member


Hospital Staff Registered Nurse, Turnover Intention, Organizational Commitment, Nurse Leaders, Surveys and Questionnaires, Quality Improvement

Subject Categories

Neurology | Nursing Administration | Quality Improvement


Nurses are known to be overworked, overwhelmed, undervalued, and understaffed at dangerous levels throughout various inpatient hospital units across the United States (U.S.). Hospital registered nurse (RN) turnover is a significant issue that has accelerated since the COVID-19 pandemic, resulting in economic impacts and other burdens for organizations, individuals, and communities. Evidence suggests that evaluating Registered Nurses’ Turnover intention (NTI) and Organizational Commitment (OC) can help maintain a ready and capable team of skilled RNs; however, most healthcare organizations (HCOs) do not collect or analyze NTI and OC data and focus on staffing numbers and monetary incentives to get adequate nursing numbers. Research shows that RNs with higher OC tend to demonstrate lower NTI and stay in their profession, jobs, and HCO longer. In a local example of one 32-bed stroke unit at a large regional medical center in the Midwest, high staff RN attrition resulted in inadequate RN staffing and closed unit beds, delaying patients' access to timely care. Despite increasing staffing by 3.6 Full-Time RNs, the degree of NTI and OC among nurses working on the stroke unit remains unknown, placing the unit at increased risk of closing beds and disrupting care access in the future. Therefore, the purpose of this Quality Improvement (QI) Project was to provide new data to the Nursing Leadership and the healthcare executives who oversee RN staffing. The project was guided by the Plan-Do-Study-Act QI framework and aimed to evaluate the relationship between NTI and OC through a systematic record review of staff RN questionnaire response data following a unit’s recent increase in RN staffing levels. Due to the sensitive nature of the data, the project’s data collection could not occur. Despite the limitations encountered, the lessons learned from the project and the proposed use of the NTI/OC Questionnaire in this Report can offer valuable insight to RN leaders in understanding staff RNs’ intent to leave and commitment to the organization, which may ultimately help to maintain a ready and capable nursing team and prevent avoidable nursing turnover and delayed patient access to care services.

Acknowledgement 1


Acknowledgement 2


Licensing Permission

Copyright, some rights reserved. Attribution – Noncommercial – Share Alike



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